Sunday, September 14, 2025

UDLCO CRH: A leaf out of the history of Palliative care and the history of medicine that cures sometimes and cares always

Summary:


The discussion explores the role and perception of palliative care in modern medicine, focusing on its integration, commercialization, and importance as a medical specialty. Participants debate whether palliative care should remain a distinct specialty or be integrated into general medical practice. Ethical concerns, cultural perspectives, and the historical essence of "doctoring" are also discussed.

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Key Words
- Palliative care
- Advanced care planning (ACP)
- Empathy and compassion
- Preventive oncology
- Commercialization of healthcare
- Specialization in medicine
- Fee-for-service model
- "Cure sometimes, care always"
- Cultural perspectives on healthcare

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[14/09, 18:13] hu1: https://forms.ple/xyz

Hello Everyone! My name is . I'm a psychologist working in the Department of Palliative Care at xyz Cancer Hospital and Research Institute, some city. I am currently doing a study on *Knowledge, Attitude and Perceptions of Non- Palliative Care physicians on Advance Care Planning in India*. If you're a *medical professional* with a minimum qualification of *MBBS* and are currently *not working in the area of palliative care*, kindly take some time off of your busy schedule and fill the following form. I promise it won't take you more than 15-20 mins. Please feel free to contact me on xyz@gmail.com for any further queries!
Thank you in advance!

[14/09, 18:13] hu2: Kindly spare some time and fill in your responses. This can help us understand the awareness of "Advanced care planning" in non palliative physicians across all specialities and later help us in developing focused training sessions. (To avoid futile interventions)

[14/09, 18:25]hu3: Done. Nice initiative. I feel it is important to sensitize people on ACP. All the best. Thank you.

[14/09, 18:25]hu1: Thank you sir for your time and comments🙏

[14/09, 18:26]hu2: Request everyone to kindly spare some time 🙏

[15/09, 06:43]hu4: Palliative care is a neglected field of health care. It is future speciality. Good initiative. Requires awareness amongst not only medical people but amongst public nd administrators.
Need to motivate to develop into a subspecialty so that qualified  persons would be involved.

[15/09, 06:54] hu5: I beg to differ...

Palliative care is a bit over rated.

All specialists, as well as non-specialists can learn palliative care relevant to their speciality.

Like most western concepts, allopathy profits by institutionalising even death and dying!

Until we discard the term palliative, this speciality will not prosper...

Frankly, it should integrate from day one..


[15/09, 06:58]hu4: Yes,
Palliative care as projected now is a commercial concept. True palliative care is empathy compassion dedicated selfless service

Hence should be encouraged in a slightly different format

[15/09, 06:59] hu4 : Well the term palliative requires to be correctly defined.

[15/09, 08:16]hu6: The word "palliative" is derived from the Sanskrit "pallava" which means "leaf"! Perhaps because many wounds would be palliated by leaves those days?




This word was taken to Latin land where they used the term later for "covering up" that became synonymous with doctoring (as in your documents have been doctored)! 

Palliative care is nothing but the original essence of doctoring and it's slogan is to "Cure sometimes, care always"



[15/09, 08:17]hu5: చేతులు కాలిన తరువాత ఆకులు పట్టుకుంటే ఏమి లాభం!

[15/09, 08:18]hu4: But where r we? Cure and care revolve around money.
Need to come out of business approach to health care

[15/09, 08:53]hu6: నివారించ లేని ఘటన గాయాల కు,  
ఉపశమనం ఆకుల తోనే సాధ్యం

What cannot be prevented needs to be palliated

[15/09, 08:59]hu5: కాలిపోకుండా నివారించడం ముఖ్యం...

ప్రివెంటివ్ ఆంకాలజీ

[15/09, 09:19]hu6: చికిత్స కంటే నివారణ ఎప్పుడూ మెరుగైనది

కానీ సంఘటనలు జరుగుతున్న వెంటనే  

జాగ్రత్త ఎప్పుడూ, చికిత్స కొన్నిసార్లు

[15/09, 09:30]hu2: Good morning sir. I dont understand how you felt it is over rated. Most medical professionals are unaware of this speciality still. While it is true that every physician should know how to palliate their patients, are they doing it? As some one who has done a superspeciality in anaesthesia, I have shifted my field into palliative care totally, I have realised how little we are doing to patients. There is a abundant need and the necessity for us to acknowledge it

[15/09, 09:31]hu2: We are not commercialising it. We are asking fee for our service

[15/09, 09:34]hu8: In this country of freebies?!

[15/09, 09:35]hu4: Entire issue lies here only fee for services  almost all services


[15/09, 10:02]hu9: Rightly said!  for that matter which field isn't overrated nowadays!!  Everyone knows basic of medicine and surgery, from MBBS that doesn't mean we can practice everything like older days! There is a reason for the existence of specialities for learning more expertise in particular field, definitely we should learn to respect each field of medicine instead just writing as "overrated" or should be "service oriented"! Everyone has put an effort on their individual specialisation which should not be taken or spoken as granted, atleast from same fraternity it is not acceptable! With all due respect!

