BOOMERANG- with the measure you use, it will be measured to you

(TWO YEARS AGO

The serene lanes of Lamtaput bustle with life at 7 AM in the morning. Children run merrily in the ground staining their uniforms with dust. Like a Maharajah’s procession a train of motor vehicles trudge along the market street. As one gets down the vehicle, he can smell the sweet Jalebi from the nearby eatery. Women in a variety of tribal attires present a cultural odyssey before the day of intense marketing begins. It is Saturday and it is Hato meaning market in local dialect.  By 8 AM the noise hits a higher octave as men and women bargain in full intensity at fish stalls as children obstinately drag their parents to a confectionery shop. Ladies squat in the midst of their vegetables trying to strike the right deals with the customers.

 It is one of such ladies who shall be the object of this story. Gurubari is a 50 year old woman who has presented to AshaKiran hospital with intense knee pain that she was brought on a gurney to the consultation room. I, more out of dead habit, than empathy, initiated, ‘kono hella ma?’ (What happened). She narrated her story of how she suffered from joint pains for long. “Why didn’t you come early?”, I contended. She was silent. I quickly asked her a series of questions and sent her for some investigations. She returned complaining that she did not have enough money. I humorously remarked with my co-doctor ‘These people have money to buy mobile phones and bikes, but when it comes to hospital they are reluctant to spend.’ Gurubari, introvert by nature turned away reluctantly from the consultation room and returned with X-rays of both knees. I looked at them perfunctorily and said ‘osteo-arthritis’. “You should stop the work you do. Take rest and medicines. Do not lift heavy weights and avoid strenuous activity.” For the first time, I saw Gurubari smile not heartily but sarcasm and noted, “I work in the fields after I finish my daily chores at home. I must take care of kids, cattle, goats, and my mother-in-law. How can you ask me to stop working?”

This young doctor got offended by the candid statement of an illiterate tribal woman. My demeanor changed from frivolity to anger and I said “If you want to get your knees right, listen to what I say.” And not satisfied with my vengeful words, I added, “Those are your legs and not mine. You are not doing me any favour by taking those tablets”, with an obvious tone of doing a favour for her by the whole consultation. Before she could ask any doubts, I said, “Review in a week. You can go.” Needless to say she never came back.

                                                                         ( THE PRESENT)
                                                                                                      

The plush air-conditioned room betrayed the scorching heat of Hyderabad. The alarm screamed laboriously after 10 successive snoozes. It was 9 AM and this hard-working writer was still in the bed. I had to take my mom to an orthopaedician and that was the cause of this early wake up. With hair stuck out like radio antenna and saliva drooling from my mouth, I had to get up and move to make it to the appointment at 11. I had shower, quick breakfast, pressed my clothes, checked my Facebook notifications and left the home by 10:30. Mom had just celebrated her 50^th birthday. Three days ago while travelling from Karimnagar she had experienced severe back pain. Wincing she crashed onto the bed and could not get up for a couple of days. Elderly in age, known hypothyroid, peri-menopausal and over-weight, I had suspected my mom to have osteo-arthritis. After a non-compliant regime of pain-killers, my mom finally succumbed to my request of seeing a bone-doctor. I had surfed the internet, the new power of the layman and found this doctor from Google.com. I booked an appointment over phone after talking to a benevolent receptionist.

The car traversed the traffic lanes to reach a posh hospital on one of the busiest roads. As we got down, the security greeted us in servitude. I waved and entered the reception area. A beautiful woman who can be mistaken for model from Fashion TV asked us to have a seat. “The doctor will be here in 30 minutes. Please wait.” My mom looked at the giant wall-clock and said, ‘The doctor will be here by 12 then’. I knew that one profession that does not follow time more because of business than choice is medicine. I knew surgeons who would be just opening the abdomen and answering a phone informing than he was on the way. So when doctors say half an hour, it is certainly not half an hour. We waited, waited and waited. The beautiful but professional receptionist was keen enough to collect the consultation fees and we were sort of trapped and I learnt a vital lesson in life I that one should not choose a doctor from Google.

The doctor had finally arrived. We were called in. The consultation room, sorry the consultation lounge, sorry the consultation luxury suite was an abode of comfort.  He asked, Emaindamma (what happened in Telugu). He examined my mother and asked “why didn’t you come early?” My mother was silent. He looked at me and said aggressively, “you look educated. Why didn’t you bring your mother early?” Staying calm saved my life. If I had told him that I was a doctor, some among you would be writing an obituary of me. He scribbled some tests and told us to go to a diagnostic centre and I want to call it centre H. (H for hell). I looked at the investigations and they were genuinely needed for workup of arthritis. Then we had to do some X-rays. The radiographer was supercilious from the moment I entered his dungeon. For a moment I was lulled into the delusion that Roentgen stole the X-ray invention from this guy. I asked for any female attendant. “Why do you need a female attendant?” he asked irritated by my unreasonable request. After much embarrassment and struggle we got the X-rays done.

Two days later, we saw the doctor with the reports. My mother was diagnosed with Lumbar Spondylosis and osteo-arthritis both knees grade 2. The doctor looked at the X-rays and nodded in disapproval. My mother’s heart skipped a beat. I patted her assuring and comically noting that her heart was not in her knees. He took a deep breath and said, “Are you prepared for surgery?” I was flummoxed. Who on earth will do a total knee replacement for Grade 2 osteoarthritis? Please come to Hyderabad. My mom was on the verge of surppassing her emotional threshold. I requested him to give medicines for now. He scribbled two tablets which were economical and encouraged us to buy a third capsule which was costly and gave a phone number to contact the medical rep. The medical shop abutting the hospital was equally posh. I asked for two ‘economical’, tablets which priced 1000 rupees for a month. I thought, I must post a free-ad on Quickr.com to sell our land before calling the medical representative. From the ominous moment of entering the hospital to buying the medicines, we had to shell out 5000 rupees. The doctor asked us to review in a month. We would be below poverty line if we see the doctor again.

                                                                      

As we drove back no matter how much I tried, Gurubari came back to my mind and the present episode had a déjà vu feeling about it. Gurubari resembled my mother in many ways. The greater tragedy was that I resembled the doctor my mother saw. Both had the same problem and both the doctors they saw had no compassion towards their patients. Being medical professionals we are in a great danger of losing this precious quality of empathy.  The orthopaedician and I gave a damn to the economic condition of the patient. We pounced on them and feigned our ideas on them. No rationality, no ethical standards towards Gurubari  came to my mind, till my mom became a patient. It was like falling into a self-dug hole. It was like hurting yourself with your own boomerang. Empathy not just regarding the disease, but also social and economical conditions, is the need of us as doctors, nurses, radiographers and lab technicians. In our quest for a  professional approach towards patients may be this fact that they are members of some family misses our mind- until a tragedy strikes our own family. My pediatrician friends, deal with compassion with the children or else your own children may face uncompassionate care. My obstetrician chums, please be generous towards women in labor for one day you yourself may go through that ordeal. What we give to the world will come back to us. We give love and care it will come back to us. We become stone-hearted we and our families will be meted out the same treatment.

A sense of shame dawned on me as I thought of all the experiences I went through. With repentance and prayer I looked to the Lord, opened my Bible and my eyes fell over this sentence “For in the same way you judge others, you will be judged, and with the measure you use, it will be measured to you.”