Paradox of Life

Paradox of Life

Paradox of Life

I met Dr Dilip Pawar by chance. But what a good chance it turned out to be. He is an oncologist turned clinical pharmacologist and a leading figure in the discovery of cancer drugs. A sagacious person of calm temperament, Dr Pawar worked with cancer patients throughout his career, especially the poor, and has seen suffering from very close quarters. I was surprised when he said that one out of every three cancer deaths in India is caused by poor diet, lack of awareness and failure to use cancer screening tests for early detection. All these factors are linked to poverty, which is also a barrier to accessing effective cancer therapies.

Dr Pawar comes from the poorest of the poor strata of society and grew up in Mumbai slums. His mother ensured that despite all odds he received a good education and he lived up to the challenge. A medical graduate from Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, Dr Pawar did his post-graduation from Lokmanya Tilak Municipal Medical College, Sion, Mumbai, in Oncology. He later pursued a PhD, Fellowship in Clinical Pharmacology from the University of California, and Global Clinical Research training from the prestigious Harvard Medical School, and it was the plight of the poor not getting good cancer medicines that drove him into Cancer research.

After working for some time in the industry, basically, to understand the dynamics of the global pharmaceutical industry where a few corporations hold the most patents, he did an MBA in Pharmaceutical Marketing at Southern New Hampshire University, Manchester, USA, and later worked at Nicholas Piramal India Limited, Dr Reddy’s, and Unichem. He is considered the final word in Clinical Research and Pharmacovigilance, dealing with the understanding and prevention of adverse effects of any medicine.

Our discussions, held over tea in my house, meandered from the treatment of cancer to the end stage of life. Cancer is inherently a chronic disease with well-understood risk factors. If it is diagnosed early, surviving it is not much of an issue anymore. Early-stage cancer that hasn’t spread and isn’t too big is more likely to respond well to treatment. The problem is early detection, and it is not a small problem. Tests used by doctors to identify and treat cancer are different from those used for cancer screening. When it comes to your body, you know it best. If you notice anything that isn’t normal for you, or if something doesn’t feel quite right, speak up. If colon cancer is detected at an early stage, more than 90% of patients survive the disease for 5 years or longer.

Our hospitals are overcrowded, doctors are overworked, and the poor have no means to go to a private medical practitioner. So, early diagnosis of cancer remains a buzz word and unless people are approached at the community level, it is impossible to have any early cancer diagnosis. Increasing the reach of life-saving healthcare initiatives is crucial, and mobile screening vans that offer cancer screening to individuals where they live and work is one important method to do this. 

Working with Dr Chinnababu Sunkavalli and his Grace Cancer Foundation, Dr Pawar mobilized support for organizations donating buses and other equipment and what was once considered impossible happened.  The fact that there is no end to medical research and there is always more to learn is one of its great advantages. Their work has shown that if you find cancer early, the treatment went from something complicated, expensive, and terrible to something that was relatively simple—simple meaning we were already in the minimally invasive world of surgery.

But what moved Dr Pawar most was the plight of the end-stage cancer treatment, which is basically no treatment but pain management and nutritional support. It is common for cancer hospitals to discharge such patients saying let them be at home, but the idea of a home is indeed grossly misunderstood. Dr Pawar remembers living his early childhood in Goregaon in Mumbai where 16 people were living in a 100 sq.ft. room. We must roll out a system of affordable palliative care. This would need social awareness, voluntary work, and above all, committed nursing professionals. 

According to Dr Pawar, it is becoming more and more obvious that there will not be a single “cure” for cancer in the future. Instead, each patient will receive care that is tailored to meet their individual needs.  But for personalized medicine to become a reality, we must have a wide enough selection of medicines to address every type of cancer. Personalized vaccinations, cell therapy, gene editing, and microbiome treatments are four technologies that will transform how cancer is treated, according to Dr. Pawar.

