Gandhian Philosophy and neurorehabilitation

This is the essay and poster on Gandhian Philosophy in Neurorehabilitation prepared for the 10th World Congress in Neurorehabilitation, Mumbai, India.

Gandhian Philosophy and Neurorehabilitation_Sahlgrenska


 

Neurorehabilitation is a complex process that involves minimization of neural damage and compensation of limitation of functions arising from neural disorders. New insights on neurorehabilitation can be gathered when observed from a Gandhian point of view. The perspectives, ideals, and vision of Gandhi are relevant today that one can find many parallels of principles from his life that are now used in medical practice worldwide.

Simplicity is prominently reflected in Gandhi’s ideas and way of living. His affinity to simplicity was evident even during his early days in England, when he cut down all unwanted expenses and chose to live in a modest setting. Gandhi firmly believed that happiness and prosperity are not bound to materialistic things but are derived from internal peace and satisfaction. He was against over-consumption and affinity to material possessions. The Gandhian virtue of simplicity has an important role in neurorehabilitation where the focus is on patient’s personal satisfaction and fulfilment. Oftentimes, the simplest of all interventions might be the most therapeutic to the patient. Some of the most complex life decisions of the patient can be changed simply by offering new perspectives. In neurorehabilitation, some of the most effective interventions such as mirror therapy and physical exercise are cheap, simple and inexpensive.

Gandhi had a holistic approach to his development as a complete social being. He did not divide his personal and private life into watertight compartments and mixed social, political and religious work harmoniously. He also believed that all life goals should be defined in such a way that it should make progress not only to one’s lifestyle, but also to one’s family, nation and the world. This philosophy of holism is one of the pillars of modern neurorehabilitation. A neurorehabilitation professional not only caters for the physical and psychological aspects of the patient, but also for the social and cultural dimensions of his/her personality. Neurorehabilitation involves working with not only the patients, but also their families. It also draws no boundaries between personal needs and social needs. Neurorehabilitation deals with several aspects of the patient’s life including nutrition, mobility, cognition etc. Thus, quality rehabilitation can be administered only by considering the patient as a whole, and not as a sum of organs.

Inclusivity and diversity were Gandhi’s core values. The ‘Hind Swaraj’ of his vision was the one where people thrived and cooperated despite differences in caste, creed, gender or religion. The same vision is applicable to neurorehabilitation in which all medical practitioners, caregivers, the family, and community have to work together with the patient to bring him/her to the fullest possible potential. There cannot be any hierarchy in terms of work division and everyone’s role is crucial in rehabilitating the patient. Gandhi emphasized that one’s action should be directed at the well-being of the poorest and weakest man (woman). This principle is of great importance in neurorehabilitation where the healthcare professional has to deliver the most care to the neediest and weakest patient.

Gandhi warned his followers that ‘healing should be its own reward’. In the present day world, medical care is commercialized and monetary reward is the primary reason for those involved in the healthcare industry. Gandhi had foreseen this problem as early as in 1925 when medical science was in its infancy. In neurorehabilitation where often debilitated patients might need lifelong treatment, it is inhumane to be acutely business-minded. Gandhi had also noted that science without humanity is the root of violence. In neurorehabilitation, the focus of the researcher and practitioner is on being compassionate, empathetic and tolerant. These humane values are emphasized more in neurorehabilitation than in other branches of medicine.

Gandhi had a life-long commitment to his ideals. His lifelong dedication to ahimsa and satyagraha are well-known and are praised by scholars and disciples alike. Similarly, in neurorehabilitation, the patients often need life-long care. Hence, neurorehabilitation becomes an integral part of the lifestyle of the patient. The patient and the healthcare professionals should work hand-in-hand, often throughout the lifetime of the patient to meet the goals of the therapy. Gandhian value of satyagraha encompasses the same philosophy: being patient, working consistently, and not stopping until the goal is reached.

The ideal community as envisioned by Gandhi is a reformed one where each individual works harmoniously to produce a self-sustaining economy. This aspect of community involvement is well-established in neurorehabilitation. The ‘social safety net’ provided by the state, and the ‘social cushion’ provided by the community are very important for patients needing neurorehabilitation. Community support and social awareness regarding neurorehabilitation are essential for enforcing policy change for accessible public spaces, pension plans and return-to-work policies.

