Storytellers

The difficulty of being an adolescent in a poor rural household  Vijay Gopichandran This Sunday, I saw two young adolescents in my clinic. One was a 14-year-old girl and the other a 17-year-old boy. I realized how difficult it must be to be an adolescent in a typical poor rural setting in Tamil Nadu. They came to me for completely different reasons, but a lot was common between the two. I will describe the reason for which they came and present an analysis of some of the inferences I made for myself from seeing them. The young girl, Lakshmi (name changed), was accompanied by her father. That itself was very strange. When a young girl is brought to the clinic, it is usually the mother who comes along. Lakshmi was a beautiful girl, with beautiful big eyes, with a sparkle shining in them. She also had a very pleasant smile on her face with a small hint of shyness spreading all over it when I greeted her "Good morning". Lakshmi shyly lifted her right hand to the side of her...

It was a busy day in casualty and I was on duty. As I was seeing other patients, my colleague handed over me the notebook of a patient and said, “She needs a referral to the higher center because her creatinine is 4.1 mg/dl. Make it as soon as possible” As soon as I finished seeing other patients, I walked towards her to talk. She was 40 years old,  sitting over the bed with a huge smile on the face. She looked a little anxious and I was able to make out that she is visiting this hospital for the first time. I slowly checked her blood pressure and it was 230/140 mm Hg. It is highly unlikely for a 40-year-old female to have this blood pressure unless she has a long-standing kidney problem or an endocrine problem. Then I asked her, “What is your problem? Why did you come to OPD today?”. She replied, “I don’t have any problems doctor. Why did you place an injection in my hand (IV cannula)?. Leave me! I have to go home. I have a son to take care of”. I explained to her that she is hav...

Some things have happened over the past 3 days and they have taught me some very important lessons. I am writing about three wonderful people in my life. I am not going to identify them by their names. Their names and identities are not important. What is important is what I am writing about them. I am fairly sure they will read this at some point in time. They will know that I am writing about them. They may probably smile a bit. I think that little smile is worth it. The first person is very complex. We became friends only several years after we knew each other. Initially, the relationship was professional. But circumstances had it that we were put together in the same office space for more than 10 days, with very little else to do. We spent several hours in intense conversation. I learned that this person is a lot like me. The person is what one would call an introvert. The person is not shy but is not very popular either. Not very polite, but not disturbingly rude either. N...

Emotional sister, over bearing brother in law and a neglected brother: a triangular story.  Vijay Gopichandran Thirty-year-old Vignesh looked emaciated and sick. He had no fat or muscle anywhere in his body and was just skin and bones. He had a very sad look on his face as he walked up to where we were seeing the patients on Sunday. Right behind him were three people – his elder sister, her husband, and their 4-year-old daughter. I had seen Vignesh in the past, I could very vaguely recollect his face. If we take one look at him, it looked like he must have either tuberculosis (TB) or HIV, two conditions that can cause severe wasting in a person. The brother in law was the first person to talk. He said, “doctor, do you remember us? We came to see you almost 8 months ago. My brother in law here is very sick now. He has diabetes and has been off medicines for many months now. We found him like this in Chennai, at his home and brought him back here with us yesterday. Help us.” ...

The greatest lesson of life Vijay Gopichandran The clinic was closing up. Not many patients today. There was no electricity in the clinic today. Yesterday there had been a heavy downpour in the village and lightning had struck the nearby trees. This had led to a major power shutdown in the village. It was cloudy all day today and the interior of the clinic was dark, dusky and humid. So, we started seeing patients outside in the open. It was uncomfortable but manageable. So, as we started winding up the clinic around 2 PM and preparing to leave, an elderly lady limped to the open area where we were seeing patients. I was seated on a mat on the floor and was checking my mobile for messages. The signal was poor and so I was feeling a bit irritated. This lady limped in and sat in front of me on the mat. She was Mrs. Kalanjiyam. She is one of my regular patients. Kalanjiyam and I had a very comfortable equation. She calls me “nee”, “vaa”, “po” – all Tamil words which mean “you”, “...

The importance of saying “I don’t know” Vijay Gopichandran “I don’t know” are the most difficult three words to speak out for most people. These three words superficially mean the lack of knowledge on a subject. However, these words have a far deeper meaning embedded in them. To some people, “I don’t know” means declaring openly that they are vulnerable. As knowledge is power, the lack of it is vulnerability. By openly accepting that they are vulnerable, they are exposing their weakness to the person standing opposite. “I don’t know”, to some, means that they are incapable of knowing. To them, it means that they are accepting their inability to know something and their lack of competence. To certain others, “I don’t know” just means an open declaration that they do not care to know or that they are lazy and do not want to know. These embedded meanings behind “I don’t know” make them three of the most avoided words. This is very much true among medical doctors. Medical do...