By comparing the DNA sequences of the tumor and of healthy cells, it is possible to identify multiple cancer mutations and select the ones that are more likely to provoke a strong reaction from the immune system. The vaccines are administered as messenger RNA, a molecule that tells cells how to make a specific protein, in this case, a cancer antigen that strengthens the immune system’s defence against the tumor. Unlike with gene editing, vaccines do not directly edit human DNA, but just provide the message. Another advantage is that the production of messenger RNA is cheaper than that of other cancer treatments. In can be done. It can be done in India. And it will be done, according to Dr Pawar.

In 2018, US FDA approved cell therapy for cancer. Immune T-cells from the patient are taken and genetically modified to target a particular tumor antigen in a procedure known as CAR-T cell therapy. By engineering T-cells to carry a molecule, borrowed from another type of immune cells called natural killer cells, with the capacity to target 80 per cent of cancer cells, each patient will be treated by his/her own cellular material. Though CAR-T cell therapy is promising, these are still in the early stages of clinical trials and will need a few years before they can reach the market. Dr Pawar points to the PI hospital system, which is taking a global approach in the concurrent development and dissemination of CAR-T cell therapy.

CRISPR/Cas9 has already changed the field of gene editing by making it much simpler and faster to modify DNA sequences with high precision. It is very much doable to use CRISPR gene editing to remove a gene from immune T cells that encodes a protein called PD-1 that tumor cells can use to evade an immune attack. Dr Pawar even envisions off-the-shelf CAR-T cell therapy that is sourced from donors. By making two edits to the donor T-cells- to attack only cancer cells versus indiscriminately attacking the patient’s cells, and to cloak the T-cells so they don’t appear foreign to the body and deliver a more robust reaction, cancer can be effectively treated.

But perhaps the most exciting is going to be oncologists teaming up with microbes. In inflammatory disorders like cancer, the microbiome can help to stimulate an immune system that has been repressed and to regulate an overactive immune system. As our knowledge of the interaction between the immune system and the gut microbiome grows, we know that within the microbiome there are peptides that mimic antigens on the surface of tumors. These can be used to make the tumor visible to the immune system again.

The paradox of life is that it carries death with it as a body moves around with its shadow. Both are inseparable. But by having more light, shadows can be less frightening. Dr Pawar’s son has already become a medical doctor and he is doing his integrated master’s in Spain. His daughter is in architecture school and one of her dreams is to design an end-stage living module. May Dr Pawar’s tribe increase! 

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Minimum Working Hypothesis About Life

Minimum Working Hypothesis About Life

Minimum Working Hypothesis About Life

It is normal to consider the meaning of life after leading a fulfilling life. I lived an active life that included travel, met many saints, outstanding people, and celebrities, and had my due share of disappointments and accomplishments. Life is not about making merry or amassing more wealth than necessary. It is also not about exerting power over other people. All those who set these as their objectives failed, regretted, and died unfulfilled. Why should I do that? And why should you? 

Life is meant to work, that much is certain. Work has varied meanings at various phases of life. Education and skill building are priorities for young children and growing teenagers; for adults, it is to have a good livelihood, start a family, and attain peace and comfort. Those who are able to do this are fortunate enough to have a contented life in their old age before finally departing. It is heartbreaking to witness elderly individuals who are uncared for, exasperated, disoriented, and living in poverty.  

I have read scriptures – the Vedas, the Upanishads, the Bhagavad Gita, epics such as the Mahabharata and the Ramayana, books by Swami Vivekananda and Dr. S. Radhakrishnan, and about Western philosophy. Victor Hugo and Leo Tolstoy, French and Russian authors respectively whose English translations I read, are unparalleled in terms of writing prose. My favorite English author is Aldous Huxley. From Vyas, Homer, Virgil, and Dante, to Shakespeare – poets whom I believe to be incarnations of superhuman genius – I have read them all.  

