The power of kindness

"Sister, could you please hand me the Normal Saline solution?" I called out to the staff nurse on duty. I was dressing the foot ulcer of Mr. R. He had gone to work on his groundnut fields last week, barefoot. A stray thorn had pricked the left foot. What started as a small blister the next day had developed into a deep ulcer. Fortunately, it was not infected. I was cleaning it up and applying a clean saline dressing. 

"Doctor, I need some urgent change. Do you happen to have 20 rupees on you?", the nurse asked. 

"I have exactly 20 rupees in my shirt pocket. However, that is all the money I have now. You have to give it back to me by evening, otherwise I will not have cash to pay for my bus ticket." I said and continued, "take it out from my pocket yourself" and I bent down so that she could reach into my pocket and take the cash, as I was wearing gloves and did not want to dirty my shirt pocket. 

Mr. R and I go a long way. He came to me seven years ago with severe pain in the ankle joints. At that time, when I had done some routine laboratory tests, I had identified gout, a condition where there is accumulation of uric acid in the blood. This uric acid collects in the joints and causes swelling and pain of the joints. Since then he has been on regular treatment for gout. Before coming to me, Mr. R had self medicated extensively with a tablet called Diclofenac. It is a very potent painkiller medicine. However on excessive indiscriminate use, the tablet can cause kidney failure. The incidence of kidney failure induced by Diclofenac is not uncommon. Some research reports mention that about 15% of all drug-induced kidney failure is due to Diclofenac. It was a very challenging process to wean him off Diclofenac and at the same time maintain effective pain reducing effect with alternative medicines. Currently Mr. R is under regular follow up for his kidney failure. He still has some kidney function left and so we are doing all that we can to protect the remaining kidney function. 

"You should take it easy for the next week or so. Do not go back to the fields barefoot. Your son can take care of the fields for the next week. I insist that you should give it some rest. Otherwise the ulcer may not heal." I warned Mr. R. He thanked me and walked to the pharmacy counter to get the medicines that I had prescribed for his wound. The pharmacy is just adjacent to the room where I was sitting and I could hear the conversation. 

"Will you buy all the medicines?" the pharmacist asked. 

"No, please give me just for 2 days. I don't have money now. I will come back tomorrow and get the rest of the tablets." 

I know from past experience that the 'tomorrow' never comes. One of the commonest reasons for why people like Mr. R, who belong to rural agrarian backgrounds, have poor compliance to medications is that they are unable to ration money for medications over other competing priorities like food, wages for labourers in their farms and other household expenses. So I quietly texted the pharmacist to waive off the charges on his pharmacy bill, which I would pay later. If I had made a scene of this by going to the pharmacy and asking the pharmacist to give the medicines 'free of cost', Mr. R would have definitely been offended by it because he is a man of great self-respect. 

"Please take the tablets for the full 7 days. You can pay us when you come back next week for review. I will make a note" said the pharmacist to Mr. R. 

The clinic went on and I started to leave by the scheduled public bus that goes past the clinic. If I miss that bus, the next one is scheduled only after one hour. In a hurry I packed my bag and rushed to the bus stop and just as I was walking to the stop, the bus arrived. As I got in, I noticed that Mr. R was also taking the same bus. We nodded at each other. I got a seat by the window two rows behind the driver. Mr. R was sitting about two rows behind me on the aisle seat in the opposite side of the bus. As the bus started moving, the bus conductor came to my seat and put out his hand indicating that I had to purchase my ticket. It was just at that moment that I realized that I had no cash with me. I had forgotten to take the money that I had lent the nurse while coming out of the clinic in a rush. It was an extremely embarrassing moment for me. There is another conductor in the route who is a good friend of mine. If it had been him, he would have understood and i could have told him that I will pay him tomorrow. But this was a new guy. He was staring at me and waiting. I opened my bag and swept my hand through all the pockets looking for some stray coins or change. Nothing was there. My heart was beating fast. I just looked up to apologise and say that I don't have money. 

Exactly at that moment, Mr. R walked up and called the conductor, "Here, take this money. I am buying the ticket for both of us. How can you ask our Sir for ticket? Do you know who he is? Come here...take the cash and give the ticket." The conductor turned to him and gave him the tickets and collected the cash. Mr. R nodded at me again and thrust my ticket in my hand. I was speechless. He had just saved me from a very embarrassing moment. Before I could say anything he walked back to his seat, sat down and started looking out to the other side. A sense of immense gratitude and happiness was overflowing in my mind and body. In a few minutes, Mr. R's stop came. He got up and walked to my seat. I turned and looked up at him. He held out his hand. I held out mine. He grabbed my hand and said good bye and walked away. As he was walking away, I noticed that he had thrust a 100 rupee note in my hand while he had grabbed it. It was buffer cash that he gave me to cover the rest of my travel home. My eyes teared up with emotion. As he got down from the bus, he looked up at me. I was trying to gesture my gratitude to him, he just nodded as though nothing had happened and walked away. 

One week later, Mrs. R, his wife, came to see me for her asthma. The moment she walked in, the pleasant memories of the beautiful gesture by Mr. R flooded through my mind. After our clinic encounter was over Mrs. R got up to leave. She said, "He told me about how you arranged for him to get all the medicines free of cost. I have brought the money for it and I insist that I will pay today." I gestured her to sit down. "Amma, you have no idea what a great man Mr. R is. He saved me from a very embarrassing situation. That day I did not have cash on me for the bus ticket...." She interrupted me even as I was saying it. "You must not say these things. It is not a great thing. We know you and we would do it for you any day." I sat there speechless, looking at her and thinking of Mr. R with admiration and respect.