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POLST, as told by Danny DeVito in the video which could have been a lot more awesome, is short for Portable Medical Orders (go figure the logic why it isn’t PMO or PortMO and so on). In essence, it’s a form that captures your wishes wrt how you would like to be taken care of when ill, and a summary of your most crucial medical history. It is of course for the seriously-ill or frail and not for anyone who jokes about illness. While in theUS, POLST has different names, I wonder what would it be called in India - DOST, YamDost (as in friends from Yamlok) or maybe a snazzy coined name if a startup would choose to pick this idea.. something like LastLeg or FinalWhistle!
So the concept is fairly simple, seriously-ill people fill up a form and tell medical folks how to care for them when the time comes and bunch of things they can or can not do. Like, don’t give me CPR, ever - not because I want to die but because I want to be awake and choose who does it. By the by, it is certainly possible for some terminally ill people in the US to have a legal “do not resuscitate” (DNR) order so that there is no attempt to bring them back if they’re on their way.
In India, things are not so structured as they are grey. We are a land of believers in miracles where people can rise like phoenixes, we would like to eternally hold on in body and spirt, our loved ones, until there’s something good on the telly or one has to go pub-hopping or choose your favourite vice.
What would folks fill in a POLST form if it were to be a thing in India? I Know what I would fill, though I hope I cut my chute long before that time comes. I would like to listen to Dylan and Hendrix and Metallica and Pink Floyd and Ghulam Ali and Begum Akhtar and everyone else between the 60s to 80s, I would love for my ashes to be sprinkled in the Himalayas, have a proper bath daily, alternate breakfast between continental and Indian, I would want my grand-kids if any, to spray-paint graffiti in the room they put me in and of-course, brew drip-coffee round the clock to fill the room with the fragrance. Now, there would certainly be some serious psycho-existential crap going on in the head which would be more amplified than ever and I would surely want them to juice me up to keep it all at bay and just play the song “the candy man” in My head, in psychedelic Eastman colour.
And then there’s the whole “will” thing that you could also add in the forms I guess - who do you leave what?. Now that might get tricky in India! I mean imagine a document of medical significance carrying everything material that belongs to the person in question. There would be all sorts of possible ways that people can attempt to alter the contents or re-create a replica with alterations, unless of course there’s a self-attested copy of Aadhar and PAN card attached with the documents then there’s no way they can be tampered with. I guess the best way would be to get all this notarised, self-attested with an affidavit because that is something nobody can mess with in India, right?
Or maybe go digital so that before you touch me to provide medical-aid, you must enter my Aadhar number into a system and get all details including my bucket-list and preferences which tell you how many needles you can prick me with in a day and whether or not you lace my I.V. with a beverage of choice, oh and a smoking room please.
Now the Prime Minister had recently launched the National Digital Health Mission from the Red Fort which entails the mammoth task of building the (no, not that!) health stack for the nation. Now if you look at an old draft which I did a while back, it is an atrociously ambitious plan for a country of our size and dynamics but hey, we got Aadhar in every nook and corner of the country didn’t we? Even in places we didn’t want I guess. All we need is an Indian company of repute to launch a nearly free medical insurance plan which asks for your Aadhar number and makes it mandatory to share all your medical history and if you’d want to fill a POLST form too. And voila! there you go, the digitisation and adoption is taken care of, far and wide.
You know what I say though? No, thank you, I’ll stick to the classic way of trial-and-error where-in the seasoned hands of doctors treat me like the next person who has no medical history in the cloud or a POLST form and land up on my feet, either side of the fence.