It is bad to be taken advantage of... Vijay Gopichandran It is bad to be taken advantage of. But it is worse to be denied when there is a genuine need. When I was a post-graduate trainee, there used to be a system in the hospital where I worked, in which the doctors could write off the bills of needy patients. The hospital was extremely busy and very famous for its maternity services. So, women from far and beyond would queue up in the delivery room to have a safe delivery. The delivery charges were highly subsidized. Many women could not afford even the subsidized rates, and their husbands and families would seek help from the junior doctors to have their bills reduced or waived completely. The biggest dilemma faced by the junior doctor would be whether the woman’s family is telling the truth about their financial status or not. It was one such scenario, where the mother of a woman who had recently delivered in the hospital by an emergency cesarean section, had come to me as...

The fatigue of trying to be good Vijay Gopichandran As soon as I came home from work today, I sat near my mom and asked her, “When we were children did you always try to be your best self in front of us? How difficult was it to always be the perfect person?” My mother thought for a bit and then laughed. She said, “You are crazy. When we were parenting you, we never had time to think about all this.” But I don’t remember even one stray wrong action or a moment of weakness of my parents when I was growing up. I wondered how they managed such a façade of perfection. I must describe the basis for this question. I am a teacher. I teach in a medical school. There are many kinds of students in my college and I have unique relationships with some of them. There are so many varieties of them – hardworking, sincere, lazy, happy-go-lucky, serious, superficial, intense, arrogant, introverted, gregarious, reserved and all the other types that are there. I strongly believe in certain ...

When fragrance becomes a disease Vijay Gopichandran Imagine feeling sick every time you come across a good fragrance. When the powerful smell of freshly bloomed jasmine hits the nostrils, she felt sick and vomited. When the pleasant aroma of cashew nuts being fried in butter swifts down the kitchen, she felt like vomiting. Every good, strong smell made her sick. Mrs. Thangam is a 45 years old lady, who came to the clinic today complaining of an intense sick reaction with headache and vomiting whenever she smelt something strong. I knew of a cousin of mine who got bad headaches where room freshener was sprayed or when one of us wore body spray. All kinds of fragrant objects were banned in her house. But this is a condition she had right from her childhood. She was brought up with no strong fragrances in her home. Soaps were mild, shampoos were mild, there was even no agarbatti in their home during worship. But this patient was not like that. She had a recent onset exaggerat...

மாணவி ஸ்ருதியின் எண்ணத் தெளிவையும் , வார்த்தை வலிமையையும் , ஆங்கில மொழி ஆளுமையும் கண்டு வியந்து இந்த பதில் மடலை அவருக்கு வரைகிறேன். தற்போது வைரமுத்து அய்யா அவர்களின் கட்டுரைத் தொகுப்பான “தமிழாற்றுப்படை” என்னும் புத்தகத்தை நான் வாசித்துக்கொண்டிருக்கிறேன். அதன் தாக்கம் என்னை விட்டு அகலாததால் , தமிழில் எழுத கைகள் துடிக்கின்றன. எனவே , அவருக்கு தமிழிலேயே பதில் வரைகிறேன். ஸ்ருதி அவர்கள் , என் முந்தைய கட்டுரைக்கு மிகத் தெளிவாக பதில் அளித்திருந்தார். அதில் அவர் பட்டிமன்ற மரபைப் பற்றியும் , பட்டிமன்றத்தின் மாண்பைப் பற்றியும் தெள்ளத் தெளிவாக எடுத்து விளக்கியிருந்தார். உண்மை பகிர வேண்டுமானால் நான் இதுவரை எந்த பட்டிமன்றத்திலும் பேசியதில்லை. எந்த பட்டிமன்றப் போட்டியிலும் பேசி பரிசு பெற்றதில்லை. எனவே இவை அனைத்தும் எனக்கு மிகப் பெரிய படிப்பினையாகவே அமைகின்றன. இன்று காலை மாணவி எழுதியிருந்த கட்டுரையைப் படித்ததும் அவருக்கு வாழ்த்துக்கள் தெரிவித்து ஓர் குறுந்தகவலை அவருக்கு அனுப்பனேன். அதற்கு பதில் அளிக்கும்போது மாணவி , “என் கருத்துக்களுக்கு சம மதிப்பு கொடுத்து அவற்றை கேட்டதற்கு நன்றி” என்று பதி...