So what???
I just try it sporadically.
C’mon m not a chain smoker!
Stop creating havoc about tobacco; it isn’t that big a deal!

Please stop!
Stop making excuses. Whom are you fooling? Whom are you explaining?
We all are smart enough to understand the good and the bad effects of every little thing.

Let’s assume of a world full of smart, grown-up adults, who are chain smokers and tobacco addicts. How do you like that? Do you wish your kids and your loved ones to be living in that world? How would like to see your children learning the same habits from you?

Since philosophy is a science of extraordinary minds, we being people with a bit of less smartness, will talk about facts!

  1. In a 20 yrs prospective study of over 1 million people, conducted by the American Cancer Society, in 1960s, tobacco alone was found responsible for:
  • 30% of Cancer deaths;
  • 22% of deaths due to heart attacks;
  • 27% of deaths due to strokes; and
  • 72% of deaths due to COPDs (Chronic obstructive lung diseases).
  1. After 1965, with increasing awareness about its dangers, its use has decreased significantly. But still as per 2004 statistics: In men, most oral cancers.
  • 78% lung cancers;
  • 16% heart attacks;
  • 10% deaths due to brain strokes;
  • 9% of TB deaths; and
  • 49% of deaths due to COPDs (chronic obstructive pulmonary diseases – diseases resulting from damage to the internal structure of lungs).
  1. According to a 50 year follow up study on British doctors, more than half of the long term tobacco smoking doctors (>50%) died earlier than their expected life span! On an average they lost 10 years compared to non-smokers. Those who died in middle life lost around 20 years.
  2. According to a huge study, which included 1.1 million homes from different parts of India,
  • Smoking is responsible for 20% male deaths and for 5% female deaths which occur prematurely between the ages of 30 and 69 years;
  • For men, the rate of premature deaths in smokers was 1.7 times that in non-smokers of similar age, educational level and alcohol status. For women who smoked, the chances of a premature death got doubled;
  • With increasing severity of smoking, the risk of premature death also increases.

As a whole,

  • Tobacco is the largest cause of preventable premature deaths across the world!
  •  10% of premature male deaths in age bracket of 30-44 yrs and 19% of premature male deaths in age bracket of 45-59 yrs are attributable to tobacco use!   (WHO Global Report, mortality attributable to tobacco, 2012)
  • On an average, tobacco smokers end up dying around 10 years earlier than non-smokers!

Let’s now discuss the reasons why “smoking looks cool” or “smoking releases your stress” or “a cigarette in your hand enhances your personality”.
There is no addiction until you make it a habit. No peer pressure or circumstances can make you give up your life to these poisons.
We, at THATMATE, listen to you and your problem and are there to guide you. Look for a person, your THATMATE, with whom you can discuss your problems.

Problems are ephemeral, life’s not; don’t give it up to drugs or tobacco, let it be perennial!

Mansi Pareek


Why Tobacco smoking is never safe?

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Many of us are justifiably concerned about nuclear wars, weapons of mass destruction and war. Yet we tend to ignore the far more immediate and likely dangers to our lives. In fact we sometimes literally court death with the choices we make—these dangers are available to us freely and cheaply and they are addictive. Almost every person who reads this will have at least five people known to them who are using tobacco in some form. Almost every person who reads this will also know two people who have died of tobacco-related illness. Still people flock to this habit and the government does precious little to stop the sale of these weapons of mass destruction.

The stimulant effects of tobacco are temporary and illusory. The end effects over a period of time are almost always the same—illness and death.

World over daily 1 billion men and 250 million women smoke. Almost the same number chew tobacco in developing countries, especially in Southeast Asia. In India, almost 35% of the adult population uses tobacco in some form—a large majority use it in chewable form while the rest smoke it.

 A wolf in sheep’s clothing

Tobacco can be found in various items, some that seem innocuous. For example, “masheri” is traditionally used as a substitute for toothpaste and it contains tobacco. The “friendly” paan we have at many weddings contains tobacco. Then of course there are obvious sources of tobacco such as cigarettes, bidis, gutkha, pan masala. The new fads of hookah and vaping (e-cigarettes) are also just ways to consume nicotine and harmful to us. Thus, tobacco can be accessed in various ways and knowingly or unknowingly harms your body.

Health Hazards


Smoked tobacco contains nicotine. Nicotine is a drug which causes physical dependence. Hence, once a person develops the habit, it’s difficult to quit. It also leads to tolerance—the need to increase the dose to achieve the same effect. This is often the cause behind chain smoking.

