Between thoughts and words

A thin built 20 something young man walked into the clinic as I was winding up for the day. The staff nurse who was at the registration desk had closed shop for the day and was getting ready to leave for lunch. I was packing my bag and watching from my table as he gave her a broad smile. He was a charming young man, not the striking looks of a movie star, but a very cheerful and charming countenance. I couldn’t hear their conversation, but somehow, he convinced her to register him as the last patient for the day, way beyond registration time. I have never seen the nurse give such lenience for anyone. If he could charm her into registering him, this boy must really know what he is doing! He walked into my room with a skip in his step. He gave me a polite smile and entered and sat down in front of me. He was wearing a dark blue full sleeve round neck T shirt which was loose fitting for him. He had a washed grey jean on. It was evident that he was not someone who dressed for comfort, but ...

  When two contrasting worlds collide, it leads to a lot of confusion. Mr. V is a 65 year old man with type 2 diabetes for more than 10 years. He belongs to a village located about 10 km from our clinic. He is a highly religious man with orthodox values and beliefs. He strongly believes in astrology and vouches by the fact that all humans are governed by their respective planetary alignments. “Doctor, what is your  raasi ? What is your  lagnam ?” he asked me a few years ago. In astrology  raasi  refer to the zodiac sign in which the moon was positioned at the time of one’s birth and  lagnam  is the rising sign which is the zodiac sign that was rising in the eastern horizon at the time of one’s birth. In astrology it is believed that  raasi  represents the inner mind and personality traits that govern the self, and  lagnam  represents the way a person interacts with the external world. An astrologer uses a person’s  raasi  ...

“No doctor, I am sure there is something in there. Please cut it open and check.” Mr. R kept insisting that there was some foreign object under the skin over his right elbow. A 32 year young man working in a local small scale factory in the village, Mr. R was in the clinic for the fourth time. He came for the first time almost a month ago. While returning from playing a cricket match one Sunday afternoon his motorbike had skid and he had fallen on the road. There was a deep laceration over his right elbow. He had gone to a local clinic near where he had fallen. They had cleaned up the wound and sutured it up. This had happened almost 15 days prior to his first visit to our clinic. He came with complaints of a vague pain over the elbow and watery discharge from the wound. When I examined the wound, it looked healthy. The sutures had been removed, and the wound had healed nicely. There was no redness, swelling or discharge from the wound.   “There is no problem with the wound Mr. R. ...

  கோயில்களுக்கு கூட்டம் அதிகம் இல்லாத நா ட்களில் ,  கூட்டம் அதிகம் வராத அதிகாலை நேரத்தில் போவதையே நான் விரும்புகிறேன். அப்படிப்பட்ட நேரங்களில் கடவுளுடன் தனிமையாக பேச்சுவார்த்தை நடத்தும் உணர்வு கிடைக்கிறது. கோயிலுக்கு நான் பெரும்பாலும் காலை எட்டு மணிக்கு முன்னரே சென்றுவிடுவது வழக்கம். அப்படிச் செல்லும்போது பல நேரங்களில் இறைவனும் நானும் மட்டுமே நின்று பேசும் உணர்வு எனக்குக் கிடைத்துள்ளது. ஞாயிற்றுக் கிழமை அன்று திருமீயச்சூர் லலிதாம்பிகை உடனுறை மேகநாத ஸ்வாமி திருக்கோயிலுக்குச் செல்லும் வாய்ப்பு கிடைத்தது. ஞாயிறு விடுமுறை நாள். அதுமட்டுமல்லாமல் அன்று இராம நவமி நன்னாள். நாங்கள் கோயிலைச் சென்றடையும் நேரம் காலை பத்து மணிக்கு மேல் ஆகிவிட்டது. கூட்டம் அதிகம் இருக்கப்போகிறது என்று நினைத்து பயந்து கொண்டே தான் சென்றோம். வழக்காமாக கூட்டம் இருக்கிறது என்பதை வண்டிகள் நிறுத்தும் இடத்தில் எத்தனை கார்கள் ,  வேன்கள் ,  பேருந்துகள் நிற்கின்றன என்பதை வைத்தே கணித்துக்கொள்ளலாம். அன்று அவ்வளவு கூட்டம் இல்லை போலும். எல்லா இடமும் காலியாகத் தான் இருந்தது. இதைக் கண்டவுடனேயே மனதில் சிறிய உற்சாகம...

I started seeing Mr. N recently in the clinic. A 70+ year old gentleman with a thick dash of milky white hair on his head, and a glowing smile, Mr. N’s face was marked with numerous thick, deep lines that indicated his age. When people have difficulty in hearing, initially they talk too loudly so that they can hear their own voice, and with time they lose even this little hearing and their voice fades away. Sometimes they don’t even complete words and sentences. Mr. N was in the latter phase. He spoke so softly, that it took a lot of effort to understand what he says.   “I have this mild breathing…….” That would be his sentence. He would have said “breathing difficulty” but the words would have faded away.    When I meet Mr. N, I sharpen my visual observations and keenly watch out for his lip movements. Mostly the end of his words and sentences are just lip movements without any sounds. It took us several visits to develop a kind of comfort in communication. The initial f...

  Having good communication skills may not be enough for effective patient-physician relationships. Sometimes the situation may be unfavorable for the patient, that however hard we try to make the encounter pleasant, we end up failing and it becomes a bitter experience for both the patient and the physician. This happened to me a week ago and it took me quite some time to process the episode and gather my thoughts to write about it.    Mr. K was a lean, tall, balding, middle-aged man from a town about 20 Km away from the clinic. He walked in with a pleasant smile. Right behind him came his wife and she had in her arms their 2 year old daughter. The baby was crying and his wife was standing with the baby in her arms, trying to comfort and quieten the child.  “Do you want to take the baby out and calm her down? It is quite crowded in here and also not a friendly environment for a child.” I suggested.  “No doctor, I want to be around. Ignore us. She will be quiet. ...

Yesterday’s clinic was quite eventful. Early in the day, there was a huge crowd waiting outside the consultation room and people were agitated and were fighting with the staff in the reception counter.  “How much longer should we wait?”  “Why is one patient in there for so long?” “We are waiting for so long. We can’t wait anymore” All these phrases could be heard being hurled around at the staff. A few patients even walked out angry. The reason for all this was a 45 year old man, with whom I had to spend more than half an hour.    Mr. M entered the consultation room with a stooped posture. He was wearing a white shirt and white dhoti. He had a dark blue towel around his neck. There was a bright sandal paste on his forehead and thick salt and pepper beard and moustache. There were Tulasi beads around his neck. He had taken holy vows to practice austerity for 48 days and then visit the Sabarimala temple.    This was his second visit to the clinic. I had seen ...