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Emotional labour of community health work

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Every Tuesday I meet with the community health workers who are the face of our community health program in the rural area where we serve. They are an enthusiastic bunch of 10 people from the local villages, 8 women and 2 men. Hailing from modest backgrounds, they are workers with excellent people skills, cool conversationalists and go-getters who can accomplish tasks assigned to them with perfection. Every Tuesday when we meet, we start with greetings and the broad opening question, “How are you all today? How has the last week been?” Some days they are silent and take time to warm up and start talking, on most other days they just start talking about the activities of the week, the challenges they faced, the unique problems they solved and the doubts they have regarding their work. Our meeting room is the noisiest space in the office and sometimes we end up disturbing the work of others in the office. But, I think this dynamic and vibrant discussion space has been one crucial factor t...
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Self care

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Yesterday there were two women who came to the clinic. Both of them had chest pain which was disturbing them. They had diabetes and hypertension for a long time and were taking medicines for it. Both came alone to the clinic, and were in obvious distress. I did ECG for both. One, Mrs. S showed features of long term heart disease that remained unrecognized and unattended (which happens often with patients with diabetes as they do not have symptoms) and the other, Mrs. AK showed a heart disease condition that is recent in onset. Both these women were relatively young (in their 50s), and so prompt consultation with a cardiologist, coronary angiogram, and treatment would be the next steps in their care pathway. But there was no scope for all this in either of their lives.     Mrs. S lives alone as her spouse left her for another woman many years ago and she doesn’t have children. She has an older sister and brother, both of whom are unwell and cannot accompany her to the hospital ...
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Stormy adolescence

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      “I am having severe neck pain doctor. I have taken all home remedies that were suggested to me. But it is not going away,” said a demure young woman. She was the 68 th  patient of the day. The complicated and memorable patients always seem to come to the clinic towards the fag end. Is it a pattern? Or am I vividly remembering them because they came last? The brief interaction with her left a deep impact. I was thinking about her for a long-time last evening.    Mrs. L must be all of 24-25 years of age. She must be about 5 ft 4 inches tall, thin built, pitch-black hair well oiled, parted in the middle and worn as a plait. She also had a bright  kumkumam  dot on her forehead, it was not the typical dark maroon color that most women in the area wear. It was a light red to orange colour dot, commonly worn by women belonging to the Irula tribal community. We have a practice of routinely collecting information about caste in our clinic case record...
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Tribute to the kindest man I have seen

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I was not feeling very well yesterday. It has been this long-drawn cough, cold which had morphed itself into a sinusitis and headache. As soon as I wound up clinic around 1.30 PM, I decided to leave for home. My friend, a physiotherapist had come to clinic and whenever he comes, I hitch a pillion ride on his motorbike till Chengalpet from where I take the train home. But yesterday was not a routine day. Early in the morning, I got a call from the wife of one of my long-term patients and good friend. He had been fighting for life in a critical care unit with complications of chronic kidney disease for more than a week now. He passed away early yesterday morning. This was running in my mind throughout the day. I was conflicted between going to to their home and going home to get some rest. I decided I will go home. I got on to my friend’s motorbike and almost reached Chengalpet. Throughout the ride all I could think of was the man who had passed on and his family. So somewhere just befor...
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Whose story is it?

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He is a thin built middle aged man with balding hair. Whenever he comes to our clinic, he would stand in one corner quietly with his hands folded across his chest and head bent in what I assume is reverence. So far, I have never seen a smile on his face (except yesterday, read on..). I would classify him as quiet, but I never got the mental picture of calmness. Mr. S, is a tailor by profession and has his own tailoring shop in a village near our clinic. He stitches shirts, pants, and women’s dresses. I have heard from our community health worker who makes home visits to follow up on him that he also has some land in which he does agriculture, usually paddy crop two times a year.     Mr. S has type 2 diabetes which is very poorly controlled. I first saw him only a few months ago. He came one day to the clinic with a panic-stricken face and in hushed tone told me that he was coughing up blood since early that morning. After a series of tests and back and forth interactions with ...
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School teachers: the unsung heroes of our stories

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  The 49 th  Chennai Book Fair was a good event. The event was held between 8 th  and 21 st  of January 2026. I visited twice and could not finish seeing all the stalls. I heard of many people there who visited on all the days and still couldn’t complete seeing all the stalls. On the two days that I went, was the book fair overcrowded? I wouldn’t say so. The first time I went alone and spent 4 hours and the second time I went with a friend and spent around 2. Both days the crowd was not too much. Most of the stalls were empty and there were a lot of people cruising the aisle having not decided about entering into any particular stall. There were some with specific agenda, for example, there was a group of people with ochre robes, monks of some order, who were all crowding the spiritual and devotional literature stalls. As expected, the stalls that sold English books and novels had a lot of young crowds. My friend, with whom I had visited the second time knew exactly ...
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Hundred: One

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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 ...
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