Nicotine is an alkaloid poison which affects the heart and blood vessels. Hence chronic smokers can develop gangrene (blackening of fingers and toes) which can actually cause their digits to drop off! They are also at a high risk of heart attack because of this.

Smoking is also harmful in women in specific ways. Women on oral contraceptive pills who smoke are at double the risk of heart attacks. Smoking in pregnancy can cause intrauterine growth retardation and even death off the foetus.

Cigarettes are harmful not just because of nicotine. They also contain tar which has many chemicals which damage your heart and lungs. Hence many smokers suffer from lung diseases like bronchitis and emphysema.

Tobacco smoke contains 61 known carcinogens. Tobacco has been implicated in almost 14 cancers. These include lung, oral cavity, pharynx, larynx, oesophagus, pancreas, bladder, nasal cavity, stomach, liver, kidneys, ureter, cervix and myeloid leukemias.

Vaping and hookahs

The new fad of using e-cigarettes and hookah is equally dangerous. E-cigarettes are known to contain particulate matter (in addition to tobacco), which is implicated in causing asthma, coronary artery disease along with lung cancer. They come in interesting flavours to entice young people. In kids consuming these can lead to asthma and poor lung development.

Hookahs, though they contain less tobacco, are traditionally smoked for a much longer time than cigarettes. An average person takes around 50-200 puffs over an hour as compared to 8-12 per cigarette, which becomes the equivalent of smoking 100 cigarettes at one go.

Smokeless tobacco

In India, especially in the hinterlands, this is a bigger menace. Children as young as 12 years old, start chewing some form of tobacco. Most of the smokeless forms of tobacco also contain areca nuts which contain the chemical arecholine. Arecholine is also a certified carcinogen and along with tobacco increases the risk of cancer. Smokeless tobacco is implicated in the development of cancers of the oral cavity, pancreas and oesophagus. Other than that, they also cause a condition called sub-mucous fibrosis where the mouth opening becomes progressively smaller and in due course totally closed. It can also give rise to leukoplakia, which are white patches in the oral cavity. These two conditions are also pre-cancerous.

Thus tobacco, in whatever form consumed, damages the body. The stimulant effects are temporary and illusory. The end effects over a period of time are almost always the same—illness and death. Be smart. Quit tobacco.


‘प्रेम’ की कोई सीमा नहीं।

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प्राकृतिक सेक्स और अप्राकृतिक सेक्स। मूलत: समस्या इस नाम से ही शुरू होती है। प्राकृतिक क्या है? एक डॉक्टर की नजर में प्राकृतिक ‘सेक्स’ पुरूष और नारी के मध्य ही संभव है। शरीर की संरचना, हॉर्मोन, और सेक्स से जुड़े प्राकृतिक स्नाव (सीक्रीशन) उसी हिसाब से बने हैं। हाँ! अगर ‘सेक्स’ की जगह ‘प्रेम’ डाल दें, तो ऐसी कोई सीमा नहीं। कोई भी प्रेम अप्राकृतिक नहीं कहा जा सकता। प्रेम में पुरूष, नारी, पशु-पक्षी सब आ जाएँगें।

लोग अपना जीवन बस एक तोते के साथ भी गुजार लेते हैं, उससे बातें करते हैं, उसी से मोहब्बत करते हैं। और यह मैं व्यंग्य की तरह नहीं कह रहा। प्रेम और ‘सेक्स’ का मौलिक विभाजन आवश्यक है। अब तकनीकी संरचना पर आता हूँ। मान लें कि पुरूष-पुरूष में प्रेम हो जाए, नारी-नारी में प्रेम हो जाए, और अब वो ‘सेक्स’ करना चाहें तो प्राकृतिक रूप से ये कैसे संभव है? अप्राकृतिक रूप से करने से कई चिकित्सकीय समस्याएँ हैं, और जब हल है, तो ऐसा करना क्यों? इस तरह के किसी भी संबंध में ‘ऐक्टिव’ और ‘पैसिव’, दो तरह के लोग होते हैं। ‘ऐक्टिव’ पुरूष की भूमिका में, ‘पैसिव’ नारी की भूमिका में। हालांकि अदला-बदली भी संभव है, पर अमूमन मनोवैज्ञानिक रूप से नहीं होता। एक व्यक्ति आज मानसिक तौर पर पुरूष है, कल नारी बन जाए, वापस परसों पुरूष बन जाए, यह कठिन है। इसी तर्क से निर्णय आसान है।