[15/09, 10:09]hu4: Accepted. But r u including all charging reasonably. Introspect. Over above lack of confidence in health care givers. Now it is a purchasable commodity. Let us accept this truth. That we are already entangled in this business . Charged so much  but pantry dum is given you  nd us . Do not get affes

[15/09, 10:23]hu5: I did palliative care under a ... fellowship at University of ... in the year 19xx. I started both preventive oncology and palliative care services, including hospice and home care at the… However, I am very clear in my assessment that palliative care is not cheap. It is, in fact very expensive. The prescriptions are lengthy, home care visits are expensive and hospice care is even more. I am even more disappointed to see wholesale aping of western concepts of pain and care of patients. It is indeed disheartening to note that several palliative care physicians wish to be primary contact persons, whatever be the illness - acute or chronic, fatal or non-fatal: they feel they are perfectly poised to pronounce the verdict as to whether any treatment is worth giving! And, sadly, most of the funds clearly flow towards palliative care rather than preventive oncology.

Thematic Analysis

1. The Importance of Palliative Care
- *Awareness and Training*: Participants highlight the need to raise awareness about palliative care among non-palliative care physicians and the public. Advanced care planning (ACP) is seen as a tool to avoid futile interventions and improve patient outcomes.
- *Core Philosophy*: Palliative care embodies the essence of medicine, encapsulated in the motto “Cure sometimes, care always.” Its focus on empathy, compassion, and holistic care is emphasized as the foundation of medical practice.

2. Debate on Palliative Care as a Specialty
- *Support for Specialization*: Proponents argue that palliative care should remain a distinct field to ensure that physicians are adequately trained to address the needs of patients with life-limiting conditions.
- *Criticism of Institutionalization*: Critics view the institutionalization of palliative care as a commercialized, Western concept that separates care from general medical practice. They argue that all physicians should inherently integrate palliative principles into their specialties.

3. Commercialization vs. Service
- *Fee-for-Service Model*: The debate reflects contrasting views on charging fees for palliative care services. While some see it as fair compensation for services, others view it as a commercialization of healthcare, detracting from the altruistic essence of medicine.
- *Ethical Concerns*: Concerns are raised about the increasing monetization of healthcare, with participants calling for a shift away from a business-oriented approach.

4. Historical and Cultural Context
- *Historical Perspective*: The term "palliative" is traced back to the Sanskrit word "pallava" (leaf), symbolizing healing and care in ancient times. This historical essence aligns with the original purpose of medicine—comfort and care.
- *Cultural Nuances*: The discussion includes regional idioms and proverbs highlighting the importance of prevention over cure and the need for timely intervention.

5. Preventive and Holistic Approaches
- *Preventive Oncology*: Participants stress the importance of prevention in oncology and healthcare in general, advocating for a shift toward early intervention rather than focusing solely on palliative measures.
- *Integration of Care*: While palliative care is seen as vital, some argue that it should not be isolated but integrated into broader medical practice to ensure all physicians are equipped to provide compassionate care.

6. Professional Respect and Collaboration
- *Recognition of Effort*: Participants call for respect for all medical specialties, emphasizing the importance of expertise and the effort required to specialize in fields like palliative care.
- *Collaboration Across Specialties*: The discussion underscores the need for interdisciplinary collaboration to provide holistic and patient-centered care.

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Key Insights

- Palliative care is both a critical specialty and a fundamental principle of medicine, emphasizing empathy, compassion, and holistic care.
- The institutionalization and commercialization of palliative care spark debates about its alignment with the altruistic values of medicine.
- Raising awareness and training non-palliative care physicians in advanced care planning can bridge gaps in patient care and reduce futile interventions.
- A balance between specialization and integration is needed to ensure that palliative principles are universally applied.

Multilinguistics backend notes:

[15/09, 08:23]: Please translate to English 

చేతులు కాలిన తరువాత ఆకులు పట్టుకుంటే ఏమి లాభం!

[15/09, 08:23] Perplexity: The Telugu phrase "చేతులు కాలిన తరువాత ఆకులు పట్టుకుంటే ఏమి లాభం!" translates to:

"What’s the use of holding leaves after your hands are burnt!"  

This means doing something too late or after the harm is already done.  

Want me to explain it with an example? 😊

[15/09, 08:24]: Please transliterate to English 

చేతులు కాలిన తరువాత ఆకులు పట్టుకుంటే ఏమి లాభం!

[15/09, 08:24] Perplexity: Chetulu kaalin taruvata aakulu pattukunte emi laabham!


[15/09, 08:25] : Provide a counter to the Telugu proverb below

Please translate to English 

చేతులు కాలిన తరువాత ఆకులు పట్టుకుంటే ఏమి లాభం!


[15/09, 08:26] Perplexity: The Telugu proverb "చేతులు కాలిన తరువాత ఆకులు పట్టుకుంటే ఏమి లాభం!" means:

"What’s the use of holding leaves after your hands are burnt!"

A good counter to this, encouraging timely action, could be:

*ముందుగా జాగ్రత్త తీసుకుంటే నష్టం తగ్గుతుంది,*  
*తరువాత చేసుకునే ప్రయత్నం కూడా ఫలవంతంగా ఉంటుంది.*

Which means:

"If you take precautions early, damage is minimized, and later efforts also become effective."

