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'Rituals and scriptures must not be taken literally, but in the context of the day'

Last updated on: November 22, 2008 03:27 IST
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Manoj K Jain is an infectious disease physician, a writer, and a national leader in health-care quality improvement. Memphis-based Jain, 45, also writes for publications including The Washington Post. He received his medical engineering, public health and doctorate degrees from Boston University and has served as a consultant to the World Bank on HIV. He is a clinical assistant professor at University of Tennessee-Memphis, and medical director at Tennessee's Quality Improvement Organizations. He was 7 when he migrated to America with his parents.

What is religion and spirituality's role in our health and well-being?

I believe we need to have a place of spirituality in our lives. Meditation is to our mind what exercise is to our body. Most evenings, I chant and meditate for 15 minutes as I put my youngest child, who is 9, to sleep. He does not have to remind me to do it but he often asks me, 'Dad, can you come and do the Navkar Mantra.'

In the Western context, prayer is a form of meditation and I am not shy to encourage my patients to use spirituality to heal their body. Religion is a double-edged sword. It clearly has benefits: Social ones--temple or church gatherings; cultural--performing rituals such as puja; and psychological--reducing a sense of loneliness.

But people can also misuse religion.

There are potholes with religion. When one becomes fundamental in their beliefs, may they be Hindu, Muslim, Jain or Jewish, that is when everyone is threatened. Rituals and scriptures must not be taken literally, but in the context of the day.

You recently wrote on how you encounter bias as a doctor, especially in the South.

This was my first piece for The Washington Post. I talk about how my brown complexion sets me apart from white or black doctors. I wondered, 'Do my patient's think I am a foreigner?' Yet, at the same time, I realized I developed the same level of biases about my patients if they were black, Hispanic, elderly, or drug addicts. Once I became aware of how I thought when I encountered patients, I was able to start changing. My forced reflection helped reduce my stereotype. I also noticed that as my conversation develops with patients, the stereotype melts away. I begin to see my patients, rather than their social group. I hope my patients would do the same for me.

How did you get started as a writer?

It feels funny when someone calls me a writer, because I think of myself only as a doctor. In 2003, when the SARS epidemic hit China, I wrote my first op-ed piece on 'a birth of a virus' and was ecstatic that the local paper printed it. Then, I knew I had a niche, medical journalism. Helping people improve their health and navigate this crazy health-care system. Now I write a health column once a month in The Washington Post, The Commercial Appeal [a Memphis daily], and The Times of India, and often for The New York Times. The Post syndicates the articles so I get reader e-mails from all over America.

What are some common themes in your writing?

I want to unearth the doctor-patient relationship. Our health system has advanced technologically with PET scans and PCR tests, with robotics surgery and advanced chemotherapy, but what good is all this if doctors and patients can't talk to each other or-- better yet--understand each other? I want to help patients understand doctors and vice versa. I write about quality of health care, our Indian heritage, our family and spirituality. If the American health-care system is to improve, we must reduce costs, reduce medical errors and make the system safe, timely, and patient-centered. I keep drilling this in my writing. I am impressed how Jhumpa Lahiri uses Indian-American characters to explore universal themes, in the same way I am not afraid to share my Indianness and my spiritual views in my writing.

You write cookbooks too?

Yes, when I was in high school I started helping my mother--a great cook--it some of her recipes. In the process we put together three cookbooks. One is Jain Food: Compassionate and Healthy Cooking, written with Tarla Dalal.

One of the articles you wrote for a local publication had the headline: 'A can a day will keep fitness away'

The article was written with American children in mind, but it can be of use to children anywhere. I say in the article, it is 7th grade math. One 12-ounce can of soda has 150 calories. There are 365 days in a year. One can of soda per day will add 54,750 calories in a year. One pound of body fat has 3,500 calories. So, if one can of soft drink is added to a typical diet, this will lead to 15.6 pounds of weight increase in a year. Though we would like to deny it, as would the food industry, soda is one of the causes of our obesity epidemic. New studies each day are pointing to this cause and effect link, much like tobacco and lung cancer.

