We tend to live our lives working on the edge in today’s world

…Some people enjoy it – “Adrenaline Junkies” and some dont (Me and believe most of us). Believe it or not …we are all becoming one of them (Adrenaline junkies I meant). Its either because of our bosses, wives, parents or peers (better to blame others). In reality its us…We are forgetting how to prioritise our lives.Living a life where you are constantly on the go is exciting but takes its toll on our body and mind…..BTW speaking of mind…As ophthalmologists our entire world revolves in and around 24 mm of space of the eye ball. We are inclined (Voluntarily/Involuntarily) towards forgetting the rich knowledge imparted onto us during the golden years of our graduation. This period taught us a lot many things about the miracle of nature – The Human body and its “central processing unit” – The BRAIN.

Everyone seems to have one but it is seldomly used by most.

The anatomy of the human body and its understanding hasn’t really changed much in the last couple of centuries (Dua’s layer being an exception), however its physiology is a constant dynamic entity which is still being researched upon. We know what the BODY is, but we are still trying to understand how it works, how it functions.

The anatomy of the human body and its understanding hasn’t really changed much in the last couple of centuries (Dua’s layer being an exception), however its physiology is a constant dynamic entity which is still being researched upon. We know what the BODY is, but we are still trying to understand how it works, how it functions.

Going back and in the process of trying to understand myself, I happened to stumble upon an entity which finds mention in allied disciplines such as Homeopathy and Ayurveda ( I can hear the groans from the idealistis) but is rarely mentioned in the medicine textbooks of allopathy. Sigmund was a dude…unfortunately people are still trying to understand what he said and what he didnt…

Anyways…..with the recent developments in the field of “Science” and the need to publish something (PUBLISH OR PERISH Click if you like), Psyhcologists/Psychiatrists/Shrinks have acknowledged the presence of this entity known as “SYMPATHETIC OVERACTIVITY” (Ta daaaaann).

I shall try to explain this physiological process which when thrown into an overdrive can have some really nasty (pardon me but by ‘nasty’ i meant SHITTY) adverse effects in a variety of ways.

With the ever so competitive world driving us towards the brink of insanity,

we are often compelled to throw our “Flight or Fight” response into play more than it is required. Wondering what do I actually mean? Let’s pay a visit back in time to the physiology class where we usually spent sleeping (Presuming you were like me and presumptions/assumptions are usually correct & even if they were not…who cares).

[Setting – 1st year MBBS, classroom, Not so sympathetic Physiology prof (sorry sir), talking in a monotonous voice (enough to put even the gods to sleep)]

Definition of Sympathetic system: The sympathetic nervous system (SNS) is one of the two main divisions of the autonomic nervous system, the other being the parasympathetic nervous system. [Source] [Source]

The autonomic nervous system functions to regulate the body’s unconscious actions. The sympathetic nervous system’s primary process is to stimulate the body’s fight-or-flight response. It is, however, constantly active at a basic level to maintain homeostasis. [Source] The sympathetic nervous system is described as being complementary to the parasympathetic nervous system which stimulates the body to “feed and breed” and to (then) “rest-and-digest”.

The sympathetic nervous system is responsible for priming the body for action, particularly in situations threatening survival, [Source]. Sympathicotonia is a stimulated [Source] condition of the sympathetic nervous system, marked by vascular spasm, [Source]elevated blood pressure, [Source] and goose bumps. (ZZZzzzzzzzzzz)

Ok…wake up ….rise and shine…the lecture is over….You’ve got the definition.

So for me till date “Sympathetic system” was synonymous with “Sympathy”(something which we never got) and “Parasympathetic system” was its kryptonite. Apparently Sympathetic system plays a huge role in our day to day lives. Right from operating in the OT to driving, from playing on the mobile to paying a visit to the loo (Loosens up the sphincters as well).

Thrown in to over drive – ‘ANXIETY’ is the collection of symptoms caused due to Sympathetic activity overdrive and STRESS is what precipitates it. When overdrive is in the top most gear the resultant condition is a “Panic attack”. Anxiety is a phenomenon which is very much subjective. In fact the old saying “Still waters run deep” holds true for most of the medicos.


When examining the patients we are constantly on the vigilance (Are the relatives going to hit me??). On one hand we are trying to do justice to the patient and on the other hand we are trying to be legally, diplomatically, NDTVically, Congresstically, BJPtically, Arnab Goswamitically and financially correct.

The medical professionals are required to maintain a “Poker face”

when facing the patients and the relatives, when there is a great deal of turmoil inside (not the turmoil of bladder). We often ourselves mistake this for “being in control” when we have succeeeded in maintaining an emotionless face.

In reality what is the result is, a DEEP & HEAVY IMPACT on our autonomic system which is made to run continuously never taking a break.The susceptibility to chronic stress varies among individuals and changes across lifespan. Working in a corporate or under someone, achieving targets or examining maximum number for patients for the sake of surgeries, STRESS is usually the ultimate result. The stress puts our body to activate the sympathetic system.

Operating 100s of cases in day, seeing 200s patients in the opd. Have to finish the OPD but yet do justice to the patient. Finish OPD and move over to the ot. Finish OT and move over to the OPD. The OPD sister is un-coperative, the patient is un-coperative, the seniors are un-coperative, the consultants are un-coperative. Blah Blah Blah…..STRESS STRESS STRES

So you get the picture…

Shit happening->STRESS->Sympathetic overdrive->More Shit Happening->Stress…

Living on “Stimulants” such as coffee, energy drinks (Tapri ki Chai included) and combined with the stress of the profession, we agitate our bodies to a point where we are unable to calm down.

