Posts

Big Failures and Small Satisfactions

-
Image
We diagnosed Mrs. R with breast cancer last year around the same time. We have been treating her for diabetes and hypertension for several years, but Mrs. R never once complained about a lump in her breast. We also failed to perform a routine clinical breast examination. Suddenly last year she hesitantly told me, “I don’t know how to say this to you. I am thinking of you like my own son and saying this. I have a small peanut sized swelling in my right breast. I don’t know how to handle this. Will you help me?” From here all subsequent events flowed in a frenzy from a detailed physical examination to referral to the tertiary care hospital, a diagnosis of advanced breast cancer stage IV, till radiation therapy to remove some tumor in the breast. Mrs. R was given a bad prognosis and was told that nothing much can be done about her cancer as it had spread to her lungs and all bones.     Through this entire ordeal Mrs. R and her 28 year old son S would regularly visit me and sit an...
Post a Comment
Read more

Injustice bites

-
Image
  “I thought God dealt me a raw deal with diabetes and high BP. Not just that. He constantly beats and pushes me down. I am the unluckiest person on earth” Mr. K lamented at the close of our clinical encounter. It was Mr. K’s first visit to our clinic. I see patients in the clinic on Mondays and Fridays and it was a Monday morning. There were not many patients waiting and so we had some time to talk. After obtaining clinical information from him, we were discussing about his life.     Mr. K recently retired as a clerk from the registrar’s office. He worked there for more than 25 years. Registrar’s offices are fertile grounds for corruption and bribe. “On an average day we would earn 14-15 lakh rupees in bribes for land registrations” Mr. K did not even bat an eyelid when he said this. This amount is way more than my annual income, and I struggled hard to keep my jaw from dropping.    “The sub-registrar would make all the collections and put them in a cloth bag. ...
Post a Comment
Read more

Periya (senior) Doctor

-
Image
  Mr. G is a resident of our village and rarely comes to our clinic for some minor ailments. He makes it clear to us that the only reason he comes to our clinic is because it is very close to his home. He takes treatment for his diabetes, hypertension and heart disease in a private hospital far away from our village. Whenever I try to ask him details of his other treatments he retorts, “Why do you want to know those details? My doctor is very good and he will take care of those problems. I came only for this cold. Just give me cold medicines.” We are a small community-based clinic and Mr. G is also a member of our community advisory board. I explained to him one time that it is important to know details of other treatments that patients are taking even if I am giving ‘just cold medicines’. But Mr. G did not want to share any details.    Last week Mr. G came with a dry cough, low grade fever, body aches and headache. This is a season for influenza like illness in our area ...
Post a Comment
Read more

Deepavali induced pressure on patients

-
Image
  Deepavali is a complicated time of the year. It is marked by overcrowded textile shops and shopping centers and the inordinate traffic jams on roads. People from all over Tamil Nadu try desperately to get buses and other transports to reach their hometowns to be with their family for the festival. When I was growing up, we used to carry boxes and baskets of sweets and savories and visit friends and relatives wearing our new clothes. An essential part of Deepavali would be elaborate discussions on the new sarees and dresses that were worn on that day. Today there are very few visits to friends and relatives, but these are replaced by photo ops which are shared on social media.    Deepavali has always been a commercial festival. As a child, I remember the social gradient in school, when all children would be allowed to wear and display their new clothes on the day after Deepavali. The dresses, the designs, the colors, the shine of the clothes would be so different for dif...
3 comments
Read more

Kindness

-
Image
  Being kind is often organic and effortless. However, when the kindness is taken for granted, misunderstood as weakness, or exploited for selfish gains, it takes immense efforts to continue being kind. In this blog I want to reflect on kindness and the challenges of being kind.    I had a conversation with a senior professor yesterday. She was very polite and courteous. But she was not kind. I was supposed to travel to her university to teach. But I did not get train ticket reservations. I am a very light sleeper with low back pain issues. So, I prefer to take a day train when traveling because it helps me get a night’s rest after the travel so that I can be ready for the teaching session the next morning. But all trains were fully booked and so I did not get a proper train reservation. I was explaining this to the professor. But she kept insisting that I travel somehow. She suggested that I should travel by night train or I should take a bus. She kept missing the issues...
Post a Comment
Read more

Impact on the world

-
Image
Jane Goodall, the primatologist, conservationist and educator who died on 01 October 2025, said, “You cannot get through a single day without having an impact on the world around you... What you do makes a difference, and you have to decide what kind of difference you want to make,” I heard her say these words today in a Netflix documentary titled “Famous Last Words”. It is the last interview given by her and released posthumously, as the Famous last words from her to the world. She lived her life by these words and what a great play of destiny that I had to hear these words today.     I was feeling extremely low and sorry for myself in certain ways since afternoon. I had a class to teach this afternoon. The audience were post graduate residents of various medical colleges attending a research methods course. I had to teach two topics very interesting to me, ‘biases in research’ and ‘qualitative research’. I went well prepared and I think I delivered two well-rehearsed lecture...
2 comments
Read more

Efficient Time Management

-
Image
Unique issues arise when we run outpatient clinics on Sundays. Usually Sundays are holidays for most working people, and they prefer to come to see the doctor. Working sons and daughters also find it convenient to accompany their elderly parents to the clinic. Public transport is relatively free in rural areas on Sundays. Those who work for weekly wages receive it on Saturday and they have dispensable money in hand to bring to the clinic. However, Sundays are also the only day of the week when working people catch up with personal household chores like washing clothes, cleaning the house etc., the day of the most elaborate meat-based meal in the afternoon and the day to catch up on an afternoon siesta or television, friends or family time. So having come to the clinic, everyone wants to leave as soon as possible to catch up with all this. So, Sunday clinics are a recipe for crowds, impatient and irritable.     Yesterday was no exception! When I entered the clinic at 8.40 AM, t...
Post a Comment
Read more