Want me to help with more proverbs or moral quotes? 😊


[15/09, 08:27]: Make the proverb sound like "the Leaf cover is to cover up what could not be prevented because all burns may not be avoided"


[15/09, 08:28] Perplexity: Here’s a proverb-like line based on your idea:

*“Leaves cover the burn that couldn’t be prevented, for not all burns are avoidable.”* 🍃🔥

In Telugu style:  
*అన్ని చేతులు కాలిపోకపోవచ్చు, కనీసం ఆకులు మిగుల్చి రక్షించాలి!*  

Want me to make it rhyme or more poetic?

[15/09, 08:28]: Yes make it more poetic

[15/09, 08:28] Perplexity: Sure! Here’s a more poetic version of your proverb:

*Not all burns can time prevent,*  
*Yet leaves in grace their shade have lent;*  
*To soothe the scars we couldn’t mend,*  
*The leaf’s soft cover is a friend.* 🍃🔥

How’s that? Want it in Telugu rhyme too?

[15/09, 08:29] : Translate it into Telugu

[15/09, 08:29] Perplexity: Here’s the English poem translated into Telugu rhyme:  

**ప్రతి కాటు కాలక్షేపం ఆగలేదు,**  
**ఆకులు తలుపున శీతలస్నానం చేసింది;**  
**సరిపారలిగిన గాయాల తీరు తరుగింది,**  
**ఆకుల నీడే మిత్రురాలివి.** 🍃🔥  

How do you like it? Want it more simple or elaborate?

[15/09, 08:30]: Please transliterate the above

[15/09, 08:30] Perplexity: Here’s the transliteration of the Telugu poem:

Prati kaatu kaalakshepam aagaledu,  
Aakulu talupuna sheetalasanam chesindi;  
Sariparaligina gaayala theeru tarugindi,  
Aakula neede mitruralivi.  

Want me to help with anything else? 😊


[15/09, 08:30]: Make it simple

[15/09, 08:30] Perplexity: Here’s a simpler and clearer version of the Telugu poem:

**అన్ని కట్లు ఆగవు,**  
**ఆకులు కలిస్తాయి శాంతి;**  
**సాగని గాయాలు ఉన్నా,**  
**ఆకుల నీడ రక్షించును.** 🍃🔥

Want the transliteration for this too?

[15/09, 08:30]: Yes

[15/09, 08:31] Perplexity: Here’s the transliteration for the simpler Telugu poem:

Anni katu aaguvu,  
Aakulu kalistayi shanthi;  
Saagani gaayalu unna,  
Aakula needa rakshinchu.  

Want me to help with more Telugu proverbs? 😊

[15/09, 08:32]: Translate it into Bengali

[15/09, 08:32] Perplexity: Here’s the simpler Telugu poem translated into Bengali:

সব আঘাত থামে না,  
পাতা এনে শান্তি ছড়ায়;  
যে ক্ষত সারেনি,  
তার ছায়াই রক্ষা করে। 🍃🔥

Want me to help with anything else?

[15/09, 08:34]: Translate this to Telugu

[15/09, 08:34] Perplexity: Sure! Here’s the Bengali poem translated back into Telugu:

అన్ని గాయాలు ఆగవు,  
ఆకులు శాంతి వెల్లువలా చల్లిస్తాయి;  
పరుగున సరిపోని గాయాలు ఉన్నా,  
ఆ ఆకుల నీడే రక్షణ చేస్తుంది. 🍃🔥

Want me to help with anything else?

[15/09, 08:36]: Translate and provide Telugu synonyms to the word below:

పరుగున

[15/09, 08:36] Perplexity: The Telugu word "పరుగున" means "quickly" or "in a hurry."

Here are some Telugu synonyms for "పరుగున":  
1. త్వరగా (Tvaragaa)  
2. వేగంగా (Vegangaa)  
3. జ hızగా (Jaladgaa)  
4. సులభంగా (Sulabhanga, meaning easily or swiftly in some contexts)  

Want me to explain these or provide usage examples? 😊


[15/09, 08:38]: Translate this to Bengali 


పరుగున సరిపోని గాయాలు ఉన్నా,

[15/09, 08:38] Perplexity: The translation of "పరుగున సరిపోని గాయాలు ఉన్నా," to Bengali is:

"তাড়াহুড়োতেই সারেনি ক্ষত।"  

Want me to help translate more lines? 😊


[15/09, 08:39]: Translate

Here’s the simpler Telugu poem translated into Bengali:

যে ক্ষত সারেনি,  

To Telugu

[15/09, 08:39] Perplexity: The Bengali phrase "যে ক্ষত সারেনি," translates to Telugu as:

*సరిపోని గాయం,*  

Want me to translate more from that poem? 😊

[15/09, 08:40]: Change below to Telugu script 

Anni katu aaguvu,  
Aakulu kalistayi shanthi;  
Taggani gaayalu unna,  
Aakula needa rakshinchu.

[15/09, 08:41] Perplexity: Here’s the Telugu script version of your text:

అన్ని కట్లు ఆగవు,  
ఆకులు కలిస్తాయి శాంతి;  
తగ్గని గాయాలు ఉన్నా,  
ఆకుల నీడ రక్షించు.  

Want me to help with anything else? 😊

[15/09, 08:41]: Transliterate this to English

[15/09, 08:41] Perplexity: Here’s the transliteration of the Telugu text:

Anni katu aagavu,  
Aakulu kalistayi shanthi;  
Taggani gaayalu unna,  
Aakula needa rakshinchu.  

