I wonder.....

This 20 years old young lady came to show herself a few weeks ago. She had a skin lesion on her left hand, which was clearly a pauci-bacillary Hansen’s Disease. (Leprosy). We initiated her on treatment and asked her to be on follow up for 6 months. Yesterday was a busy OPD. In the midst of the crowd, this girl and her mother walked in. I did a quick 30 seconds examination, and told her you can pick up medicines for a month and come back. The mother hesitated, and asked me a question. Does the patient need to come back, or can she (Mother) come and collect medicines every month? I casually replied, no issues, anyone can. Then something in her facial expression caused me to wonder, why is she asking this. I asked, why cannot the patient come. Then the story poured out. She is being send back to her husband’s house and in laws. They do not know that she has this illness. She has been married for more than a year. She started getting this lesion a few months back. And we brought her home for a family occasion and used that opportunity to get her treated. And if the husband or the family comes to know that she is on treatment for any disease, she might be thrown out, or more money will be asked, and she is bound to face consequences. So please help us, we will come and collect medicines, do not ask the patient to come. She also asked, give some ointment to cover the lesion, so that no one will see it. I assured them that we will help, gave her three month drugs and send her off. I did not realize that behind a simple innocuous dermatological illness which can be cured in 6 months with regular medication, there were stories like this. 

I was left wondering - in the midst of the crowds of people we “dispose of”, how many such stories might we be missing?

This was followed by another young man in his early thirties. He had a HIV infection and was not responding to the treatment (ART) he was on. I took a little longer, 90 to 120 seconds I suppose, to do quick history and examination. A counsellor who was accompanying him shared that he had lost his wife due to HIV a few months back. He has a girl child 7 years old who is negative and a one year old son whose status is not known. I confirmed these details with the patient and send him for a CD4 count. He came back in the afternoon for the report. He had no emotion on his face, looked as if he was quite brave and able to face the challenges ahead. I told him that his CD4 was only 46, and he needs to move on to second line ART as soon as possible, which is available at Patna free. He heard me and replied, yes sir, I know this, I will go and get this done as soon as I can organize money to go. He was about to go, and I made a simple statement – do not worry, you will be okay once the new drugs start. He looked at me, paused for a few seconds and broke down sobbing. Staff took him aside talked to him and supported him. He was quite worried about what would happen to his children, he wanted to end his life. 

I was left wondering again, how many of those who we see in the OPD, behind the masks of brave and courageous faces would be carrying stories of brokenness, fears and distress.

The Master, in the midst of the crowd, felt the touch of the women with bleeding and stopped his travel to heal her and get her integrated back into society. He heard the cry of Barthemus in the midst of the crowd and noise and stopped to heal him and get him back into the mainstream. He would walk out of a busy OPD to care for a friend’s mother-in-law through a home visit.

How discerning we as followers of this Master be – to heal and not to cure only, to listen beyond what we hear, and look at interruptions as opportunity to care with compassion….