Stages of Change, Heroin, Happy People and the McLeodganj Effect

Discussing the Stages of Change model (Purchaska and DiClemente) in the Drug deaddiction ward rounds, I made a bit of a mistake and said that after the action stage came the pre-contemplation stage or in other words, there is a relapse. Understandably, my boss was not to happy about it and called me a "prophet of doom". Well, amends were made and I admitted that there might be some people who kept clean and were abstinenet for periods longer than I thought possible. That was the end of it but then I was also in the same round told of a gentleman who had been admitted some 6-7 times for heroin dependence and now was clean for many-many years and was a much respected member of the Narcotics Anonymous. That might have been the end of it, but in the afternoon OPD I was in for a surprise.

At the fag end of the OPD when I wanted to have a cup of tea more than anything else, in walked a middle-aged man. Now most opioid and specifically Heroin dependent individuals are young, in their teens to 30's and this person was in his 40's. Not the typical heroin man, but something about the way he talked, the look said heroin. And sure enough he said he was taking heroin. In the course of the interview I asked him how it had happened. He told me had been admitted in the ward some 5-6 times, was an NA member and he was pretty sheepish about coming back here. "Sir, I had gone to Mcleodganj some days back". My ears pricked up because I knew what was coming. "There I met some Happy people". "Happy", I asked. "You know sir, those goras (whites) with long hair, who play music instrument". "Hippy" I suggested, "Yes, yes, Sir exactly, well they were playing guitar under the main Dalai Lama temple, and I was sitting there with my children and saw them chasing smack, and I dont know what happened, I still dont understand, but I went and asked one for a chase, and he obliged. that night I Slep and next morning I saw the same fellow and asked him for a chase and he asked me for Rs 500".

I asked him what happened next, and he said that he had been taking upto 3gms-4gms every single day since then. " I wish I had never gone to McLeodganj, Sir", he finished. I wrote his medication and thought that I would never forget stages of change again.

I finished up the OPD, went to the student centre in Punjab university and had a cup of tea and remembered all the great times I had in McLeodganj. Its time to go there again and to steer clear of the 'Happy' people.

Ataxia

Ataxia
Originally uploaded by Shubh M Singh

Ataxia From Greek α- (used as a negative prefix) + -τάξις (order), meaning "lack of order". It is a neurological sign and symptom consisting of gross in coordination of muscle movements. Ataxia is an aspecific clinical manifestation implying dysfunction of parts of the nervous system that coordinate movement, such as the cerebellum.

I was in Mcleodganj a couple of days back for a weekend trip and beyond the usual irritations, the weather was fine, the back was holding up and life seemed good. Even photography did not seem important, life did for a change. And it did not look fantastic. Not all of it anyway.
I was sitting in the bright sunshine one afternoon at the tshuglagkhang or the main temple, and watching the bands that the shadows on the railings made on the floor. The 1000 prostrations lady carried on as usual, gave me a glare to make sure that I do not photograph her and Mcleodganj looked again the place where everything seems right with the world.
Then this guy walked by, beat up, rundown, staggering gait and beyond the obvious ataxia lay a story, heroic maybe, a walk across the Himalayas maybe. Or was it just too much booze?
The next time he walked across, I knew he would be back to make some more circumambulations.
And the next time, i was ready and i took his picture.