It is evident that Gandhian philosophy is closely in alignment with the core principles of rehabilitation. Gandhi’s ideas and practices should continue to inspire healthcare professionals to seek provisions for applying ahimsa in various facets of their work in neurorehabilitation. In current times of intense competition, we, the healthcare professionals, must embrace Gandhi’s integrity and avoid the temptation to forego morality and empathy.

15 thoughts on “Gandhian Philosophy and neurorehabilitation

  1. you do appear trying to make sense out of nothing.Reality does seem more complex than this . and this idea is doesn’t seem to make much change in the world. even with him and his philosophy india is still a shitty place to be (may be the reason why you left it)

    1. Reality is, of course, far more complicated. I understand that, in simplifying the problem, one has to sacrifice the accuracy of the results – but something is better than nothing. I have my reasons for leaving India for the time being, and although many Indians are poor, I it is not a bad place to live in. You are free to disagree, though.

  2. you comment about accuracy and stuff while what you say seem to be purely subjective and there are no numbers/stats mentioned anywhere. i have no option but to disagree

  3. FYI you were the one who commented about” sacrificing accuracy of results” (what results?? do you have any??)’ i merely refuted .i do know that philosophy cannot be judged by rules of science.Gandhi’s intentions were good mostly , ido like him for that. i dont know his own philosophy has done any good in helping him making any good decision.His half knowledge had indeed proven to be be costly to the lives of lakhs of people. he did let the partition of 1947 happen in a rushed manner before addressing the tension between muslims,hindus and the sikhs . didn’t 1-2 million people die follwing the partition.( i dont know whether the historians are plagued by hind sight bias ,but there are references that suggest that ghandhi, mount batten ,and Jinnah knew that this would happen and they let it happen anyway for the sake of their own ego and selfishness).
    even the person who had drawn the line of partition had made it clear that he was not given adequate time to make an unbiased decision.

    you could say that he did a pretty good job and it is far better than what is happening in syria/ or the ethinc clashes in africa . but i dont think this was the best decision at all. didnt his half knowledge costed the lives of millions?? and it is difficult to say something is better than nothing

    i would like you to ask wheteher his own philosophy did any good in his own personal life . his eldest son was inebrieated on the day of gandhi funeral that he did not even perform the religious rites he was supposed to perform. have you ever asked yourself the question why in your country even now people are sentimental enough to erect the statue of godse and his ashes worshiped everday.and why Gandhi is still being hated by people and was hated enough to be killed.

    It is perplexing to think that the country you are living now has a better indicator of health and economy and the country where gandhi lived is still poor and have got much to improve even with his philosophy and after half a century.

    anyway i do accept that philosophy should not be judged by rules of science , but i would like you to specify how should one judge philosophy . if you to comment that one should accept something that cannot be judged ,i must ask how much diiferent are you from the religuous fundamentalists.

    all that being said , i do not bleieve that there are no winners here .all the sides (india/pakistan/bangladesh are still very backward and this is to stay for quite a long time ). it does seem like the tension between hindhus/sikhs/muslims is going to persist . it is depressing and frustatimg for me to see that people are wasting tremendous amounts time/money in fighting each other and basic needs like health and education are being forgotten.

    my own personal experiences tell me that this hatred is not going to end easily . yesterday (3/25/2018) i met a schoolkid who was conducting a quiz for prizes at a gurudwara(the quiz was held commemorating the death of 2 sikh martyrs). i tried to google only one ,about why Zakariya Khan was killed , what i found out was that he was a brutal muslim viceroy who had caused death of many sikhs and they were suggesting that he deserved to be killed. this kind of propaganda is not going to make any muslim feel safer. similar propangnda suggeting that hindus/sikhs are cruel do exist and are likey to remain for a long time. all i can say is that this I feel to little and helpless to make any change. it would be nice to see people making rational judgments not affected by any emotional /religious sentiments for their own well being but that too seems to be very diffucult to attain.(even for myself after subjecting myself to intense scrutiny).

    i would like to end by saying i would like to be proven wrong on everything i have said, even though i may seem like an extreme pessimist( i try to think that i m a realist though)

    1. Accuracy v/s Simplicity : The broader the argument is, the lesser the chance that it is applicable in all contexts. If I’d say that all tigers are white, I am sacrificing the accuracy of my argument for the sake of simplicity. I could go further and say that all albino tigers are white, and be more accurate but the context at which this principle can be applied gets narrowed. If you want to know more about judging the merit of an argument in philosophy, please Google it and educate yourself.