मेरे एक परिचित के मित्र नॉर्वे में ‘सेक्स-चेंज’ करवा कर प्रसन्न हैं। अब काफी कुछ प्राकृतिक ‘सेक्स’ संभव है। अब पूरी की पूरी योनि की रचना ‘प्लास्टिक सर्जरी’ के द्वारा की जा सकती है। हॉरमोन में बदलाव किए जा सकते हैं। यह सुलभ है। चूँकि ‘सेक्स-लाइफ’ मनुष्य के जीवन में कम से कम तीन-चार दशक का मामला है, आवश्यक है कि वह प्राकृतिक रूप से ही हो। पर प्रश्न यह उठ सकता है कि गर पुरूष को नारी ही बना कर प्रेम करना था, तो सीधे नारी से ही प्रेम क्यों नहीं? उत्तर बहुत ही स्पष्ट है। प्रेम शरीर से नहीं, मन से होता है। हृदय से होता है। वो डॉक्टर नहीं बदल सकते। वो ‘सेक्स-चेंज’ के बाद भी यथावत है। तो एक लेस्बियन युगल भले ही शारीरिक संरचना से पुरूष-नारी बन गए हों, मन से दोनों आजीवन नारी ही रहेंगें। और स्वस्थ रहेंगें। किसी भी ऐसी बीमारी से ग्रसित नहीं होंगें, जो समलैंगिक संबंध से जुड़ी है। हालांकि कई बीमारियाँ ‘मल्टीपल पार्टनर’ से जुड़ी हैं, पर उसके लिए समलैंगिक होना आवश्यक नहीं। इसका अर्थ समस्या प्रेम नहीं व्यभिचार है, विश्वास की कमी है। वो इन संबंधों में भी उतनी ही आवश्यक है जितनी पुरूष-नारी के संबंध में।


Dr. Praveen Jha

Not Knowing it was OCD

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Obsessive Compulsive Disorder (OCD) has a huge impact, not only on the individual with the disorder, but also on the person or persons living with the OCD sufferer. Being married to someone with OCD can be hard. In some instances, the partner of the person with OCD simply denies that the disorder exists, but in most cases, spouses report that their loved one’s OCD greatly affects them. Spouses and other family members often report feelings of frustration, isolation, shame and guilt.

Often spouses and other family members have to adhere to rituals around eating or cleanliness. Or they may have to allow significant time to leave the house so rituals can be completed, or repeatedly provide reassurance or make excuses for their spouse. These types of behaviors by spouses and other family members of those with OCD are called “accommodations” and it has been found that nearly 90% of individuals with OCD live with a spouse or other family member who accommodate their symptoms in a considerable way. Over 80% of family members know that their loved ones obsessions and compulsions are unreasonable and 66% realize that making accommodations does not help to alleviate OCD symptoms. Spouses who participate in or help with compulsive behaviors often become emotionally over involved and frequently neglect their own needs. This tends to worsen the cycle of obsessions and compulsions and recent studies have found that avoidance and accommodations made by spouses serve as an indicator of poorer treatment outcomes.

Things spouses (and other family members) do to accommodate their loved one with OCD include:

  • Giving reassurance (e.g. reassuring spouse that he or she is not contaminated)
  • Waiting until rituals and compulsions are completed
  • Helping to complete a ritual or compulsion (e.g. checking the door for the individual with OCD)
  • Providing spouse with items needed to perform compulsions (e.g. purchasing excessive amounts of soap)
  • Doing things so the spouse with OCD doesn’t have to (e.g. touching public door knobs)
  • Making decisions for the spouse with OCD because the spouse with OCD is unable to do so
  • Taking on additional responsibilities that the spouse with OCD is unable to perform
  • Avoiding talking about things that could trigger the spouse’s OCD symptoms
  • Making excuses or lying for the spouse with OCD when he/she missed work because of OCD
  • Putting up with unusual conditions at home because of OCD

The good news is that there are effective forms of treatment that can help the person with OCD to lead a normal life and can teach spouses of those with OCD to learn what to expect and how to respond to the waxing and waning cycle of OCD.


Let’s analyze!!

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Not all those who know the rules of a game can play the game. Similarly, knowing about OCD is different and analyzing and understanding its symptoms is different.

Occurrence of an image or a thought repetitively out of a person’s control is obsession but thinking occasionally about getting sickness or safety is not.