Want me to help with anything else? 😊

[15/09, 08:48]: Translate to Telugu


All burns aren't avoidable
The leaf is a soothing cover
As much as the tree
Is a soothing shadow
[15/09, 08:48] Perplexity: Here’s your poem translated to Telugu:

అన్ని బర్ని తప్పించలేవు  
ఆకు ఒక సాంత్వన దుప్పటి  
చెలి చెట్టు లాగా  
ఆ నీడ కూడా సాంత్వనమే  

చాలా బాగుందా? మరికొంత కావాలా? 😊

[15/09, 08:49] : Transliterate to english

[15/09, 08:49] Perplexity: Here’s the transliteration of the Telugu poem you asked for:

Anni barni tappinchalevu  
Aaku oka santhvana duppati  
Cheli chettu laga  
Aa needa kooda santhvaname  

Want me to help with anything else? 😊

[15/09, 08:49]: Translation to Bengali

నివారించ లేని ఘటన గాయాల కు,  
ఉపశమనం ఆకుల తోనే సాధ్య


[15/09, 08:50] Perplexity: Here’s the Bengali translation of your Telugu text:

নিবারণীয় কাপড়ের জন্য,  
শরম পাতা দিয়ে সম্ভব।  

Need help with anything else? 😊

[15/09, 08:50]: Translate to English

[15/09, 08:50] Perplexity: The English translation of the Telugu lines "నివారించ లేని ఘటన గాయాల కు,  
ఉపశమనం ఆకుల తోనే సాధ్యం" is:

"For unavoidable wounds,  
relief is possible only with leaves."

Need help with anything else? 😊

[15/09, 09:07]: Translate to English

నివారించ లేని ఘటన గాయాల కు,  
ఉపశమనం ఆకుల తోనే సాధ్యం

[15/09, 09:08] Perplexity: The English translation of the Telugu text "నివారించ లేని ఘటన గాయాల కు,  
ఉపశమనం ఆకుల తోనే సాధ్యం" is:

"For unavoidable wounds,  
relief is possible only with leaves."  

Need help with more translations? 😊

[15/09, 09:08]: Transliterate to Telugu

[15/09, 09:08] Perplexity: The transliteration of the English text to Telugu is:

నిషేధించలేని గాయాలకు,  
ఆకులే ఉపశమన దాయకం.  

Want me to help with anything else? 😊

[15/09, 09:09]: Transliterate to English

నివారించ లేని ఘటన గాయాల కు,  
ఉపశమనం ఆకుల తోనే సాధ్యం

[15/09, 09:09] Perplexity: Here’s the English transliteration of the Telugu text:

Nivarincha leni ghatana gaayalu ku,  
Upashamanam aakula thone saadhyam.  

Want me to help with anything else? 😊

[15/09, 09:09]: Translate to English

కాలిపోకుండా నివారించడం ముఖ్యం...

ప్రివెంటివ్ ఆంకాలజీ

[15/09, 09:09] Perplexity: Here's the English translation of the Telugu text:

"Preventing without burning is important...

Preventive Oncology"

Want me to help with anything else? 😊


[15/09, 09:11]: Translate to Telugu 

Prevention is always better than cure but once the events happen care always cure sometimes

[15/09, 09:11] Perplexity: Here's the Telugu translation you asked for:

కనుక తప్పించుకోవడం ఎప్పుడూ మెరుగైనది, కానీ సంఘటనలు జరిగిన తర్వాత జాగ్రత్తే కొన్ని సార్లు చికిత్స అవుతుంది.

Want me to help translate anything else? 😊

[15/09, 09:11]: Transliterate to english


[15/09, 09:11] Perplexity: Here’s the English transliteration of the Telugu text:

Kanuka tappinchukovadam eppudu merugainadi, kaani sanghatnalu jarigina taruvata jaagratthe konni saarlu chikitsa avutundi.

Want me to help with anything else? 😊

[15/09, 09:12]: Translate to Telugu

Prevention is always better than cure


[15/09, 09:12] Perplexity: Prevention is always better than cure in Telugu is:

*చికిత్స కంటే నివారణ ఎప్పుడూ మెరుగైనది*  

Want me to translate more? 😊


[15/09, 09:12]: Transliterate to english


[15/09, 09:12] Perplexity: Here's the English transliteration of the Telugu phrase:

*Chikitsa kante nivarana eppudu merugainadi*

Want me to help with anything else? 😊


[15/09, 09:13]: Translate to Telugu 

but once the events happen 

care always cure sometimes


[15/09, 09:13] Perplexity: Here’s the Telugu translation for your phrase:

కానీ సంఘటనలు జరుగుతున్న వెంటనే  
జాగ్రత్త తీసుకోవడం ఎప్పుడూ, చికిత్స కొన్నిసార్లు జరుగుతుంది.

Need a hand with anything else? 😊

[15/09, 09:14]: Transliterate to english


[15/09, 09:14] Perplexity: Here’s the English transliteration of the Telugu text:

Kani sanghatnalu jarugutunna ventane  
Jaagratha theeskovadam eppudu, chikitsa konni saarlu jarugutundi.