      Whether or not Gandhi was a good man, or if Indians despise him is beyond the scope of this article. All I say in this article is that Gandhian philosophy has elements that are applicable in the context of neurorehabilitation. If you have any questions on this particular subject, I shall be glad to answer. All other pointless comments shall not be answered, because I have better things to do than educate a random anonymous person on the internet.

      Thanks for understanding.

  4. what i was trying to say in my previous lengthy comment was that Gandhian philosophy in a broader context never worked out as good solution and left his own family and the country in chaos.Nor his principle of ahimsa accepted anywhere. i sorry that i still dont get it how you can apply his philosophy in neurorehabiltation.
    you comment about effectiveness of simple measures like mirror therapy and physical exercise ( assuming that this is the ghandian way in paralysed person -passive exercise given by a caregiver,recreational activities and conventional method of rehablitation ). I would like you to disprove that these techniques are more effective than complex and individualised techinuques like VR simulations, Rehabilitation Gaming System(RGS) or robotics technology like ARMEO system .
    i dont believe that these technologies are cheap and not everyone is going to afford them considering the fact that you come from india ,were you even aware of these during your graduation. consider this selfish , if it was for myself or someone i love i would want the best care for them no matter how big the price tag is.
    i must say that in hypocrites of indian politics on either sides are very good at professing the gandhian philosophy making the poor indian people believe that their poor clothes , under supplied medical system are quite good.may be in india (where you had presented this poster) you may find widespread acceptance (as people are not used to the best. i am not going to buy it.
    would it be wrong for me to want the best and to think that best comes only from shit loads of time and money spend for R&D.
    maybe that is not the indian way. the indian way is to mock at the western medical / academia for the high price they are charging while their own quality /quantity of research or care is pathetic and to parasitically depend on the the drugs and technology developed by the US /EU without putting any effort.
    as always i would like to be disproved .

    1. I disagree the part about ahimsa and satyagraha. They are still in practice in many parts of the world. Let us just agree to disagree.

      VR simulations, gaming systems and robotics can only act as complementary to physical exercise. Ultimately, these systems are also offering physical exercise, but in a more engaging and controlled way. I don’t think any health professional will dare to stop conventional therapy and switch to newer methods completely.

      The newer technology will get cheaper over the time, just as mobile phones became way cheaper and a lot faster in around ten years time. I believe that VR will be as ubiquitous as mobile phones are in next ten years in such a way that it will be affordable by most of the Indian population.

      Speaking about individualized therapy : Mirror therapy is the most individualized therapy I have ever seen in rehab medicine – here you see the mirror image of your own limb. Thus, sophisticated technology is not a pre-requisite for providing individualized care.

      Your comments about research in India/Europe/US etc. shall not be answered because they are beyond the scope of this article.

  5. what happened to moderation ?? i did felt more comfortable with it ,that i could be kept in check if had overstepped

  6. what about the underlying neural mechanisms of mirror therapy.??? (wasnt it invented by some indian guy who did his Phd from abroad ,like you) please do tell me if you find anything simple about it. it is difficult for me accept simple generalizations when on the other hand people like head of the human brain project says that even with a billion euros(estimated cost of the project) 100ds of year will be needed to understand the brain. please do forgive for my outbursts , i was just too frustrated that in my RCT i had just submitted for ethics committee clearance , i cannot be fully truthful.

    1. I did not claim that the neural mechanism is simple, I only told that the intervention is simple. And mirror therapy is indeed a simple intervention regardless of how complex the mechanism of recovery/compensation be.

      You seem to change the subject every once in a while. I see that you started out with something about Gandhi being irrelevant and now you are up at mirror therapy criticizing its simplicity. I think that you are bringing up new arguments just for the sake of argument. I am also slightly disappointed that you had to put on an anonymity cloak despite being a very good friend of mine in the past. You for sure don’t like me now 🙂