So you get the bigger picture…

Shit+coffee->STRESS+STRESS->Sympathetic overdrive->More Shit +COFFEE->STRESS

So basically speaking in normal terms… we are brewing up a storm within ourselves which becomes self sustainable and self propagating. Its like the Juggernaut…Not stopping (Even for a pee). Round the clock stress just puts the sympathetic system in the “Autopilot” mode which is active even during our sleep.

Sleep deprivation and fleeting attention from one stressful situation to another, we are plagued by the stress of striving for perfection. We tend to perform the same task 20 times: ten times in our head before the actual event, once during the event and nine times after the event as we analyze how we could have improved our performance.

Combined with the other factors the need to be omnipresent on the social media (Oh yeah

– “SELFITIS” is an “IN” thing) , the conferences, the news and the academic front just adds to the trouble. The constant desire to prove ourselves to others and achieve celeb status ( I did it – I created someting new and F@#$ myself) is just adding to the troubles.

Waise going back to social media….Taking and posting Selfie has been officially been declared a mental disease. Come to think of it…why do we take selfies???

Because Its the only way we are seeing ourselves smiling…looking into the mirror in the morning we are too busy thinKing of the day ahead and what we are gonna face (Indian doctors leave the house with the ‘KAFAN’ tied around their head). So back to the topic….posting the selfies as soon as they are taken on the social media just to prove who all you’ve been with (Im a culprit too…but hey!..its what everybody does) in the conference so that u can increase the footage is another thing that stimulates the Sympathetic system. You shall not be able to rest till the point you post it.


Ever wondered why some of us dont feel happy after coming back home and would want to spend few moments more in the hospital/clinic/chamber/car to finish that study/project/social media post?? Ever wondered why the only thing buzzing in your mind is the damn INTERESTING CASE you saw in the morning even when your head hits the pillow?? Ever wondered why your colleague (opposite gender or in some cases same gender 😉 suddenly seems more interesting than the family??…why the extra marital affairs are on the rise?? Is something such as workplace husband or wife normal?…Read below

Sympathetic system also helps us in achieving our goals by providing the driving force. This ensures the reward center being constantly stimulated which ultimately programmes our mind to associate the activity which stimulates the sympathetic system with pleasure and rewards. Most often THIS is our professional life and that’s where we get inclined leading to marital problems.

Your spouse if not from the same field suffers the most.

Your colleague (Again .. opposite gender or in some cases same gender 😉 is something which is treated by ur subconcious/unconcious mind as a part of that “ACTIVITY” which shall reward you and satisfy the satiety of your reward center. Try spending some quality time with your family and suddenly your WIFE/HUSBAND again becomes attractive(ROFL).

The inability to concentrate on activities at home

(Like peeing in the basin or venturing out of the washroom without your shorts) after a long day of work at the professional front indicate the wearing off the sympathetic system activity. This often forces many of us to choose between the two, the professional or the domestic life. Striking a balance becomes difficult for many of us.

You need references and citations for eveything. Everything needs to be justified and clarified. I remember asking my mechanic the references and studies when he mentioned that the new engine oil will give me better mileage.


Insomnia, acid reflux, headaches from jaw clenching, increased muscle tension leading to cramps and chronic muscular pain, constipation, frequent urination, low libido, palpitations, hypotension/hypertension, adrenal fatigue, poor digestion, cold extremities, restless legs, urge to keep on walking, compromised immunity are few of the symptoms to name. The need to continuously chew on the gum is also a way of trying to vent out the stress.

Basically u r on the verge all the time. The moment someone utters something which might not be justified….you want to lash out and kill the poor person, Strangle him, bang his head on the wall (Not me…I am cool as ICE )…

Lack of energy, lack of joy, SELECTIVE decreased LIBIDO, decreased ability to handle stress, a compromised immune system and memory lapses which all eventually lead to a sub clinical depression where the only stimulant for the mind is the activity associated with the activation of the sympathetic system (AGAIN AGAIN …. opposite gender or in some cases same gender, Social media, PUBLICATIONS, STUDY, PROJECT…..)This gives us a false sense of happiness (In pursuit of happyness).

Oh yeah!“Rushing women syndrome” is another term coined by few which is applicable to men as well.

“Thou shall Know!”

Parasympathetic system activation is the key. It’s the “Rest and Digest” system of our body.

Remember you are not “SUPERMAN/WOMAN”. You need rest. You need to be happy. You deserve to be happy. Get your priorities right and understand that you need to get back your life. The need to succeed should not be a burden or a curse or a punishment for your family. The constant need to prove oneself should be stopped. The cycle needs to be broken. Any habit to be formed takes 20-30 days. Hence that is the period where you shall have to pay attention and avoid the above mentioned urges. Once it becomes a habit, you shall find bliss. Then slowly steadily reintroduce your priorities one by one.


We forget to prioritise our life and activities and hence feel overloaded with work (like my desire right now to complete this damn blog and publish it).

Sleep is critical in order for the body to heal and repair. Break away from the electronics and unplug from the digital world for a few hours every week. Yogic exercises are a great away to achieve this. Try following Modiji for a change…:).

However realization and acceptance shall be the first step. Managing and maintaining ‘Mindfulness’ round the clock is the key. Once that is achieved the next step is the activation of the parasympathetic system to help us in analyzing the situations and coming to conclusions. Mindfullness is the key to success. Thats what the stalwarts do.

One way is delayed reaction(except in the OT). Whenever a situation arises, think about it and forget it. Try not reacting immediately. Sleep over it and give it sometime. Somehow it shall seem trivial later and the answers shall come easily.

Wouldn’t it be ironic if I suggest the use of GOOGLE to find out the ways you can achieve the calm state by the balance of the autonomic system?