Between thoughts and words

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. ...