Repetitively performing time consuming activities can be a compulsion but practicing bedtime routine or religious activities is not.

Similarly, there are many different activities which are/ are not a symptom of OCD. Let’s brief them so as to understand the disease.


  • Thoughts, images, or impulses that occur over and over again and feel out of the person’s control.
  • The person does not want to have these ideas.
  • He or she finds them disturbing and unwanted, and usually knows that they don’t make sense.
  • They come with uncomfortable feelings, such as fear, disgust, doubt, or a feeling that things have to be done in a way that is “just right.”
  • They take a lot of time and get in the way of important activities the person values (socializing, working, going to school, etc.).


  • It is normal to have occasional thoughts about getting sick or about the safety of loved ones.


  • Repetitive behaviors or thoughts that a person engages in to neutralize, counteract, or make their obsessions go away.
  • People with OCD realize this is only a temporary solution, but without a better way to cope they rely on the compulsion as a temporary escape.
  • Can also include avoiding situations that trigger their obsessions.
  • Time consuming and get in the way of important activities the person values (socializing, working, going to school, etc.).


  • Not all repetitive behaviours or “rituals” are compulsions. Bedtime routines, religious practices, and learning a new skill involve repeating an activity over and over again, but are a welcome part of daily life.
  • Behaviours depend on the context: Arranging and ordering DVDs for eight hours a day isn’t a compulsion if the person works in a video store.


The descriptive analysis done here may help you to know if a person is suffering from OCD.
No cure can be started before diagnosing the disease and hence to diagnose or cure OCD, along with patience and methods to diagnose, a deep study and understanding of the mentioned disorder is required.


Gender Dysphoria (Gender Identity Disorder)

Aditya to Aditi: ‘A woman soul trapped in man’s body…’

It was another busy OPD day. Last client… “Good Evening Aditya (Name changed)! How can I help you my friend”.   Aditya broke down into tears. “Doctor, I want to end my life. I feel my life is not worth living”.  I passed on a glass of water to Aditya and was waiting for him to ventilate his feelings. Aditya spoke, “I am not happy being a man. I feel, I am a woman soul trapped in a man’s body. I belong to a small town from interiors of Maharashtra. Nobody understands what I am going through… please let me die.”


Aditya was a young male client who was suffering from Gender Dysphoria (Gender Identity Disorder). He was uncomfortable with his biological male gender role since childhood.  On inquiry, He always disliked dressing male clothes. As he grew up into adolescence, his distress about being male increased. Aditya was not comfortable with the change in his voice and mustache. He expressed his feelings to his parents but parents turned deaf ear to his plea… He joined classical dance classes and started developing interest in cooking. His anxiety decreased being into this female gender roles. One day he expressed wish to change his sex by undergoing sex re-assignment surgery to his family members. He could not convince his family and was out caste from the community.

Diagnostic and Statistical Manual of Mental Disorder 5 (DSM 5) describes Gender Dysphoria (earlier known as Gender Identity Disorder) as ‘a definite mismatch between the assigned gender and experienced/expressed gender for at least 6 months duration as characterized by at least two or more of the following features –

1.    Mismatch between experienced or expressed gender and gender manifested by primary and/or secondary sex characteristics at puberty

2.    Persistent desire to rid oneself of the primary or secondary sexual characteristics of the biological sex at puberty.

3.    Strong desire to possess the primary and/or secondary sex characteristics of the other gender

4.    Desire to belong to the other gender

5.    Desire to be treated as the other gender

6.    Strong feeling or conviction that he or she is reacting or feeling in accordance with the identified gender.

Published prevalence of gender dysphoria range from 1.9 to 4.72 per 100000 populationwith a male to female ratio of 3:1. (1) Number of people diagnosed with this condition is increasing due to increasing awareness among population. Christine Jorgensen was the first person to become widely known in the United States for having sex reassignment surgery in 1951. In 2015, is an American television personality and retired Olympic gold medal-winning decathlete made headlines and appeared on Vanity fair magazine for her transformation from Bruce Jenner to Caitlyn Jenner.

Gender dysphoria involves a conflict between a person’s physical or biological gender and the gender with which they identify. People with gender dysphoria may be very uncomfortable with the gender they were assigned, sometimes described as being uncomfortable with their body (particularly developments during puberty) or being uncomfortable with the expected roles of their assigned gender. Often other people do not understand the wish to be of another gender, and this can cause difficulties in relationships with friends and family. It may cause stressanxiety or depression. Gender dysphoria is associated with high levels of stigmatization, discrimination and victimization, contributing to negative self-image and increased rates of other mental disorders.

