How an Agarwal family in Canada planned a big, fat Hindu wedding for their son and his groom

When Rishi Agarwal told his family he was gay, his parents shocked him with their reaction. They now help other families cope with their children coming out.

It wasn’t until he finished university that Rishi Agarwal found the courage to come out to his parents.

When he was in high school, he knew of a gay Sikh student who committed suicide after coming out to his parents. And though he was aware of his feelings from a young age, he came to realise that he couldn’t change when he was university.

“It was a tough time for me,” said Agarwal, 35, an accountant by training. “My parents were social butterflies, and in that time frame we were attending about 15 to 20 weddings in a year. I was very happy for my family friends. But it also struck home inside, the feeling that I am never going to have this – marry a person I love, and share that with my family and friends. It was hard to accept that was the reality.”

But on a plane ride back home from a work trip to Vancouver in 2004, he knew he had to reveal his true self. During his two-week stay there, he had met someone. “It was the first time I held someone’s hand in public,” said Agarwal. “Even though my parents had a large social circle of family and friends, it did not extend to Vancouver. So I was able to try something new. And that person gave me his heart, through poetry. He gave me a card. It touched me, but I threw it away in the garbage. I cried the entire way on the five-hour flight back. And in that moment I knew that no matter what other people feel, whatever the reaction of my parents, they have to know.”

Coming out

While Agarwal recounted his story at the family’s spacious home in Oakville, a suburb in the Greater Toronto Area, in Canada, his parents Vijay and Sushma Agarwal looked on. While the senior Agarwal carried a sheaf of papers for the meeting they had convened for the launch of a PFLAG (Parents and Friends of Lesbians and Gays) chapter aimed at South Asians, his wife kept an eye on the kitchen timer. The smell of samosas being warmed in the oven wafted over.

In many ways, Vijay and Sushma Agarwal are like your typical Indian uncle and aunty. During my visit, one of their main concerns was whether I was well fed and hydrated.

“You must have a samosa,” Sushma Agarwal insisted, while ladling dollops of bhelpuri on my plate.

“I don’t how this girl is not thirsty,” Vijay Agarwal kept on saying. “I’m talking so much and I am thirsty. Here, drink water.”

But their reaction to their son’s announcement was not your typical Indian uncle and aunty response.

When Agarwal told his mother that he had something important to tell her, she ran to the garage to fetch her husband.

“I thought Rishi was in big trouble, maybe he had gotten a girl pregnant or something,” she said. But she was devastated when Rishi made his announcement. “I was just sitting quietly, all these different thoughts coming to my head. How will he travel? He loves travelling. I didn’t know anything. I came from such a sheltered life.”

Vijay Agarwal, on the other hand, who describes himself as the person who “does the most of the talking in this house,” started asking his son a series of questions – Was he sure? Had he read any books on the matter? Was it just a phase, a fascination?

Agarwal, meanwhile, was on tenterhooks. After 90 minutes of interrogation from his “engineer father with a logical mind,” he wanted to know where he stood. Would he still be coming home for Sunday dinner, or not?

“I asked them if I was allowed back home, and my dad said, ‘This is always your home. Don’t even think otherwise.’ I felt like a ton of bricks had lifted off my shoulders,” said Agarwal.

For the next three days, his parents went into deep research mode. They went to the local library and borrowed everything they could find on the LGBTQ subject – from books to DVDs made by the National Film Board of Canada.

Sushma Agarwal talked frankly about her ignorance on the subject at the time. “I grew up in India at a time when girls were supposed to get educated only to find a good husband,” she said. “My life was school and back, we didn’t go out anywhere… When we were taking out the books from the library, I was thinking what this librarian must be thinking of us.”

Getting a second education

The Agarwals also started attending meetings of the Parents and Friends of Lesbians and Gays chapter in Toronto that took place once a month.

“At that time, we really needed the support,” said Vijay Agarwal. “Because the thoughts were coming, why us? What did we do wrong? When we went to the first meeting, we felt – thank God we are not alone. There are others like us. This means it’s not that unnatural.

He added: “We never missed that meeting. I was so impressed that we volunteered to be on the board for a year. And we formed our minds that when we have some time, we will do our part to help. This is so unfortunate for people who are born this way.”

Soon after Agarwal came out, his parents insisted he start dating. They wanted to fulfill their duties as Hindu parents, and see their son well settled with a life partner. When Agarwal met Daniel Langdon, and eventually proposed, his parents went about throwing a big fat Hindu wedding. This was in 2011.


“We had already decided that as far as we are concerned there will be no difference between our elder son’s wedding – with all pomp and show – and my younger son’s wedding,” said Vijay Agarwal. “We did all the Hindu ceremonies – mehndi, sangeet, wedding, the whole shebang.”

But convincing a priest was not a simple matter. The Agarwal family approached eight priests, who refused to conduct the ceremony. Frustrated, Vijay Agarwal called his brother, who was visiting India at the time.

“I said get some wedding books from Dehati Pustak Bhandar,” said Vijay Agarwal. “And that if no priest is available, I will do the damn wedding myself… Thank god we were able to find one priest who was willing to do it. It was a beautiful ceremony.”

With their parental duties fulfilled, the Agarwals are now taking action on the promise they had made to themselves. The retired couple recently launched a chapter of PFLAG that will be open to all, but will primarily focus on helping other South Asians whose loved ones come out to them. As it is, they have already been informally helping people in their social circle to come to terms with their queer identified children. The new chapter is scheduled to meet on the first Sunday of the month.

“When we used to attend the PFLAG meetings, there were so many conversations going, between people from all different backgrounds,” said Sushma. “One couple's son committed suicide on Father’s Day because his father would not accept him. And we realised that this is not something you can put under the rug and forget about.”

Added Vijay Agarwal: “There are many myths and misconceptions in our community. And my message is very simple. If you take time to understand the issue and gather the knowledge, not only the kids will be happy, you yourself will be happy.”

As far as Rishi Agarwal is concerned, his parents’ support for the LGBTQ cause has benefited him on a personal and public level.

“Over the last 12 years, many of my friends, who saw the way my parents handled the situation, started talking to their own families," he said. "They told me how their relationships have improved. And those friends have now become some of my closest friends."

He added: "In the broader community, this has also had an important impact on my life because I can be very proud of my parents. Already, I can see how much they have helped people, just by doing this launch.”

All images courtesy Channa Photography.

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What hospitals can do to drive entrepreneurship and enhance patient experience

Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.

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Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.

At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.

Getting the best from collaborations

Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”

Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the marketing team and not by the editorial staff.