Need help with anything else? 😊


[15/09, 09:14]: Translate to Telugu 

care always cure sometimes


[15/09, 09:14] Perplexity: Here’s the Telugu translation for “care always cure sometimes”:

జాగ్రత్త ఎప్పుడూ, చికిత్స కొన్నిసార్లు

Need help with anything else? 😊
[15/09, 09:15] Rakesh Biswas: Transliterate to english
[15/09, 09:15] Perplexity: Here’s the English transliteration of the Telugu text:

Jaagratha eppudu, chikitsa konni saarlu

Want me to help with anything else? 😊


[15/09, 09:18]: Translate to English 

*చికిత్స కంటే నివారణ ఎప్పుడూ మెరుగైనది*  

కానీ సంఘటనలు జరుగుతున్న వెంటనే  

జాగ్రత్త ఎప్పుడూ, చికిత్స కొన్నిసార్లు


[15/09, 09:18] Perplexity: Here’s the English translation of the Telugu text you provided:

*Prevention is always better than cure*  
But once the events happen,  
Care always, cure sometimes.

Want me to help with anything else? 😊


[15/09, 09:18]: Transliterate to English 

*చికిత్స కంటే నివారణ ఎప్పుడూ మెరుగైనది*  

కానీ సంఘటనలు జరుగుతున్న వెంటనే  

జాగ్రత్త ఎప్పుడూ, చికిత్స కొన్నిసార్లు


[15/09, 09:18] Perplexity: Here’s the English transliteration of the Telugu text:

*Chikitsa kante nivarana eppudu merugainadi*  
Kani sanghatnalu jarugutunna ventane  
Jaagratha eppudu, chikitsa konni saarlu

Need help with anything else? 😊




Rashomon around the derivation of palliare (palliative) from pallava:


[15/09, 11:26] Metapsychist AIIMS Prof M: There are numerous cognate words in languages of the Indo-European family but pallava / pallium are not among those. 

Sanskrit Pallava is a cognate of the ancient Greek Phyllon, Latin Folium, French Feuille, and English Blossom

The Latin word Pallium, meaning cloak or covering, comes from the Proto-Indo-European root 'Pel' meaning skin (noun) or cover (noun and verb).


[15/09, 11:29] Metapsychist AIIMS Prof M: As I have said before, facts can be stranger than fiction. There are so many words of shared etymology between the languages descended from Sanskrit and Latin that there is no need to dig up false equivalences


[15/09, 11:31] Metapsychist AIIMS Prof M: Coming to AI-driven linguistics, I would much rather depend on pioneers like Acharya Suniti Kumar Chattopadhyay and Sir William Jones


[15/09, 11:38] cm [15/09, 10:57] hu1: Interesting
Tried to do a quick review and didn’t find any source mentioning the  “Pallava and palliative” connection.
Can you share any please?


[15/09, 11:00] hu2: https://en.m.wiktionary.org/wiki/%E0%A4%AA%E0%A4%B2%E0%A5%8D%E0%A4%B2%E0%A4%BE#:~:text=%5Bp%C9%90l.l%C3%A4%CB%90%5D-,Etymology%201,%2D%20(%2Dka%2D).


[15/09, 11:01]hu1: This, I got

“Pallava and palliative”?


[15/09, 11:04]hu2: Palla is derived from pallava which means leaf (actually it means a cluster of growing leaves)

https://www.wisdomlib.org/definition/pallava


[15/09, 11:05]hu3: Guess Latin root- palliare/pallium


[15/09, 11:08] hu1: I went through all these..

The blog explicitly states “palliative” is derived from “Pallava”
So got more interested .. 😀


[15/09, 11:10] hu2: Isn't it?

So it's like palla (cloak) from pallava (leaf covering) and then exported as Latin palliare (cloak)


[15/09, 11:11] hu1: Ok…
Linguistics and etymology can be very confusing and overlapping sometimes ..!


[15/09, 11:43] Metapsychist AIIMS Prof M: As I said, I would prefer to stick to time honoured scholarship on comparative linguistics rather than AI

[15/09, 11:50] Metapsychist AIIMS Prof M: There is a term called 'false friends' in linguistics. For example, the German word 'Kissen' sounds like the English word 'kiss' but actually means cushion. On the other hand, the German word 'Küssen' sounds like cushion but actually means kiss

[15/09, 11:57] Metapsychist AIIMS Prof M: Also, let us disabuse ourselves of the idea that Indo-European languages are derived from Sanskrit. They are not - period. Sanskrit, Ancient Iranian, Greek, Latin, proto-Slavic, and proto-Germanic are SISTER languages. The mother language, Proto-Indo-European, arose in the steppes between the Caspian and the Black Seas, was materially associated with the Yamnaya culture, and is genetically marked by the Y-DNA haplogroup R1b-Z2013


[15/09, 11:59] Metapsychist AIIMS Prof M: So there is no reason to feel inferior to anyone. Neither did English arise from Sanskrit, nor did Sanskrit arise from any European language. We speak sister languages

[15/09, 12:09] Metapsychist AIIMS Prof M: https://youtu.be/VrvkSkv06Rs?si=w7Xi6I5UPEv5OTQt

This puts the relation among Indian ethnic and linguistic groups in perspective. Despite all the information, it remains engaging and is quite easy to follow.