What characterizes a brilliant writer? There are three categories of written expression. One is concerned with current events. If something is written honestly, it will always survive the life of the author. Because of their validity, the writings of the Chinese traveler Hiuen Tsang, who visited India in the seventh century, have survived. Then there are writers who examine human nature and history with a penetrating eye and write about the reasons for the events of their era. War and Peace by Leo Tolstoy is legendary for having this feature. Finally, lifelong writers who write frequently share their emotions and thoughts based on their personal experiences. Carl Jung was one of them. Aldous Huxley produced 50 books of various genres throughout the course of his 69-year life.

Huxley was a pacifist who rejected militarism and war practices in his country England. The concept of ahimsa, or “do no harm,” captivated and led him to universalism and philosophical mysticism. He even authored The Doors of Perception after consuming psychedelic drugs and described altered states of consciousness. His Brave New World and final book, Island, which describes dystopian and utopian concepts, are considered his masterpieces. Huxley’s “Minimum Working Hypothesis” is my personal compass.

Like every other scientific field, our sense experience of life must have a theory. Without a working hypothesis, there is no purpose in doing research, no justification for choosing one experiment over another, and no means of giving meaning or order to the facts that have been observed. Similarly, without a theory of life, we end up living like some fool lost in a vanity fair. Whatever we do looks good while it is done, and futile after it is done – “a tale told by an idiot, full of sound and fury, signifying nothing,” to quote Macbeth by Shakespeare. There has to be some plot to live a purposeful life, and an overall understanding of what is going on. 

On the other hand, if you have too many working hypotheses, you end up living by your whims and fancies. Being too sure about your knowledge is an error that makes most people fail. Always distorting reality to adapt to their ideas, they end up living bogus lives. When they should be changing their lives according to their circumstances, they go about pushing things to suit them. 

There are sentimental humanists. For them, life is the pursuit of happiness. They work, eat, and sleep.  At the other end of the scale are the Catholics, the Jews, and the Moslems, mindful of non-sensuous reality. They consider this life, of say a hundred years, to better their chances in the eternal afterlife. Then there are Hindus and Buddhists – believers in reincarnation. Chinese tradition is built around good conduct. And so on. 

All major religions’ adherents have created their own unique definitions and interpretations of what is good, less good, and even bad. Records of the less trustworthy and infinitely fewer valuable intuitions of psychics into the lower levels of non-sensuous reality are mixed with records of great saints’ infallible insights into the highest spiritual reality. These records are then supplemented with mere fantasies, discursive arguments, and sentimentalisms that become the religious life as practiced by billions of people across the world. 

So, Huxley articulated a “Minimum Working Hypothesis” that presents the essence of the world’s great religions for anyone willing to live a good life. I quote Huxley’s article published in Vedanta for The Western World in Great Britain in 1948:

“That there is a Godhead, Ground, Brahman, Clear Light of the Void, which is the unmanifested principle of all manifestations.

That the Ground is at once transcendent [boundless] and immanent [indwelling].

That it is possible for human beings to love, know, and, virtually, become identical with the divine Ground.

To achieve this unitive knowledge of the Godhead is the final end and purpose of human existence.

That there is a Law or Dharma which must be obeyed, a Tao or Way which must be followed if men are to achieve their final end.”

Simply put, there is a reality beyond what is seen and felt by our senses and comprehended by our intellect, science, and all the world’s knowledge. Being in touch with this reality – Godhead or Ground – is a unique quality of human life. Not using it amounts to squandering a great gift. A reflective, pure, and unhurried way of life presents before seekers all the ways and means to progress. By being mindful of the unseen, we find the ways and means to live a good life.

Generative AI has arrived. People are enjoying ChatGPT. Soon, lives and events will be controlled by the unseen intelligence that is building upon itself and free from any human control – at once transcendent and immanent, as Huxley put it.  

Various world religions remained limited by their distinctive historical and cultural contexts. Each religion possesses a genuine but ultimately unsatisfactory understanding of the unifying reality. There are, therefore, many equally valid religions. It is natural that the world is full of religious strife, violence, and even outright discrimination and persecution, where people of different faiths are living together, and the power structure is not balanced.