A person has to undergo Real Life Experience (RLE) i.e. living life of opposite desired sex for a period of 1 year so he/she does not regret the decision of sex change in later life. Sex reassignment surgery, hormonal replacement therapy, speech therapy, skin and hair treatment are the treatment available after evaluation and treatment by a psychiatrist. Primary as well as secondary mental disorders needs to be ruled out by a psychiatrist before undergoing above irreversible treatments.

Dr. Chetan Vispute

The eunuch!


बात इतनी कुछ ख़ास नहीं थी लेकिन आज ये बात बहुत ख़ास सी लग रही है।बात 21 मार्च 2016 की है,मैं प्रतापगढ़ से दिल्ली वापिस आने के लिए पद्मावत एक्सप्रेस में बैठी थी।थक कर चूर थी क्योंकि उसी सुबह मैं पूरे बारह घंटे की यात्रा के बाद प्रतापगढ़ पहुंची थी और उसी शाम मुझे दिल्ली के लिये वापिस यात्रा करनी थी।प्रातपगढ़ में 8 घंटे रहने पर भी मुझे खाना खाने का समय नहीं मिला और बिना कुछ खाये ही वापसी हुई।साथ में कुछ फल (सेब, अंगूर, संतरे,अनार)थे जो कि बुआ जी ने दिए थे।मैं अपनी सीट पर बैठी उन्हें खा रही थी। एक बेहद बुलंद सी आवाज़ आई “ला राजा, निकाल बाबू” मेरे लिए बेहद अनोखी बात थी ये।मैं थोड़ा झुककर देखने लगी।पता चला कि कोई किन्नर है जो लोगों (यात्रियों) से पैसे मांग रही है।शायद ये मेरे अब तक के जीवन में देखी गयी सबसे सुन्दर किन्नर थी।गज़ब का आकर्षण था उनमे।गेहुंए रंग की थी वो, उनके सफ़ेद सूती कुरते पर सफ़ेद मोतियों से हुई कारीगरी और प्लाजो,सफ़ेद फ्लैट चप्पल,कान में बड़ी बड़ी सिल्वर बालियां, रिबाउंडिंग किये हुए बाल, गले में मोती की माला और हाथ में एक क्लच, बाप रे उनके आगे अच्छी से अच्छी सुंदरियाँ भी लज्जा खाएं।वो मेरे सामने खड़ी थी, मुझसे रहा नहीं गया और जैसे ही मेरी और उनकी नज़र एक हुई मैं बोल पड़ी “आप बहुत सुन्दर हो” जवाब में उन्होंने कहा “थैंक यू” मैंने कहा “सेब खायेंगी?” उन्होंने कहा “न, तू खा” मैंने कहा “लीजिये न” उन्होंने सेब लिए, मैं थोड़ा सरकी और उनको बैठने का इशारा किया वो बैठी।फिर मैंने कहा “आपका सूट बहुत प्यारा है” वो हंसी, मुस्कुराती रही, मैंने कहा “संतरा भी लीजिये” उन्होंने कहा “न गुड़िया, तू खा, अपन को कौन ऐसे कुछ खाने को पूछता है? तूने प्यार से सेब खिलाया, चार बात की, तू बहुत तरक्की कर…..” इसी तरह की शुभकामनाएं करती, मुझे आशीर्वाद देती वो उठी और फिर चली गयी। पिताजी मुझे घूर रहे थे, मेरा ये व्यवहार उनके लिए सरलता से हज़म कर लेने वाला नहीं था। आज जब मम्मी से इस बारे में ज़िक्र कर रही थी तो उनकी (किन्नर) बातों में छुपी वेदना महसूस हो रही है, कि कोई उन्हें वो सम्मान नहीं देता जिस सम्मान का हक़दार हर मनुष्य हर जीव है। मानवीय व्यवहार के नियमानुसार ये बातें बेहद सामान्य सी हैं किसीको भोजन और पानी के लिए पूछना, किसीकी प्रसंशा करना, किसी के साथ प्रेम से बात करना।लेकिन हमारे ही व्यवहार की कठोरता ने इस सामान्य व्यवहार को भी कितनी विशिष्ट श्रेणी का बना दिया है।

Medini Pandey