Between thoughts and words

  Mrs. K walked into the clinic with a broad smile. Today she had cropped hair that was oiled and parted in the middle held by a series of clips. Usually, she has long hair that is braided. She must have gone to a temple to fulfil a prayer to the God and had her head tonsured. The hair must have slowly grown back. Women in this part of the world, especially women Mrs. K’s age (mid 50s), do not cut their hair short for style. It is usually to honor a prayer. Also, the fact that the hair had grown this much told me that I hadn’t seen Mrs. K in more than 3-4 months. I smiled back at her and offered her a seat. As soon as she sat down, she handed her case record notebook to me. When I flipped the pages, I noticed that I had seen her 4 months ago. Along with the notebook she also slid an envelope. When I opened the envelope and pulled out the slip of paper in it, I noticed that it was a lab report from yesterday. Her fasting blood glucose level was more than 200 and post meal blood gluc...

  “Your medicines just don’t work. Are they really medicines, or are you just giving me some dummy pills? My shoulders, hips, knees, feet, everything aches. I don’t know why I keep coming here to see you repeatedly!” Every encounter with Mr. Kuppan (name changed) starts like this. Mr. Kuppan came to us 6 years ago with loss of sensations, numbness and pins and needle sensations over his hands, especially his fingers. Detailed evaluation led to a diagnosis of lepromatous leprosy. We referred him to Central Leprosy Training and Research Institute (CLTRI) in Chengalpet for evaluation and treatment. He completed 9 months of tablets, and it was extended further to complete a full year. Mr. Kuppan had a rather stormy course of treatment. He developed many side effects of the drugs. It took a lot of empathetic hand holding and comfort care to lead him through the treatment. We expected that completing the treatment for leprosy would feel like a great relief and freedom from an illness. Ho...

I am writing this blog after a long time. This hiatus is because of a mental health set-back. I am trying to recover and get back into a routine. I am grateful to some of my readers who remembered and asked me specifically why I haven’t been writing. Thank you for your trust and your patience.   When I used to be a teacher in a medical college, one of my favorite classes used to be an interactive narrative session on caste as a determinant of health. My work with RUWSEC, a Dalit women’s organization over the past 15 years has given me significant insights into caste as a major determinant of health, wellness, illness, and treatment seeking behavior. I used to share stories from the things I have seen and heard during my work in RUWSEC. I vividly remember one of the classes in late 2023. It was a class of first year medical students. I was talking to them about the story of how I was dressing the wound over the foot of a patient. The patient belonged to Dalit community and when I we...