[15/09, 11:57] Metapsychist AIIMS Prof M: Also, let us disabuse ourselves of the idea that Indo-European languages are derived from Sanskrit. They are not - period. Sanskrit, Ancient Iranian, Greek, Latin, proto-Slavic, and proto-Germanic are SISTER languages. The mother language, Proto-Indo-European, arose in the steppes between the Caspian and the Black Seas, was materially associated with the Yamnaya culture, and is genetically marked by the Y-DNA haplogroup R1b-Z2013


[16/09, 08:20]cm: I guess one can still try to falsify this idea that indo european languages are derived from Sanskrit by gathering sufficient evidence to the contrary and if Karl Popper is right about science thriving on falsifiability (for example if I say invisible fairies are typing this message, there's no way one can design an experiment to falsify it and hence the statement inherently becomes unscientific) then perhaps my attempt at cherry picking apparently cognate words between Sanskrit and Latin is an experiment to hold this to a learned audience simply to see if there are adequate evidences to the contrary?

More here from Karl: Falsifiability is science and whatever can't be falsified is a fairy tale

https://www.facebook.com/share/p/16wpVoqBhj/?mibextid=oFDknk

UDLCO CRH: Reflex Movements in near Brain Death, thanatology and liminality management

Summary:


The discussion explores reflex movements observed in near brain death, focusing on spinal reflexes in brain-dead patients, their clinical significance, and the ethical, cultural, and emotional dimensions of handling such cases. The conversation delves into the liminal phase of thanatology, emphasizing participatory medical cognition and training healthcare providers to address these phenomena thoughtfully.

---

Key Words
- Passage of rites
- Participatory medicine
- Ethical approval
- Caregiver communication

---

Conversational transcripts:

[14/09, 11:50]hu1: Yesterday's afternoon session demonstrating a hitherto unknown near death sign in a patient who also had the Narketpally sign 👇



[14/09, 11:54]hu1: Another near death sign driven by the oculocephalic reflex, first reported by @⁨Participatory Medicine Elective Student Author⁩ while on his elective at another medical college in India👇



[14/09, 12:40]hu1: The near death involuntary signs 👇


[14/09, 12:45) hu2 : Thank you for sharing 

So much work remains post singularity. Folks are busy freaking out

...

Brain death - Organ transplantation is a critical ethical question. 

Is an EEG done on them? Even if flatlined, are there any artefacts in the cortex correlated with these spinal reflexes.

[14/09, 12:47] hu1: Wish we had wearable EEGs

[14/09, 12:48] hu2: Even with that avoiding electrode skin contact break would be difficult


[14/09, 12:50]hu2: See if your dept is willing to procure from a Delhi based manufacturer 

8 channels only, but have good signal quality


[14/09, 12:51]hu2: 8 channels will not suffice.

Actually 64 or even 128 channels would give a wonderful picture under continuous monitoring


[14/09, 13:32] hu1 : We have only 27000 as patient capital in the department https://medicinedepartment.blogspot.com/2025/09/udlco-medicine-department-patient.html?m=1


[14/09, 13:59]hu2: BITS Hyderabad or others can sponsor for your patients.

IIT Hyderabad has a strong medical devices practice


[14/09, 15:38]huai1: Of course. Based on the study you provided from the *Journal of Korean Medical Science*, here is a clear summary of the key points regarding near-death involuntary signs in the context of **brain death**.

### Summary of the Study on Reflex Movements in Brain Death

This prospective study investigated how often and what types of involuntary reflex movements occur in patients who have been declared brain dead.

#### **Key Findings:**

1.  **Frequency:** Out of 26 brain-dead adult patients, **5 (19.2%) exhibited involuntary reflex movements**. This shows that while not the majority, these movements are **not rare**.

2.  **Types of Movements Observed:**
    The study documented several specific spinal reflexes:
    *   **Pronation-extension reflex:** The most common movement (3 patients), typically an arm movement involving pronation (turning the palm down) and extension.
    *   **Abdominal reflex:** A contraction of the abdominal muscles in response to stimulation (2 patients).
    *   **Triple flexion reflex:** A reflex of the leg involving flexion of the hip, knee, and ankle (2 patients).
    *   **The Lazarus sign:** A dramatic, complex movement where the patient briefly raises both arms and drops them onto the chest, often in response to a stimulus (1 patient).
    *   **Periodic leg movements:** Spontaneous, repetitive movements resembling those seen during sleep (1 patient).

3.  **Triggers:** These movements were evoked by various stimuli, including:
    *   Painful stimuli (applied to the sternum, nail beds, etc.)
    *   Tactile stimulation (touching the palm or sole)
    *   Neck flexion
    *   The apnea test (a test to check for the absence of breathing, which can cause a rise in blood CO2)

#### **Why This Is Important (Clinical Significance):**

*   **These are SPINAL reflexes, not BRAIN reflexes.** The study emphasizes that these movements are generated by the spinal cord, which can remain active for a short time after the brain itself has permanently ceased to function. They are **not** a sign of life or recovery of brain function.
*   **Prevents Misdiagnosis:** Without awareness of these phenomena, healthcare providers or family members might misinterpret these movements as a sign that the patient is still alive. This could lead to:
    *   **Delays in diagnosing brain death.**
    *   **Confusion and emotional distress for families.**
    *   **Potential delays or cancellations of organ donation,** as the family might question the diagnosis.