As generative AI gains more control, a universal truth will surely emerge and strife will be replaced with synergy, conflict with harmony, and competition with cooperation. Sooner than later, mankind will obey certain Universal Laws, following a Way that would be the only viable way, and humanity will flourish, living in abundance. This is my optimistic view, through rose-coloured glasses perhaps, in line with Aldous Huxley’s words: “The secret of genius is to carry the spirit of the child into old age, which means never losing your enthusiasm.”

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Intentional Asceticism

Intentional Asceticism

Intentional Asceticism

My long-standing friend and publisher of several books Piyush Kumar sent me a copy of Lifespan, a book by David Sinclair, regarding the science behind aging, during my stay at AIIMS, New Delhi. Dr. Sinclair (b. 1969) is an is an Australian-American biologist and a professor of genetics at Harvard Medical School. The book declares aging as a disease and proclaims that it can be treated. This sounds hoary, but the description of aging as the root of all other diseases was an eye-opener. 

The book is rooted in science. Written for general readers in a storytelling mode, it first describes life as information (DNA) that evolved over the earth in different life forms before human beings arrived and then passed on to us by our ancestors. So, each one of us carries within us intelligence that is 3.7 billion old, when life developed on earth that was formed 4.5 billion years ago. Some apelike creatures in Africa began to walk habitually on two legs some 5 million years ago and evolved into large-brain modern human beings some 12,000 years ago. 

Now this intelligence, stored in our DNA, that we have received from our parents, contains the secrets of how life survived all along. Though the general impression is that the human genome is fully decoded, and we have some 25,000 functional genes, that make our bodies, the reality is that of the 3 billion base pairs of our DNA, less than 2 percent codes proteins and the rest — 98.5 percent of DNA sequences – remain unexpressed throughout our life span, or so the scientist believes. 

Dr. Sinclair postulates in the book “The Information Theory of Aging,” a concept that aging happens at the DNA level. This theory, like a tripod, stands on three legs: (1) Aging is caused by a loss of information in the DNA;  (2) The environment around genes decides to switch off/on genes; and (3) Loss of information happens by loss of repetitive DNA sequences at the end of a chromosome, called Telomere every time a cell is copied and is one of the main causes of aging, and it may be delayed and even repaired.

The unexpressed genome, which is most of it, carries survival circuits embedded. How our ancestors survived without food, when they were chased by wild animals, and unprotected under severe heat and old. So, Dr. Sinclair argues, what if we relive those situations – by intermittent fasting, exercising – running even if no animal is chasing you, and having cold/ hot water baths – to activate the survival circuit?

It makes perfect sense, and even if I ignore the most recent scientific discoveries, fasting is a tradition found in every major religion in the world, along with extreme physical exertion on undertaking strenuous pilgrimages and ritual baths – both in hot springs and ice-cold mountain rivers. These practices kept our ancestors healthy for the duration of their lives, which were between 30 and 40 years. Shankaracharya lived for 31, Swami Vivekananda lived for 39 years, and both of them traversed India on foot and worked tirelessly to their very last day. Dr. Kalam lived for 84 years and died giving a lecture at IIM, Shillong, in front of a packed auditorium. 

In a typically American way, the book subtly promotes supplements and medicines for reversing aging, and when you browse through the Internet all major remedies mentioned in the book – Sirtuins activators, NAD Boosters, Rapamycin – are already being sold online, as natural products and food supplements. But the point I am drawing here is to return to a simple life, a simple diet, doing some manual labour every day, sleeping for eight hours, and a few minutes of meditation. These are the surest ways to improve the internal environment around genes.

A sedentary life style of eating and  sitting is a sure way of getting in to health related issues. Human bodies are have evolved to do physical labour. The Greek term askesis, which means to exercise, practice, and train, is the source of the English word asceticism. It was initially used to refer to sports, but over time the term came to mean systematic and rigorous training of the will, the mind, and the soul in order to achieve a more virtuous existence or a better spiritual state. A spiritual seeker, or Tapasvi, is essentially an ascetic in the Vedic society.

