One of the commonest medical problems -and a real headache for us, is when a young healthy fellow walks in your OPD and says, "Doctor I am so weak, please give me a good tonic." The next 20 mins you talk to him check all his vitals and do a thorough systemic examination only to declare him that he is indeed fit for a 100-thabal chongbas. About 20 % of these patients would thank you and walk out happily. Some another 25 % may ask for or you would have given some vitamin supplements (only to realize that the unnecessary vits have come out in his urine again) and still another 30% will crave for a takat wala injection. This group is the consumer of anabolic steroids like decadurabolin-the metadecs. But the remaining 25% are adamant that something is really wrong with them. No investigation would reveal any thing wrong and they wont believe that again. At times I feel like climbing on top of Qutab Minar and shout in Sholay's Viru style, "Bhaiyon, bahenon, gao walon, tum sub theek hein!" This may just be the tip of the iceberg. Otherwise the population of these living dead could run into millions. And believe me at times we all suffer from this and that transient thing of mood swing is OK and normal.

There are many disorders, which fall either to the left or right of this illness. To mention some, the malingerers, the dissociatives, the conversions, the Munchausens etc. We will pick up each thread later on. But what is distinct in this so called disease is that these people do all the activities controlled by the older version of the brain-the brain stem-activities like eating, sleeping, drinking, roaming around. But these people will not usually perform functions controlled by the neo-version of the brain-the cerebrum; these activities are carving a niche for oneself, supporting a family or just leading a good happy normal life and say that I am alright and I am created in the image of God!

What could be the cause?
I really don't know. I don't know why some people are so motivated by themselves that they don't need anybody to tell them that they need to go in any direction. While at the same time there are others who wont just budge. Medical science doesn't have the definite answers. At times I used to wonder whether it could be the neuro-transmitters -their differential levels in the brain. These are the natural chemical messengers that are responsible for the various functions of the brain-say our mood and related functions. At times I really dream Abdul Kalam's dream of river criss-crossing project of the whole of India i.e. taking the flood waters of Brahmaputra to the drought areas of Gujarat, Rajasthan etc. I wish I can take out some serotonin (the happy or the feel-good chemical) from a manic patient (where it is high) and inject it to a depressed person (where it is deficient) and a little less to our living dead group of friends.

How do we get out of these blues?
For this friend of ours who is full of energy yet energiless and full of life yet lifeless, there isn't nothing much the medical therapies can do. The underlying depression, if any can be managed by a consultation with a qualified psychiatrist. But the rest lies in our own hands. This is the zone of Dale Carnegie, Robert Schuller, Steven Covey, Skip Rose and our own Shiv Khera. Even the religious books like the Bible, Bhagavat Geeta, Quran have lines for mortal support. They may be suitable for all or some according to our own level of comprehension. The list of books can be very long and beyond what has been mentioned above. To start with the list above is quite handy and useful.

Ibotombi an e-pao discovered friend of mine, himself a prolific writer and a scholar and full of energy once asked me a casual question, "What's the cause of Maihing/Chloasma, Swasti?" I was caught unguarded and I answered casually, "Maybe its genetic preponderance and something to trigger." Then I also realize that health and disease and our attitude towards them-all, my friend are genetic preponderance and some triggering factor. Once again let me share with you this joke:
Patient: Doctor, I want to undergo a whole body scan or MRI.
Doctor: Why? You seem to be OK. You have no complaints which needs Investigation
Patient: Dr, I spend about Rs.10,000/ per year for servicing of my Maruti car. I thought I should spend some on my body servicing.