How have you got your children off soda?

My older ones drink water whenever we have to eat out or go for an event. The youngest occasionally asks for a soda but he is also following the example of older ones. I believe if the government and the food industry will not change, we can work to change ourselves. At our Sunday school for years at hour home, where we invite many other children and also conduct Hindi classes, we offered Coca-Cola, Pepsi, or Sprite. Few years ago, we changed that. Now there is water, orange juice, and one soda. I think we will get rid of that one soda soon.

What are some of your fundamental beliefs?

The three principles that are my life's compass come from Jainism, Hinduism and Buddhism. I call them the triple A: Ahimsa or nonviolence — not harming any living being. Anekantvad or non-absolutism: Being open-minded, and aprigraha, that is non-possessiveness; sharing our wealth with others.

Which of the three beliefs is closest to you?

Nonviolence. Mahatma Gandhi, Dr Martin Luther King and Mother Teresa as well as Mahavira, Jesus and Buddha embodied this universal principle. Our task is to apply the philosophy of nonviolence in our lives.

What drives you?

The fact that I can help make a change. I wake up early--4:30 each morning--and spend two hours writing and then spend four hours at the hospital treating patients-- mostly heart and lung transplant patients. In the afternoon I work as the medical director of quality for the Tennessee's Medicare program. Here, we work to reduce medical errors and improve patient safety. Each day I ask myself, what change did I make to improve the lives of others?

How do you maintain your Indian culture?

It's a challenge. We have three kids: Sapna, 16, Monika, 12, and Rishab, 9. My wife Sunita, who is also a doctor, and I are convinced that in this globalized world, we must make our children bicultural. They need to be as fluent in the Indian culture just as they are fluent in the American culture. We participate in Indian association programs, attend religious and culture classes, visit India once every couple of years and practice our values: Be it vegetarianism or respect for parents or taking our shoes off when we enter the house.

How have you encouraged your children to be vegetarians?

They get to enjoy good vegetarian food at home, for sure. But more important, we have told each child the importance of ahimsa, and that we should not harm animals. We also meet with the school teachers and parents and tell them about vegetarianism so that they understand why our children do not eat meat or fish.

Some Indian vegetarian children secretly eat meat when they are with their classmates.

That kind of rebellion happens if the parents haven't had quality time with the children continually and if they did not discuss life and lifestyles with the children. Besides, parents themselves have to set an example, not only being vegetarians but also being caring and concerned citizens.

Could telling the children about vegetarianism lead some of them to feel righteous and superior over other students?

We have taught our children not to be judgmental. We have also told them what nonviolence means. Nonviolence is not hurting or harming others by your actions --not killing or hitting; by your speech-- not cursing, yelling, sneering, or teasing; or by thoughts or intentions--desiring ill of others. And it is loving, caring, sharing, sacrificing for others through your actions, speech and intentions.

What local initiatives have you worked on to bring change?

After growing up and being educated in Boston, we moved to Memphis 13 years ago. We have made a concerted effort to be engaged with the community. My wife has served on the board of a large hospital system. We have initiated and worked to grow the Annual Gandhi conference in Memphis. I have taken leadership to procure grants of $1.6 million from foundations to help improve health care for the city. About five years ago, we founded a group called the Memphis Quality Initiative where CEOs and medical directors from competing hospitals share their best practices to improve health care.

What projects are you doing in India?

This year we are releasing a book on the management of infectious disease in India-- a 10-year effort in collaboration with Dilip Mathai, the head of the medicine unit at Christian Medical College in Vellore. Also, in my home town of Indore, I am beginning a dialogue with local NGOs on how in 10 years we can make the city free of tuberculosis and malaria.

What is your goal in life?

To bring focus and balance in my life and of those around me: Focus on being a doctor and a writer. And balance between science and spirituality, balance between family and work, balance between the Indianness and Americanness, balance between being an activist and being a thinker.

Visit Dr Jain's columns at www.mjain.net

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