देवद्विज्गुरुप्रज्ञपूजनं शौचमार्जवम्। 

ब्रह्मचर्यमहिंसा शरीरं तप उच्यते॥

Worship of gods, saints, teachers, and wise men; purity, simplicity, celibacy, and non-violence are called austerities of the body. (Gita 17.14).

Fundamentally, asceticism is a self-discipline and self-denial program that is voluntary, prolonged, and at least partially systematic, in which one forgoes immediate, sensuous, or profane gratifications in order to achieve a better spiritual condition or a more profound absorption in the sacred. I have seen Dr. APJ Abdul Kalam an embodiment of this intentional asceticism. He will stay away from all indulgences and think several times even before changing his shoes or buying a new pair of socks. He entered the President’s House in 2002 with two suitcases as his personal luggage and checked out 5 years later with the same two suitcases. 

Asceticism is characterized by fasting, celibacy, poverty, seclusion, and even discomfort like sleeping on the floor. But there is also “inner asceticism,” which is harder to explain but even more important. Such asceticism involves staying away from wants and entanglement with sensory objects and staying away from the vanity fair of the world like awards and felicitations. The yoga system is distinctive because it combines both outward and inside asceticism.

Asceticism has a positive effect on a person’s willpower. It takes years of consistent practice to master.  As you continue to practice, stronger spiritual abilities begin to emerge. What was originally referred to as the hostile effects of the demons were nothing more than ingrained memories from our DNA that were manifesting in the present. Because doing so is impossible, these cannot be suppressed. Allow them to come as ideas and emotions, but resist acting on them with your willpower.

The purity of body and mind is very beneficial. Daily bathing, fresh clothing, moderate consumption of fresh food, and avoidance of pointless thoughts are all prerequisites for purity. No one would pour something into a dirty cup, and the same is true of a heart full of animosity. Whatever term is used, the best cure is to keep calling out God’s name. If you continue to live in this manner for a few weeks, you will experience communion with the supernatural, or reality that lies outside the realm of the senses and the mind.

So why not begin by fasting one day every two weeks, if not more frequently?  Join the ongoing and well-established Ekadashi Vrat tradition of fasting on the eleventh lunar day of a waning or waxing moon. Eat only home-cooked meals, avoid using the fridge and microwave, say no to all sweets including confectioneries and cool drinks, and drink as much water as possible! The goal is to be healthy until the very end, not to live longer! Die at work, surrounded by loved ones, not in a hospital bed being watched over by masked strangers. The decisions you make today, not just a desire or a prayer, will determine it.

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The Culture of Excellence

The Culture of Excellence

The Culture of Excellence

I spent a week at the All India Institute of Medical Sciences (AIIMS), New Delhi. My cardiac situation needed an evaluation and thanks to my long-standing friendship with Dr M. Srinivas, Director, AIIMS, it was done. I am back in Hyderabad and sharing some nice memories of the Institute and the people who work there.

First and foremost, AIIMS is a center of excellence in Medical Science. Though I am an engineer, thanks to Dr APJ Abdul Kalam’s initiative in the 1990s to develop civilian spinoffs of Defence Technology, I got involved with doctors and medical technology rather intensively. We could develop a coronary stent by developing a special steel alloy in India. 

This success was rewarded with a DRDO Award in 1997 given by Prime Minister Atal Bihari Vajpayee. More than the award, standing before the most handsome man I had ever met in my life was the biggest prize. Considering it my fountainhead in the organization, I resigned from DRDO thereafter and established Care Foundation with which I am still associated. We pioneered telemedicine using satellite even before broadband over the phone arrived and established the telemedicine link between Black Lion Hospital in Addis Ababa and Hyderabad in 2003 as part of the Pan-Africa e-Network sponsored by the Government of India. 

Medicine has undergone a transformation in the last 20 years. The best in world healthcare is now available in India and many foreigners, including patients from Europe, come to India to get major operations done here at much lower costs and with great service. For a while, modern medicine was a rich-people affair but then, in the last few years, the Government went in for a system overhaul. 