#### **Proposed Mechanisms:**

The study discusses several theories for why these movements happen after brain death:

*   **Disinhibition:** The brain normally suppresses these spinal reflexes. When the brain dies, this suppression is removed, and the spinal cord's reflex circuits become hyperexcitable.

*   **Hypoxia/Hypercapnia:** Low oxygen or high carbon dioxide levels in the blood (e.g., during the apnea test) can stimulate spinal neurons.

*   **Mechanical Stimulation:** Movements like neck flexion can mechanically stimulate the spinal cord or nerve roots, triggering a reflex.

### **Conclusion for "Near-Death Involuntary Signs"**

In the specific context of **brain death**, the "involuntary signs" mentioned are **spinal reflex movements**. They are a well-documented but potentially misleading phenomenon that occurs **after** the brain has already irreversibly stopped functioning. Recognizing them is crucial for making an accurate and timely diagnosis of brain death and for clear communication with grieving families.

[14/09, 16:03]hu3: How is this handled with caregivers? How are we training doctors and other health care providers around this?

This is a liminal phase, passage of time. How do we handle it?


[14/09, 16:05]hu3: Very interesting study.. 

I think context of India and our limitations in terms of space time etc. in terms of resources make this a nuanced phenomenon that requires training and deliberation - medical cognition.


[14/09, 16:07]hu3: If we can have certain PaJR with these moments and you conduct a session with students around this. They then deliberate and write a reflective diary of these sessions..

Since we are using PaJR 

We can contribute towards our ongoing research in different context - liminal phase, 
Passage of rites.. 

This will be an important participatory medical cognition in which technology and technical artifact will have important role.


[14/09, 16:10]hu2: In India it's handled by looking the other way and relatives simply take the patient home aka LAMA!

But as you pointed out there's a lot that remains to be explored in this liminal area of thanatology.



[14/09, 16:13]hu2: I will read this.. this seems interesting.. but this is a topic that require proper ethical approval, unless you all are training medical students on this.

I see the angle of religion also, may be caste.. 

I see emotional implications of such training.

Thematic Analysis

1. Reflex Movements in Brain Death

- *Clinical Observations*: Reflex movements such as the Lazarus sign, triple flexion reflex, and abdominal reflex are identified as spinal, not brain-mediated, phenomena. These movements, triggered by stimuli like pain or mechanical stimulation, occur in 19% of brain-dead patients, according to studies.

- *Significance*: These movements can lead to misunderstandings about brain death among caregivers and healthcare providers, potentially delaying diagnoses or organ donation.

2. Ethical and Emotional Implications

- *Caregiver Communication*: Handling reflex movements requires sensitive communication to prevent distress among grieving families. Misinterpretation of these signs as life or recovery can cause emotional turmoil.

- *Training of Healthcare Providers*: Participants highlight the need for structured training for doctors and medical students to address the liminal phase of near-death signs. Reflective practices, such as diaries, can help students process these phenomena.

3. Participatory Medical Cognition

- *Integration of Technology*: Wearable EEGs or advanced monitoring systems are proposed to better understand these reflexes and their correlation with cortical activity.

- *PaJR Framework*: Using participatory medical cognition tools like PaJR (Participatory Action in Joint Reflection), students can engage in reflective sessions to understand the liminal phase and contribute to ongoing research.

4. Cultural and Religious Dimensions

- *Thanatology and Liminality*: Reflex movements in near brain death are linked to liminal phases of life and death, reflecting a nuanced intersection of medical science and cultural beliefs.

- *Religious Perspectives*: References to caste, religion, rites of passage, and emotional implications highlight the need for culturally sensitive approaches in such cases.

5. Resource Constraints

- *Indian Context*: Limited medical resources, space, and equipment (e.g., EEG channels) are noted as barriers to comprehensive monitoring and analysis of reflex movements.

- *LAMA (Leave Against Medical Advice)*: In India, cases of brain death are often resolved by families taking patients home, reflecting systemic challenges in handling near-death phenomena.

6. Ethical Research and Training

- *Approval and Sensitivity*: Participants stress the importance of ethical approval for training initiatives and research into reflex movements and their implications on caregivers.

- *Deliberation and Reflection*: Encouraging medical students to deliberate on such cases and write reflective journals can foster deeper understanding of the liminal phase and its broader implications.

---

Key Insights

- Reflex movements in brain death are clinically significant but often misunderstood, requiring better communication and training for healthcare providers.

- Participatory medical cognition tools like PaJR can bridge the gap between scientific analysis and emotional/cultural sensitivities, fostering holistic approaches to thanatology.

- Ethical considerations and resource constraints are central to advancing research and training in this nuanced area of medicine.





Dynamic Conversational Integration:

[21/10, 09:16]hu2: BLS is a simple event of shoulder strengthening over someone's chest till the endpoint, which is a hooting ambulance tapping your shoulder and saying "c'mon buddy, enough now let the real ALS team get to work with it's high tech tracheal tube and pressure pumps and dc shockers!"


[21/10, 09:17]hu1: And, subliminal messages can be delivered alongside


[21/10, 09:19]hu2: Oh yes!

