love for blood meant hatred for life !

When for the first time 20 year old Shahid had a non stop bleeding from a nose injury while playing football , 22 years ago, he never thought  that his life will fall apart in the real sense. He kept bleeding continuously , being referred from hospital to hospital  .It took really months before hemophilia was finally diagnosed. It was a great shock for him and his family, as they had no idea of it before. He himself a student of genetics was " counselled" in the most negative way . He was advised against marriage and told that he risks dying any moment and should not do injustice to any girl by knowingly  leaving her a widow. On those lines , he purposefully broke her sweet hearts heart so that she is married to someone else ..and chose to remain single as an extended member of his brothers family. He was disturbed and could not pursue the research career of his choice .From his history it was pretty obvious to me that he has only mild hemophilia risking bleeding only from trauma.For the next 22 years in fact he never had a serious bleeding problem But the fear of bleeding was so much in the mind of doctors that he was unnecessarily troubled for simple things. Once when visited a dentist for a simple toothache , he refused to touch him till he got his factor VIII levels done !And it would be days  before he could get it done.In short he was totally fed up with life, depressed and spent the next 22 years simply brooding over the injustice life had done to him, while actually never suffering another bleeding episode again..!

Tear Gas !

This is something which one may try to hide but just can't  ! And sometimes may actually be troublesome, a person may be on the verge of  losing his job or a partner due to this problem! .. Very reluctantly at times they do come to us  for a solution. That's the problem of flatulence (in public ).The descriptions are often too hilarious  as the victim tries his/ her best to give a clear picture. One old gentleman complained about farting like a machine -gun, which reduced him  to a subject of ridicule in his family especially grand children. Another young guy was always thrown out of his workplace whenever he released those .The most descriptive one was given by a poor husband who said his wife has the ability to disturb a crowd of 150 people with a single dose !!.Imagine his plight ...

If only i did so....

When I first met Gautam, he had come with a bloated abdomen due to ascites(fluid) resulting from his alcoholic liver disease.He was discharged from medical college hospital and was unsure of what to do.
After thorough examination and reviewing his reports,I knew that he was not in a good shape. I explained his condition and  advised him abstinence from alcohol, regular intake of medications and periodic follow up. He was fully compliant  and within a few months  he was able to return to work . In between there were periods of flare up, which were taken care of.I knew it was his faith in me that was working for him. Once he offered me peanuts from his fields,as a token of appreciation. Well its unethical to accept any gift from a patient, but I didn't want to break his heart.There was a day when he was brought by his relatives in a comatose state. I had to explain that this particular complication  needed hospitalization , and I have to refer him to a facility. They were reluctant . The said "whatever happens we fully trust you. If he has to live let it be in your hands; if he has to die let it be at your feet, but we will not take him anywhere else " .These are the tough decisions we have to face. With no other option, I prescribed medicines and the way to administer them at home. He returned in  a few days  totally recovered , a big relief for them and myself too. But I knew such situations will recur many times.Once again he returned with an offering of home made puffed rice. I did accept it that time also.He was regular in his follow up, though he had to travel a lot to visit me. When for the third time he offered me some edible stuff  grown in his field, I declined,siting that it is not a good example for me as it may disturb the other patients.I checked him up as usual  and gave his prescription. After he left , I felt a little bad for breaking his heart. I wanted to explain him properly that I fully appreciate his love and accept that too, but accepting gifts repeatedly is not a good behavior for a doctor. He must not feel bad for that.I waited for his return to convey that feeling. He did return after a few weeks, a little sicker than usual. I had to concentrate more on his physical condition , gave an injection and asked his wife to wait for a while, so that i  can review him again before sending him home. When I called for him after  awhile, I was told that  a relative came and took him away as he was feeling better and thought that the consultation was over !
A few weeks passed, meanwhile I  had taken a break for few days during Durga puja .Many months later his wife returned in a  widow's attire. She said "during the Puja holidays he became very sick.You were also not there. We had to take him to the hospital.But he passed away."

Though I knew this would have occurred  sooner or later, still somewhere I had an incomplete feeling. I had to say something to him, convey him something, and didn't get a chance.I waited for too long.

I had this to say, if only I ...
Why did I wait for you to die !


   

Rituals

UnBeerAble

Rafik approaced with hot flushes after drinking beer. He never had these reactions before.I checked him up, except for mild  raised heartbeat, he seemed okay. I gave him  medicines  and  asked him to return if it recurred. He did return after about six months, and not alone. In fact his wife came before him for her own complaints.At this point I was not aware of her identity .After I was done with her she informed me that her "alcoholic husband" will follow, and that she had been  secretly  giving  him some herbal  preparations to give up alcohol. So she requested me to stress  upon him the need to give up the bottle altogether. I sort of angrily adviced her that  what she is doing is not the right method. The fellow must be counselled about alcohol intake and  must give it up voluntarily . This kind of secret treatment may  be risky.Then came  Rafik. And I understood the reason behind those "reactions". He was grinning and felt guilty about drinking beer. He said since he had the last drink 6 months before  he didn't touch it, but few days back a friend offered  , and he took.And got those hot flushes  again.He kept saying ," I drink only beer once in a while, but if that too is not suiting  me I think its better to  give that  up". I gave up my thoughts of detailed counselling and informing the wife that once in a while beer is not going to harm him at all.I rather did not want to disturb  the silent truce among them, whichever way they achieved it. If beer has become unbearable to her, let it remain "unbeerable" to him too.  All's well that ends Well !!

The most important lesson I learnt..

During one of my the peripheral postings of internship, i had to report to local leprosy control center, which was located in a retired police officer's house. I was dot in time,the office was still closed. The octogenarian police officer welcomed me and offered a seat. His equally old domestic hep was moving around . I noticed he had varicose veins and edematous legs. The officer wanted to know how the varicose veins can be treated.I was fresh with my recently acquired knowledge started blurting out all the surgeries that be done for it.The old officer simply laughed and said "see for him the treatment is to tell him that he has to learn to live with it"..And after so many years i still hold it close to my heart that it was the greatest lesson I learnt in my entire medical career.Many a times that is the only valuable treatment people need, which we ourselves should understand and help them understand that they have to learn to live with whatever ailments they suffer from..