Medical colleges are being established with the goal of every major district of India having one. Today, there are 22 AIIMS and more than 65,000 post-graduation seats in medical education in 2023, which is more than double the number ten years ago. AIIMS Delhi is ranked the best medical college in India. Private sector hospitals have also flourished but they cater mostly to the rich and the affluent. 

My problem is related to the heart. Atherosclerosis, narrowing of heart blood vessels due to cholesterol deposits, runs in my family. My father died when he was 49. My younger brother when he was 60. In 2004, when I was exactly my father’s age, I survived a cardiac arrest, for at the time of the mishap, I was already in the hospital, “working” there, and received immediate resuscitation. I had a bypass surgery. 

Twelve years later, the bypass also got occluded. The atherosclerosis had spread over other vessels. In 2017, one nearly blocked artery was opened by rotablation, and with two stents the passage of blood was restored. Over the next five years, the disease has further progressed and blocked all three arteries in a diffused fashion. This time at AIIMS, a team of doctors under Prof. Rajiv Narang, evaluated my heart through various tests, including nuclear imaging, and fine-tuned my prescription. Dr Mohsin Raj Mantoo, a cardiologist hailing from Kashmir, visited me twice daily. 

The week I spent at AIIMS has brought me in touch with a new reality – the culture of excellence. Though the hospital is overflowing with patients and there is no place to even walk in the corridors, the staff performs without losing their heads in a manner that exemplifies the stithpragya state that the Bhagavad Gita talks about. They do not succumb to high work pressure compounded by demanding patients and are steadfast in their work. All machines are the best of the line, fully functional, and manned by well-trained staff. There are 7 Echocardiography rooms and 5 Cath labs working like a factory – patients taken in, served, and replaced by new patients, almost immediately. There is no discrimination by status and no breaking the queue. No touts or agents, and the fairness of the system is appreciated by the crowd, who reciprocate with patience and courtesy.

The doctors trained at AIIMS as part of their post-graduate education, go out to work in other hospitals in the country, are amongst the best in their fields. The culture of super-specialty is evident in the way they go deep into their specialization and cross-exchange with their colleagues of other specialties. There are no arguments but healthy exchanges. The guru-shishya culture is evident and the seniors are well-respected, while juniors are well-trained. The nursing and technical staff are especially proficient, and I found them equipped with both professional and soft skills. Though there is paperwork, all data flows seamlessly across the hospital.

But the most impressive of what I saw was the use of mobile phones with free data, by the patients and their attendants. While waiting for their turns, they indulge in watching videos, with ear plugs. The security guard in the private ward, where I had a room, was using the mobile phone to prepare for his competitive exam, taking tutorials and using a slate to do the calculations. 

Hot food is available at Rs. 20/- for a meal portion and a cup of tea or coffee costs Rs. 5/-. Expansive options are not given so that instead of the majority poor watching rich people enjoying better servings, rich people consume what the poor eat, for a change. There are well-kept pharmacy outlets, and one need not go out to buy medicines. 

The truth, I realized from all this is that medicine is all about management. Whatever your malady – blood pressure, diabetes, narrowing of blood vessels, death of cells in the kidneys or liver, or wherever, and cancers – what doctors can do is to “manage”. There is no cure as such. However, as nanotechnology advances, this era of “managing” is ripe for a conclusion and in the next ten years, we will see some “cures.”

I was truly inspired by reading the theme of AIIMS – शरीरमाद्यं खलु धर्मसाधन, the body is the primary instrument to do right things – prominently written on the logo and displayed at every apron. Then, the two snakes around a rod are not the caduceus for healing but the lotus blooming at the top-end of the rod makes it the Sushumna Nadi, and the snakes are the Ida and Pingala Nadi crossing each other and reaching the Sahasrara Chakra – the lotus of 1000 petals, considered as the abode of cosmic consciousness. 