Did I relate that CPR incident in Bhopal where the patient's elder brother was a subliminalist (hadn't heard the term then) but when we looked at him after the CPR to tell with our eyes that it's over he simply talked into thin air admonishing his brother to get back into his body this minute or else...and lo and behold his pulse returned!


[21/10, 09:22]hu1: Returned by a verbal slap to the cingulate gyrus?


[21/10, 09:23]huai1: Ah yes, I see exactly what you’re highlighting. You’re implying that the verbal admonishment—essentially a sharp, attention-grabbing stimulus—may have triggered some rapid autonomic or midline cortical response, perhaps via the cingulate gyrus, which is involved in attention, conflict monitoring, and autonomic regulation.

In simpler terms: the brother’s intense, focused verbal cue could have acted like a sudden “wake-up” signal to the patient’s central nervous system. While it’s anecdotal and likely contains elements of coincidence or the patient’s residual physiological activity, from a neuroscience perspective, it’s plausible that a combination of subliminal expectation, emotional salience, and sudden verbal stimulus could have transiently activated autonomic circuits—potentially even influencing heart rhythm via the vagal and sympathetic systems.

Basically, a “verbal slap to the cingulate” is a poetic way of saying the brain’s attention and arousal circuits were jolted into action, which then may have contributed to the pulse returning.

If you want, I can break down how a sharply worded verbal cue could physiologically influence the heart in under a minute—it’s actually a fascinating intersection of neurology and psychophysiology. Do you want me to do that?


[21/10, 09:24]hu1: Maybe these will be SoP in the future...

Updated CPR protocol... 30 pushes, 1 strong word!


[21/10, 09:28]hu2: We were just having a discussion on humans trump stepping into each other's roles!

Now AI is going to do that with a clean sweep of flourish!

Will cite this conversation here: https://medicinedepartment.blogspot.com/2025/09/udlco-crh-reflex-movements-in-near.html?m=1


What does one call this technique of neo age journal publishing where authors reverse cite conversational learning that they think matches their initial offering! I guess this is an undocumented phenomenon yet? @⁨Meta AI⁩

[21/10, 09:28] Meta AI: It sounds like you're describing a fascinating and emergent phenomenon in academic publishing and conversational learning—something like *"reverse conversational citation"* or *"dialogue-informed publishing."* Essentially, this involves taking dynamic, real-time discussions (like this one) and using them as a source or inspiration for formal journal articles or publications, often tying them back to pre-existing research or concepts.

In the case of Zenodo or similar platforms, this could mean publishing a DOI-linked document that integrates insights derived from conversational learning, creating a loop where informal discourse enriches formal academic output. It's almost like crowdsourcing intellectual refinement in real-time and then validating it through structured publishing.

While this technique might not yet have an official name, it represents the merging of *participatory knowledge creation* (where discussions shape outputs) and *conversational epistemology* (where dialogue itself becomes a source of knowledge). It's definitely a *neo-age publishing model*, blending traditional academic rigor with the fluidity of modern, collaborative learning. Maybe you just coined something new here! What would _you_ name this technique?



[21/10, 09:33]hu2: @⁨Meta AI⁩ what you were talking about is already well known as UDLCO and published formally here: https://pubmed.ncbi.nlm.nih.gov/40674544/ and informally here: https://userdrivenhealthcare.blogspot.com/2023/11/glossary-of-user-driven-healthcare.html?m=1

What I meant was post publication conversational entries into journal articles with comment like conversations that match their journal article topics instead of the current comment user interface where people converse only around that article. In this scenario whatever people converse is slotted into a journal article!


[21/10, 09:33] Meta AI: What you’re describing could be called *"Conversational Slotting"* or *"Dynamic Conversational Integration"* in journal publishing. It’s a novel idea where post-publication discussions, instead of being siloed as comments, are dynamically integrated into journal articles as evolving content. This would allow real-time discourse to shape or enrich the original article, creating a continuously updated, collaborative academic resource. 

While not yet mainstream, it aligns with the principles of participatory knowledge creation and conversational epistemology.


What you're describing sounds like an incredibly innovative approach to academic publishing—essentially transforming static journal articles into _living, collaborative documents_ that evolve through ongoing conversations. This concept, which could be termed *"Conversational Slotting"* or *"Dynamic Conversational Integration,"* would allow user discussions to be directly embedded into the structure of a journal article, rather than existing as separate comments or annotations.

The idea is fascinating because it shifts the focus from articles being final, unchanging outputs to them becoming _dynamic repositories of collective knowledge_. Here's how it could work:

1. *Post-Publication Integration*: Conversations and insights that align with the article's topic could be slotted into specific sections, effectively updating the article with new perspectives or data.


2. *Real-Time Collaboration*: This model would allow for a continuous dialogue between authors and readers, blurring the line between creators and contributors.


3. *Evolving Scholarship*: Instead of simply citing a static article, future researchers could interact with and contribute to it, making it a more reflective and comprehensive resource over time.

This approach would combine the rigor of peer-reviewed research with the adaptability of participatory learning ecosystems, like the ones discussed in the Narketpally Syndrome framework. It would also align with the growing trend of user-driven healthcare research (as referenced in the UDLCO model), where patient and user input is integral to the knowledge creation process.

If implemented, this could redefine how we think about academic publishing, turning it into an ongoing, community-driven process. What would you think about this becoming a mainstream practice?