I am myself because I am a doctor…

 Vijayaprasad Gopichandran, 18.06.2023

It was 12 noon, the clouds had closed on the sky, and it was dark, there was a gentle drizzle. The out-patient clinic was lean. The past few days had been oppressively hot and suddenly it was cloudy and pouring since morning. So, people had chosen to stay home. A man about 40 years of age, wet in the rain walked into our clinic. He was wearing a dark blue striped lungi, and a red shirt with the top 3 buttons open. His hair was unkempt and wet in the rain. There was a thick salt and pepper stubble. The look on his face was one mixed with anger, apathy, and irritation. Behind him stood a woman, much smaller than him in stature, with a grim look on her face and her eyes red, probably due to a lot of crying. His body language exuded reluctance as he walked slowly into the clinic and took the seat in front of me. 

 

“Please tell me sir, what brings you to the clinic,” I said in my usual kind demeanour. He gave a shocked look filled with irritation on me and looked away. He remained quiet. The lady who had come with him spoke gently, “Sir, he has high sugar. We have come for treatment.” The man immediately flashed a very angry look towards her and gestured at her with his hand to shut up. The lady immediately went quiet. The relationship dynamics were slowly unraveling itself. It seemed like the guy was not interested in coming to the clinic. It looked like the wife had forced him to come and meet me. A fight must have occurred at home before leaving for the clinic. 

 

“Do you have weakness or tiredness? Have you lost weight? What is the problem sir? What brought you to the clinic today?”, this was me in my politest manner. The man continued to glare at me. Very reluctantly, in a very low voice, looking away from me, not establishing any kind of eye contact he muttered, “sugar is high”. I started preparing myself for a rather difficult clinical encounter. I needed to understand what he had come to the clinic for. Did any symptoms bring him to me? Did he come because of an incidentally picked up laboratory abnormality? Had any complications of diabetes already started? I needed all this information to start appropriate treatment. I thought I will probe some more. 

“Sir, I understand your blood sugar is high. But before I can go into the laboratory test results, I need to understand what is happening in your body. Could you please answer my questions?” I tried to be very polite. He was almost ready to get up and dash out of the room. But just shifted in the chair and moved to the edge of the seat. Then looking completely away from me he moved an envelope, which probably contained the lab test report towards me. He just did not show any interest in talking to me. 

 

My next strategy was to talk to the wife. I looked up at her, as she stood behind his chair. “Tell me ma, what happened? Why have you brought your husband here?” The demure lady looked at me with an expression of helplessness. Her expression showed me that if she spoke anything she would be in trouble later at home. So I gave up the idea of getting any information from her. I have a strict policy that I would not look at any laboratory reports without first talking to the patient and examining them. I deviated from this policy and opened the lab report that he had thrust towards me. I saw that his fasting blood glucose was in the 200s and the post meal blood glucose level was in the 400s. As I was reading the report and copying the values down into his OP file, I could see from the corner of my eye that he did not even turn to my side. He was seated on the edge of the seat ready to leave at the earliest opportunity. 

 

“Your sugar values are indeed high. Is there anything you would like to say? Are you having any problems?” I tried one last time. 

“Give me medicines” those were the only words that came out of him. I had lost my patience. I just wrote out a prescription of diabetes medications on his case sheet and as soon as I put my pen down, the man snatched the sheet and got up and walked out. I asked the wife to sit down so that I can talk to her to get some information. As soon as the man stormed out the wife said, “I am so sorry doctor. My husband did not want to come. I literally dragged him here” and she left too. 

 

There could be several reasons for why this man was disinterested in the clinic visit. Being unhealthy, visiting the doctor, seeking health care and taking treatment are all considered ‘unmanly’. Listening to the wife, obeying her and being brought to the hospital by force by her all must have deeply hurt the ego of the typically chauvinistic man. Kindness, talking about what they are experiencing, maintaining eye contact while speaking, are all viewed as feminine traits. I practice all this with all the patients in the clinic. When I spoke kindly to him, it went against his notion of manliness. Kindness creates a major ripple in a human encounter. We have seen it time and again in our clinic. All of us who practice medicine in our clinic, have seen how a single kind word, and sometimes even a kind look can break barriers and open the flood gates. My kind words, my attempt to establish eye contact and reach out to him, must have disturbed him deeply. He was not ready to let go of his hard exterior and open up the soft inner child to me, that too in front of his wife. This is probably one of the reasons why he refused to open till the end. 

 

All of us men, who are in touch with our feminine side and don’t shy from showing kindness, love, compassion to others often face ostracization in our circles. In fact in some male dominated departments in the medical facilities like general surgery and orthopaedics, there is often an environment of toxic masculinity. This is extremely adverse to patients, hospital staff and the doctors themselves. Toxic masculinity prevents the free expression of emotions, and this makes the men suppress their emotions which festers inside them and leads to huge emotional stress. This lack of emotional intelligence hampers doctor-patient relationships. On the other hand, those of us who freely express our emotions, stand to be branded as ‘not manly enough’ in our circles. This man and many other such men have expressed extreme discomfort when I have expressed open and unrestricted kindness in my encounters. That is probably another reason for his apathy in the clinical encounter. 

 

While many men who are in touch with their feminine side face this branding and struggle to be themselves in the hyper-sexualized world, my profession gives me the freedom to be myself. Despite being this kind, compassionate, nourishing, talking, listening, empathizing, ‘not so manly’ man, I get to be liked, respected and honored in my profession. I have noticed that in situations where I am not a doctor, I have been dismissed, not included, bullied, made fun of several times for being ‘less manly’. But in my clinic, the man who would have otherwise lashed out curse words and mockery at my ‘kindness’ sat quietly, though not engaging with me actively, but still sitting there with repressed emotions out of a respect for my position as a doctor. I am always grateful to my parents for insisting that I should become a doctor, but today after this episode and this realization, I am even more grateful. I am myself because I am a doctor.