A country becomes great due to its people and institutions. India is the most populous country in the world and its multitudes of poor, about a billion people, need medical assistance, affordable medicines, and proper food. The government of India, which is elected by these people is duty-bound to take care of them in the real sense of the word. AIIMS is a shining example of this great tradition and I wish that India has 47 AIIIMS by 2047 and that the medical insurance cover of Rs. 5 lakhs provided by the Pradhan Mantri Jan Arogya Scheme be increased to Rs. 10 lakhs right away. 

After I was discharged, Dr Srinivas sent me off with a plant and a memento. It is easy to create good institutions by the well-intent government, but they only become great due to the people who work there. AIIMS is a marvelous example of New India – a great civilization ushering in a new era of prosperity and progress. Mr. Phamdom Lasti Singh, from Manipur, who was recuperating after his cardiac bypass surgery in the room adjacent to mine, felt the same way.

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Living in Devotion

Living in Devotion

I had a respectful familiarity with the Sri Ramakrishna Mission. Besides reading the excellent books that they have been publishing, I had the fortune of visiting the Dakshineshwar Kali Mandir in Kolkata twice where Sri Ramakrishna met Narendra Nath, who would become Swami Vivekananda. I visited the Vivekananda Rock Memorial in Kanyakumari thrice where Swamiji meditated for three days and nights in December 1892 on a rock amidst the sea. In Goa, I visited a house in Margao where Swami Vivekananda stayed before sailing to Chicago from Bombay on May 31, 1893, and which is now maintained as a temple. But it is only now (in July 2023) that I could read about Sri Ramakrishna.

Published in two volumes and a more-than-thousand-page tome, The Gospel of Sri Ramakrishna was written in Bengali by Sri Mahendrananth Gupta, under his pen name M, as his eye-witness account of Sri Ramakrishna’s last years. The English translation by Swami Nikhilananda was published in 1942. The book starts in February 1882 and ends with Sri Ramakrishna’s passing away in August 1886. The last of the 51 chapters describes how 16 of Sri Ramakrishna’s closest disciples renounced the world soon after his death, Swami Vivekananda being the most renowned among them, and established the Sri Ramakrishna Math. 

I was born into a Brahmin family that followed the Santana Dharma tradition. There were brass idols and a shaligram passed on by our ancestors, called Thakurji. Kept on a small sandalwood simhasan, they were treated as living beings – given a bath every day, applied chandan and offered puja every morning and in the evening. Nothing happened in the house without seeking their blessings, including going out of the house and reporting to them on return. Thakurji are now with my mother and my younger brother Salil Tiwari is serving them in his house in Meerut. 

I drifted into Vedanta and Buddhist literature but regained my Bhakti roots after meeting Pramukh Swamiji Maharaj through Dr. APJ Abdul Kalam in 2014. I wrote four books –Transcendence: My Spiritual Experiences with Pramukh Swamiji in 2015 with Dr. APJ Abdul Kalam, A Modern Interpretation of Goswami Tulsidas’s Ramcharitmanas in 2019, A Modern Interpretation of Lokmanya Tilak’s Gita Rahasya in 2020, and Simple Spirituality – Recalling Kabir in 2022, all dealing with the Bhakti Marga – the devotional way of approaching God.  

Writing the foreword for the book on Kabir, the renowned author Bibek Debroy, who translated Valmiki Ramayana and Mahabharat into English, wrote, “The COVID pandemic caught the entire world unawares. With many of us having lost near and dear ones, the pandemic reminded us of our mortality in this world and the evanescence of life as we understand it. It naturally makes us reflective, forced to look inwards. Arun Tiwari too looked inwards. A book like this, meant for readers, is actually a book for one’s own self, one’s own search for the truth within.”

What makes The Gospel of Sri Ramakrishna special? Before answering this question, it is important to know some salient features of Sri Ramakrishna’s life. Born in 1836 to a poor Brahmin family in Bengal and named Gadadhar (Lord Vishnu), he came to work as a help to his elder brother, who was a priest in the Dakshineswar Kali Mandir created in 1855 by Rani Rashmoni on the banks of the Hooghly (Ganga) River north of Kolkata. After his brother passed away, Sri Ramakrishna became a priest there and lived the rest of his life in the temple, except for the last year when receiving treatment for throat cancer. 

