Work was perhaps my greatest distraction from the unrest I felt within. Work was like a paid vacation. We didn’t have a lot of inpatients; but the outpatient clinic was fairly busy.
I still remember the early days when patients would hesitate to come to me, for I looked too young and inexperienced to understand life or disease, and too urban for their taste. I always sensed their hesitation when they stepped in.
It used to make me anxious as well, but the most important lesson I learnt in this period was that the language of suffering is the same all over the world.
I hadn’t seen a lot of life, but being way too sensitive, I would always be drawn to suffering. I was very receptive to stories of suffering, and I was very keen on understanding how different people perceived and processed suffering. My patients sensed this and it melted all their defense. I loved this magical transformation in their attitude- they always left with an attitude different from what they had stepped in with.
I was wonder struck by the lives my patients lived. The luxury of time enabled me to see them as suffering human beings, and not merely as ‘cases’. I learnt that illness had to always be seen against the backdrop that was unique to each patient, for their circumstances were different and their personalities were different. I learnt that providing insight to the patient about his illness made a lot of difference to his perception of the illness and to his compliance with treatment. My only regret is that I never wrote down the infinite stories they treated me to.
A few faces are vivid in memory…
There was Ibrahim, a middle-aged man who was so lean that I couldn’t imagine him as a daily wage labourer. He had diabetes, and he sought treatment for the intractable pain in his legs, a complication of his chronic diabetes. The burden of a big family rested on the shoulders of his frail being, and the treatment expenses and the progression of his illness had begun to come in the way of his role as provider to his family. I would sometimes probe into his earnings and expenses, and wonder how he could manage this smile that accompanied his answers when in reality, his life was hanging on the edge. He was irregular with his treatment on account of the financial burden it posed, but sleepless nights of intractable pain would bring him back. I started saving drug samples for him.
I loved to see the relief they brought on his face…
There was Fathima, a middle-aged woman who suffered from asthma. She used to come all the way from a very remote village by the Ghats, for a solution to her asthma that limited her daily chores. Her daily chores involved walking miles uphill to gather firewood. She talked matter-of-factly about the unimaginable struggles of her day-to-day life; all she wanted was to be rid of her wheeze.
I remember young Arthi, who presented with anxiety and sleeplessness. Her mother listened helplessly as she described the episodes of abuse that were an integral part of her life with her husband and mother-in-law. She had once attempted suicide. I could feel the pain of a mother who watched in mute silence her daughter’s agony and suffering, wishing she could take up all the suffering.
I remember Sri Devi, the farmhand who was relieved of her rheumatic pain and could get back to work. For me, it had been a simple affair for she responded to the most basic treatment. But in her mind, it was a miraculous phenomenon that made her eternally grateful to me.
I remember the two kids who came up to me with sweets, announcing the arrival of a baby brother. Their father followed them, and I vaguely remembered his face. Nine months back, his wife had presented with severe dizziness, and I remember her crestfallen face when the pregnancy test came positive. She hadn’t been prepared for that, and it had taken her quite some time to come to terms with it.
I remember the old lady who got all her neighbours to visit me. I was amused that they had no ailments, but they had wanted to meet me out of curiosity.
There were unpleasant episodes too, but the warmth and resilience of these suffering souls obliterated the taste of those thankless encounters. I found these suffering souls attractive, for it gave them character. I was suddenly in love with my profession for it provided me access to the inner lives of these inspiring souls. For the first time, i felt a deep sense of contribution. The doctor-patient relationship acquired a new significance in this rural setting. It was very much a relationship, centered on a lot of teamwork. It meant sitting down together, building and defining realistic goals, and defining the path that would lead to those goals. It meant working on the mind as much as working on the illness. It meant constantly motivating, and keeping alive in their minds the promise of a better world, a world with a little less suffering than what they endured now. It was sometimes very difficult because the adversity of circumstances they endured had no immediate remedy. One could not make hollow promises, for my patients were wise from life. It was very hard to be realistic, and yet offer them hope. For the first time, I was consumed by the desire to ‘know’ so that I could use that knowledge to make a difference in the lives of these people, who asked so little of life.
That was perhaps the first time I learnt that true reassurance could only stem from the wisdom of life. ‘It will be okay’ was a hollow reassurance in most settings. A lie...
It was a strange coincidence that I chose to read ‘Lust for life‘ at around this time of my life. My life appeared very similar to Vincent van Gogh’s life in the borinage. I was moved by this picture of life that was new to me.
As I observed from close quarters people struggling to make ends meet, illness complicating the picture and disrupting the delicate balance between life and death, I was stunned into silence.
I shuddered at these glimpses, but they also instilled in me the courage to confront the horrors of my own life that had gathered momentum.
I no longer felt alone in my suffering…