Between thoughts and words

Some patients give me some of the most unexpected and unique perspectives about my clinical work. Yesterday was a very busy clinic. It was 2 PM and no major drama had happened till then. Mrs. O walked in with her granddaughter. She walked slowly with a mild stoop in her posture, but there was a graceful poise in her demeanour. A gentle smile that was somewhere between a smile of familiarity and a smile of meeting a new person was adorning her face.     “I have a troublesome itch all over my body. I am unable to sleep at night because of this” she said and looked at me with anticipation.    She was a woman of a few words. Many of my patients like talking. They express their symptoms with animated words and exclamations. They throw in a lot of onomatopoeic words like “jilu jilu”, “misu misu”, “jivvu…” etc. Some of them narrate their problems round and round in a loop. They would start with a main complaint, describe it in detail, skip to the next complaint and then to ...

  I have been thinking about futility of debates and arguments. Recently I was engaged in a debate. It is still ongoing. I will explain the details of the debate first and then write my thoughts on futility of arguments.   In early November I attended an ethics committee meeting. (I am a member in the committee) We reviewed research proposals to decide whether the proposals describe the ethical conduct of research. Specifically, we had to look after the best interest of the research participants in these studies. We had to ensure that they are not being exploited, no harm is being done to them, their rights and safety is protected.  If there are any issues that we identify then we provide our recommendations to the researchers to modify their research in the best interest of the people who will participate in the study.    It was an online meeting of 3 hours. I attended the meeting from home. One of the studies that was proposed was a public health program....

  Mr. V had not come to the clinic in a while. He was otherwise a regular fortnightly visitor. An octogenarian, with a hearty and reverberating laughter, he always brings with him the sunshine when he enters the clinic. The white hair, thick white moustache and the wrinkles on the skin on his hands are the only signs that this man is aging, otherwise he is a young lad of 18. He comes to our clinic to get his prescription refill for diabetes, hypertension and a chronic skin condition. Yesterday even before he came in, one of our staff, Mr. V’s daughter in law, dropped by my room to say, “Sir, my father-in-law has come. He recently had a heart attack and was admitted in the hospital. He got discharged day before yesterday and insisted that he will come to see you today. Shall I bring him in?” I requested her to bring him in and stood up to receive him.     As Mr. V walked into the room, I noticed that the usual skip in his step was missing. He was wearing a monkey-cap and h...

  Yesterday, I saw a middle-aged woman, in the clinic. She was breathing heavily with a lot of difficulty even as she entered my room. As she came and sat down in the chair in front of me, she looked me in the eye and could not start talking for some time due to the breathlessness. Her main problem has been worsening breathlessness that has now prevented her from even taking small steps inside her own home. She is a person living with diabetes and high blood pressure since 10 years and has been on regular medications. She developed a heart attack 4 years ago for which she was admitted in the government general hospital and treated. She is taking medicines for that too. This breathlessness started last year, and it has progressively worsened over the year.   “I am tired of this breathlessness. I cannot deal with this anymore” she said, broke down and took out a big bunch of thick folders, notebooks and loose sheets of paper and dropped them all on the table.    One of...

  “If you cannot prevent yourself from getting sick, then what does it mean for all of us?” This is one of the most difficult and often annoying questions I face in the clinic on days when I am unwell. I have been down with a viral upper respiratory infection since the past 4 days that is typical of this time of the year. It comes with a running nose, cough, clogged-up sinuses and a thick heavy nasal twang in the voice and some hoarseness. Sometimes my face also gets bloated with all the congestion that goes on inside it. My nose, throat and sinus anatomy is such a way that it leaves very little for the imagination when I am down with a cold. Every time I run the clinic with such a cold, I have patients expressing all kinds of emotions to me.  1.          Sympathy – By far, this is the commonest emotion that my cold evokes. People feel bad for me and suggest that I soothe my throat with some warm water. They give me well-meaning home rem...

Two patients over the span of three months made me understand intersectionality like never before. Intersectionality is a way of understanding the world where people are seen as having multiple overlapping identities and seeing each of these separately gives an incomplete picture. For example, gender, caste, socioeconomic status are intersecting identities that people live with. Therefore while trying to understand gender based violence, looking at gender as an isolated identity would do injustice to understanding the phenomenon, as gender intersects with caste and class to complicate gender based violence. Dalit women living in poverty experience gender based violence of a worse order than upper class dominant caste women. A poor Dalit woman’s experience of gender based violence is not just the sum of Poverty + Caste + Gender, but there are interacting effects that she experiences that are beyond the sum total of these effects. Though I had a theoretical grasp of this through reading ...