Bidirectional Compassion

 

Mr. D is a 70 year old gentleman from the nearby village. He has been visiting our clinic over the past three weeks. He has a corn on his left foot. The corn caused severe pain which restricted his mobility. He went to a local traditional healer, who took a blade to it and shaved off the upper layers of the corn. But it only worsened his pain, and he came to us for treatment. I have been doing the standard conservative treatment which includes changing to softer footwear, applying creams that will dissolve the hard tissue and pain killers. But the corn was adamant and the pain relief was marginal.

“The pain just doesn’t go away doctor. I am unable to place my foot on the ground early in the morning when I get up. I don’t know when this pain will go away” Mr. D was in severe distress yesterday morning when I saw him. 

 

Over the past three weeks I had gotten to know Mr. D a bit more than just his calloused foot. He lives alone in a small makeshift house made of tin sheets. For a roof he has an old flex banner that was bought from the village leader for 200 rupees, two years ago. It has started leaking during rains. But it is not rainy season yet and so those are matters for a different time. His wife died 6 years ago due to a massive heart attack. His only daughter lives far away with her husband and children. She visits once a month to bring him some money to manage monthly expenses. A famous charitable trust feeds the poor and needy in their village on all days other than Sundays. He goes to the centre around 11 in the morning, brings a plate full of whatever food they serve, usually sambar rice, tomato rice, tamarind rice or one such mixed rice varieties. He divides the meal into two portions, eats one at 12 noon and the other at 8 PM at night. On Sundays he goes to Church and eats there. The local Panchayat has employed him as a gardener who waters the plants in the Panchayat office. That job pays him  2000 rupees per month. He has not been able to walk to the Panchayat office for watering the plants or even to the charitable trust office to get his every day meal due to the severe foot pain. The nighbour’s grandson helps him get the food on some days, and the cook who works in the charitable trust brings home his food on others. But on a few days he goes without any food.

 

“This month my daughter did not come to meet me. She is not well. She called my neighbor by phone and told them that she will come next month. I hope she gets well soon”

 

When he said this, the meaning behind it was painfully evident. He would have to push through this month without any money at hand even for the medicines and other simple expenses. I noted this and marked in his prescription to waive all his bills. 

 

“Will the pain ever reduce doctor? Is there anything else you can do about this? I wish I can go to the Panchayat office for watering the plants again.” 

Long term pain shakes the morale of the sufferer. It makes the person lose confidence that there could be a life without pain. 

 

“Yes, the pain will go ayya. But it will take time. Problems in the feet usually take a long time to heal because the feet bear the weight of the whole body. We must give it some more time. Don’t worry, it will be alright soon.” 

 

As I was saying this, I felt extremely helpless. I knew very well that Mr. D wants the pain gone as soon as possible, so that he can get back to his routine. That routine would restore some of his dignity and independence. 

 

“Do you have your daughter’s phone number with you? Do you want to have a quick conversation with her on the phone?” I asked and offered to call her on my phone. 

Mr. D took out a small chit of paper from his trouser pocket and handed it over to me. I dialled it announced myself and handed the phone over to Mr. D. I got up and walked out of the clinic giving him privacy to talk to his daughter. He spoke to her for about 2 minutes. Then he called out to me, “Doctor, I have finished…” When I came in, I noticed that Mr. D was significantly more cheerful. 

 

“Ayya, I understand your situation. I really wish I can do something to make the pain go away immediately, but the body needs it’s time to heal and recover. But trust me, the pain will be gone soon. You will walk like before and you will be able to go to work.” 

 

Mr. D brought his palms together in a gesture of respect and had tears brimming in his eyes. He nodded and kept looking at me unable to say anything. He got up and balanced himself on his right foot. 

 

“Let this pain go away when it goes away. That is secondary. I wish and pray to Ezhumalaiyaan (The Lord of the seven hills) that you stay happy and healthy always” saying this Mr. D hesitantly lifted his right palm and placed it on my head. I bowed before him in a gesture of receiving his asirvatham (blessing). He then got up and limped away to get his medicines and leave. 

 

Mr. D’s touch was profoundly moving for me. My heart started racing, my body started shivering and I had tears in my eyes. My throat got choked up. I had an indescribable emotional experience. The pleasant warmth of that intense human connection between Mr. D and me kept washing over me wave after wave throughout the day in the clinic. 

 

Usually, the flow of compassion in the clinic is unidirectional. The clinical care providers, doctors, nurses and health professionals feel compassion, empathy and express it to patients. But with Mr. D the flow had inverted. Here was an elderly paternal figure who blessed the doctor and prayed for his wellbeing. The doctor becoming the recipient of compassion and kindness in the clinic setting is not frequent, and when it happens, it usually overwhelms us. For those few seconds, Mr. D had become the care giver, caring for me, praying for me and blessing me. These are the profound moments when the clinical detachment that is taught to doctors and health care providers get shattered to pieces. 

In recent times, I have started realising the power of narrative medicine. Learning who Mr. D is, connecting with him personally, understanding his unspoken feelings and sentiments established a human connection. Such intense human connections prove the point that medicine is not a transactional exercise, it is a relational process. Healing doesn't happen through prescriptions and surgeries alone, it happens through relationships and connections. I have written some such human stories in the course of my clinical work as a short story collection. It is titled "Hearing the Unspoken: Stories of health, illness and the human condition". It is available on Kindle, in this link. It is priced at Rs. 49 (Amazon forced me to keep a bare minimum price!) I am also happy to share a PDF if you are interested. Please comment on this blog or write to me at vijay.gopichandran@gmail.com for a PDF copy. It has Creative Commons licence. You can use it, modify it, distribute it for non-commercial purposes.