  7. Let me hypothesise that , there might be specific situations in which ,say your simple mirror therapy might be counterproductive to the neurorehabilitation ,owing to the complex unknown mechanism .please read this paper/ download from “www.sci-hub.tw” by entering DOI: 10.1097/PHM.0b013e3181b74698 in which only 4/33 patients of mirror therapyin this study did not have any complaints. dont you think that it is worth it to find out the reason or atleast attempt / make the work of someone who is to come after you easier,so that the lives people could be improved.(the only real intervention you had presented in your paper was this and physical therapy)

    i did digress from the topic simply because your suggestion of educating oneself how to judge philosophy was too non specific to be useful as the gandhian philosophy, it simply left me clueless ,with the vast amount of data internet can provide. i for atleast am glad to provide a paper/references to what i have said.it doesnt mean that i accept what you have specified your poster. i must argue that even philosophers have shifted their methods and started quoting studies to prove their point . coincendently enough , Petter Johanssonin a TED talk which was uploaded in youtube yesterday (28/3/2018) ,of lund university SWeden , department of philosophy did present his point even though it was quite new,with the help of an intervention he had done , very well. to be honest you still seem like stating facts out of thin air. you could provide atleast some references for a start.

    i didnt state that gandhi is irrelevant, i find that his philosophy didnt really help him making good decisions, w.r.t proper partition. ( the money and lives(1-2mill) lost during partition ,and the consequences (billions spend on the world’s largest Border security force(2.6billion dollar budget annualy,) and the lives that are being lost every year) .if i seem like talking in highly layered fugues please do tell.
    any way you should compare this to the Brits and BREXIT, they are doing a prettly slow but good ,job even in this era of technology ,even though it more of an economic one and no real land borders are invovled, they are not expecting brexit to go well before march/2019 .

    i dont really have the option but to be anonymous . i feel really vulnerable here. try to think about the consequences of lying in an RCT . this could blow out of proportion in to a complete shitstorm. i just hope that my lie is good enough and it wont affect any patient adversely in the long run.

    one more thing, we were never friends but i dont hate you at all . if you feel this way i will stop this useless exercise.

  8. i think it is time to end this conversation. you should atleast form a legal standpoint of view ,should have no association with me . you could call me a corrupt medical practictioner ,its not that i want to lie about anything ,these choices are forced upon me and it is difficult to choose an option that is not going to harm me. from where i come from several such practices continue to exit ,and i for sure don’t want to pretend that its all rosy ,but am on the other hand have to save my self. try reading ” The ethical doctor ” i forgot the authors name though ,it should be in kindle if you are interested, to try to understand the complexities that sustain this kind of behavior from where i come from.

    2ndly i want to iterate that my motivation to critcize you doesnt mean that i dont like you.you seem like a nice person and im sure youll do excellent work . it comes from a deeply painlful experience in the past. a couple of years ago i had visited the indian side of the wagah border, the day after 60 pakistanis were killed in a bomb blast,in the pakistani side .IN the indian side it was as if nothing had happened, crowd of 100ds of people ,cheering to cinema songs , songs claiming praising india , celebrating victory and independance. it was nauseating for me , this experience ,i couldnt get along and be ignorant of sad state of affairs , india atleast did nt seem to be perfect as the songs claim to be. it did ruin my mood in the evening (which is the very reason it painfully satys in the memory) to feel helpless ,to contemplate the enormous amoutns of resources lost to build the BSF , to be painfully conscious how poor still india is,and other stuff due to failure of dilpomacy. it didnt seem like there were winners on both sides. I discarded gandhian philosophy because even though, it is very good tocomforting oneself of the pain ,it didntseem to help anyone /or him to make good decisions. you could ofcourse reject me or what i have said . i must say that what i know about him or the country is very little , mainly from his own auto biography,”freedom at midnight” by 2 authors (both non indian and non british so that their judgement would not be biased to any side) and india after gandhi by ramcharan guha ( i think he might have released a revised version of the book. any how ), and all the news you get to read every day.

    i must admitt that my knowledge in philsophy/decision making (which iam interested ) too is limited ,mainly comes from the works of people like richard thaler (nudge, misbehaving), Daniel Khaneman on thinking fast and slow , amos trevsky , ken arrow . but i must say even this little amount was enough to leave my head spinning. these people are academacians and tons of paper by them is ,in scihub which is never going to be comprehended by a single human ,comletely due to the complexity.

    i must acknowlegde that our areas of interest are different and it it not easy to find commonground between us . i dont think this is the first case to happen so,R Thaler once did organise a conference between psychologists and economists and it didnt work out well. so please dont feel bad that i dont get you, i dont feel bad either for not being understood either,and this being a wastage of both of our time.

    pardon me for being blunt,im not going to follow up this page anymore ,.i do wish you all the best .

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