Thursday, August 19, 2010

I understand perfectly what you mean!!

Difference in the way we understand and comprehend people was something I have ,I must confess, rarely entertained.I still remember once after an impassioned interpretation of some passage, one of my juniors softly reminded me,-'mam,we are men,we understand and comprehend things differently from the way women do'.I am still trying to comprehend what he meant!
Working in a rural set-up of Jharkhand for better part of nine years,we take a lot of things for granted.I shifted to Herbertpur in the beginning of this month and thanked my stars that, for a change ,I wouldn't have to learn my alphabets from the scratch,it was Hindi in JKD and it remains hindi in Uttarakhand allright.I hadn't quite taken into consideration the local nuances that remain so much a part of India.
For instance while examining the abdomen of a patient in JKD ,when we ask a patient to bend the leg to relax the abdomen,there is one and only one way it is understood and that is what they do .In Uttarakhand they show you four different ways of doing it and ask you to choose how you would like the leg to be bent!The first time it happened I was shocked and irritated a bit and then it struck me actually it wasn't the patient's fault he was bending his legs allright,I just had not specified where I wanted it bent ,in which direction,which angle and at what joint to be specific.
Then there is the quintiessential bystander come straight from the hills who brings in a sick patient.During the process of history taking he keeps butting in to enquire if it is the patient's detail or his that I am after.
For instance ,if you ask 'how is the appetite?,the bystander will immediately reply 'are you asking about my appetite,-it is good!'
Somewhere during the long waiting hours in the hospital ,I presume they forget they have brought a patient in to see a doctor and get the sense of sitting in a village chowk ,making small talks.
I got to do my first bronchoscopy in Herbertpur the other day.For a change everything actually worked-the suction was just right,there were variety of biopsy needles,the light source was perfect,there was a camerra intact and I could actually do a video bronchoscopy and a biopsy.The right main bronchus was completely obliterated by a mass ,I took an endo-bronchial biopsy and on the retrospect thought ,I should have taken a fine needle aspirate and a brush biopsy as well-I should get to it the next time.Although the patient most likely has a malignancy,he was already looking and feeling better as most illiterate people do when they undergo endoscopies.They have this firm unshakeable belief that these procedures are curative...inspite of my having explained the procedure to them ...ask me ,I did my thesis on helico-bacter for my post-grad studies.

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