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Showing posts from November, 2019

Resilience in medicine

Resilience in medicine Vijay Gopichandran Resilience is the capacity of individuals to recover quickly from difficult situations. It is the measure of the ability of a person to pull themselves together after a fall and get up. Many patients are highly resilient. Some of them go through extreme hardships physically, psychologically and socially. Despite these hardships, they bounce back and operate optimally in their social spheres. Yesterday I saw a 70-year-old lady, a schoolteacher who came to me with complaints of extreme tiredness and fatigue. She also complained of a low-grade persistent feeling of fever that was troubling her for more than 4 months. As she walked into my clinic and sat in front of me, her positive energy and cheer instantly caught up to me. She was the personification of maternal care and love. She referred to me with words of endearment such as “Kanna”, “Raja”, Tamil words which are spoken to young boys by their mothers and other elder women, out of l

Lies, damned lies and history taking

Lies, damned lies and history taking Vijay Gopichandran Dr. Gregory House, the protagonist of the famous American television drama “House MD” played brilliantly by Hugh Laurie, says “I don’t ask why patients lie, I just assume they all do”. This typifies the personality of Dr. House, the brilliant diagnostician, who does not rely at all on the history narrated by the patients but believes in deploying uncharacteristic techniques like breaking into patients’ homes to understand their lives. Many times, it is true that patients do not tell the full truth or hide some information about their illness. There are many reasons why patients lie about their illness. In this blog, I will narrate an instance in which a patient lied to me for a long time. I will explain how this seriously impaired the quality of my treatment. I will also try and describe what this episode taught me about lies, damned lies, and history taking. Unlike Dr. House, I still believe in the art of history tak

When his blood group changed

When his blood group changed Vijay Gopichandran Mr. Moorthy was a cheerful young man with a very active social life. His family comprising of his wife and two sons were living a normal rural life in their village. Moorthy's father had been an agricultural laborer, but he worked hard to educate Moorthy till the 12th standard. After schooling, Moorthy had worked in several mechanic workshops in the nearby town repairing two-wheelers and cars. He had started his own mechanic shed recently and he was doing a good job with his own set of loyal clients. Moorthy was a happy man and had an excellent sense of humor. He would laugh and joke at every little opportunity. He would instantly bring life to every get together of friends. Being a socially conscious and active man, Moorthy regularly donated blood every three months. He has been donating blood from the time he was 28 years old. He is now 36 and counting at least 3 donations a year, he must have donated at least 24 times, thus s

Funny clinical encounters

Funny clinical encounters Vijay Gopichandran Sometimes clinical encounters are hilarious. I am writing about three such incidents in this blog. Mr. Murugan was an elderly man who used to visit the clinic regularly in the year 2010. He used to come every day demanding an injection for his breathing difficulty. He had a mild form of chronic obstructive lung disease, caused by years of heavy smoking. He would come to the clinic on ‘bad days’ when his breathing difficulty would be worse, and we would give him medications through a nebulizer (a device that delivers the drug directly to his lungs through a mask) and injections. Even on ‘not so bad’ days he would come and demand an injection. I would give him the benefit of the doubt and give him the injection on these days. But it is the third kind of visit that would really test the clinic staff’s and my patience. He would come there on ‘good days’ humming a song, reeking of freshly smoked beedi and casually demand an injection. A

Ignorance is bliss

Ignorance is bliss Vijay Gopichandran A few months ago, an elderly lady walked into our clinic. The only feature about her that indicated her age was her grey hair. She was petite, with taut skin and had a skip in her step as she walked into the clinic. She had wide innocent eyes, which looked like those of an innocent scared child. The innocence on her face was adorable and to match it she had a high-pitched voice with a child-like quality to it. She also spoke in a sing-a-song manner. She was wearing a yellow saree and had several strings of holy beads around her neck. She had holy ashes smeared on her forehead and all over her hands and a bright red vermillion dot on her forehead. Her petite form, high pitched sing-a-song voice, innocent look all indicated a young soul inside an old body. She looked endearing and lovable instantly. She had come to see me with complaints of a profuse white discharge from her private parts. As I elicited her history and reviewed her old reco

A woman’s choice

A woman’s choice Vijay Gopichandran I am not going to falsely claim that I even understand one-hundredth of the difficulties that a woman faces in our patriarchal world to work, to be noticed and sometimes to even exist. A few events happened last week and I saw a patient yesterday, all of which made me think about the choices that a woman has in this world. This essay may sound patronizing in some ways because it is a man writing about a woman’s choices. However, it is not intended in that tone. It is the expression of the helplessness of a few men who find it as hard to live and work in the toxically patriarchal world. I saw a movie last week which portrayed the herculean difficulties that women face in achieving a name in the game of football. The fact that it needed a toxic super-masculine male to ‘emancipate’ the vulnerable women itself speaks pages about the stereotypes that it perpetuates. The movie itself had several inconsistencies in the way it handled issues of