Between thoughts and words

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 ...

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...

  “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. ...

  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 ...

  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...

  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...