Since childhood, Sri Ramakrishna experienced trances. Living in a temple and visited by people regularly, Sri Ramakrishna used to go into impromptu spells of unconsciousness. Upon recovery after a few minutes, he would sing devotional songs of Chaitanya Mahaprabhu and other poets, dance and speak profound concepts. Sri Ramakrishna married Sri Sarada Devi, but lived a chaste life, treating her as Divine Mother. His wife lived with him as a celibate and was revered as Mother. He lived a pious and unblemished life in full public view and his 16 disciples created the great institution of the Ramakrishna Math and the Ramakrishna Mission, which have 221 centers all over the world. 

Three themes emerge from The Gospel of Sri Ramakrishna. First, Sri Ramakrishna had God-realization via various traditions. He trained himself in Tantra under Bhairavi Brahmani who lived in the Dakshineswar temple for six years, practised Vaishnava bhakti under a visiting monk, Jatadhari, who gave him an idol of Ramlala, and Vedanta under Naga Sadhu Totapuri, another visiting monk, who ordained him into sannyasa. Second, he interacted with great people of his times, namely Ishwar Chandra Vidyasagar, Debendranath Tagore (father of Rabindranath Tagore), Keshab Chandra Sen, Dayananda Saraswati, and Bankim Chandra Chattopadhyaya, and won their admiration. Third, he attracted some brilliant young disciples who, after his death, created a formidable institution through their impeccable example. 

Sri Ramakrishna was a mystic. The American philosopher and psychologist William James, in his book, The Varieties of Religious Experience, published in 1902, has established the experiences of a mystic to be as real as any other experience. Like the sensory self that processes sensory inputs, there is a reflective self that interprets experiences, deriving from cultural conditioning, and perhaps from certain patterns of thinking hardwired into the human brain. If you imagine something vividly and absorb yourself in thoughts of the same, they become as real for you as a tree, a building, or another human being. 

As for Sri Ramakrishna’s message, I quote from The Gospel of Sri Ramakrishna: 

The Reality is one and the same. He is Brahman to the followers of the path of knowledge, Paramatman to the yogis, and Bhagavan to the lovers of God. . . Who can fully know the infinite God? And what need is there of knowing the Infinite? Having attained the rare human birth, my supreme need is to develop love for the Lotus Feet of God. . . God cannot be realized without purity of heart. One receives the grace of God by subduing the passions—lust, anger, and greed.

A man sets milk in a quiet place to curdle, and then he extracts butter from the curd. After once extracting the butter of Devotion and Knowledge from the milk of the mind, if you keep that transformed mind in the water of the world, it will float in the world unattached. But if the mind in its ‘unripe’ state-that is to say, when it is just like liquid milk is kept in the water of the world, then the milk and water will get mixed. In that case, it will be impossible for the mind to float unattached in the world.

You see, as long as a man is under maya’s spell, he is like a green coconut. When you scoop out the soft kernel from a green coconut, you cannot help scraping a little of the shell at the same time. But in the case of a ripe and dry coconut, the shell and kernel are separated from each other. When you shake the fruit, you can feel the kernel rattling inside. The man who is freed from maya is like a ripe and dry coconut. He feels the soul to be separated from the body. They are no longer connected with each other.

So, I earnestly suggest that you spend some quiet time alone, learn to see people around you as human beings living their own lives, and having their own dispositions and dispensations as you have yours, and never call anyone’s experiences absurd. See this world as a mango grove, pick the fruit that has fallen into your lap, and relish it. Why bother about how many trees there are in the grove, how many varieties exist, and who the owner of the garden is? This life has been given and it is up to us to make the best use of it before it is lost. Live purposefully and try to leave behind a legacy – at least a good memory, a nice feeling, in the hearts and minds of the people you come across. 

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