Another Day in The Clinic

One day as I left the outpatient consultation area, I almost banged in to a couple who were rushing in the opposite direction. ‘Doctor saab, please have a look at my child. He has been running a fever for the last one week and has not eaten anything.’ I hesitated and turned to look closely at the couple. From their dishevelled clothes, tattered in places, I could tell they were from a village which had not yet heard of ‘India Shining’. The woman had a small bundle of grimy clothes clutched to her breast from which a small, pale hand peeked out. She was holding on so tight to the bundle that I was afraid she may choke the child. Voice quavering, tears ready to spring from her eyes, she looked as near desperation as only a mother could. The despondent look on the unshaven and unkempt face of her husband completed the sordid picture of poverty, neglect, ignorance and despair. There was no way one could not feel a twinge of pity for the couple.

‘Please come to the consultation chamber’, I said reluctantly and retraced my steps back to my room. ‘Why did you not go to a child specialist? I am sure they would have been able to help you better than I.’ Try as I might, I could not keep the edge off my voice; it had been a long day and the attendance in today’s clinic had been especially heavy. As I sank into my chair, I looked at them impatiently for an answer. ‘We have already been there Sir, and they sent us to you. The child was operated here for a cleft lip two months ago and so they referred us to you’, replied the mother. I was not sure that a history of cleft lip surgery in the recent past was reason enough for the pediatrician to send the child to us for the present complaints. There had to be another reason; I wondered what it was.

With a flick of my hand I guided the mother to the patient’s chair. ‘Show me the baby’, I said. As she unwrapped the soiled bundle of clothes to let me examine the child, I felt as if a train had hit me. Even from the distance of three feet or so, I could tell what was wrong with the child. There was no mistaking the limp attitude of the child and the pale colour of the cheeks. No wonder the hand which had peeked out at me from inside the bundle was pale. The child was dead! But the most telling evidence which obviated any need for me to even cursorily examine the child was the eyes. They had turned to stone; the transparent, shiny cornea had turned translucent and grainy, something which can happen only in the dead. The mouth was open, the tongue pale and shrunken, and the neck hung limply. I felt my mouth go dry. ‘How long has the child not been moving’ I asked? ‘He has not said anything or even asked for water since this morning’ came the reply. And they were carrying the dead baby around since then! I was aghast and moved at their simplicity and their ignorance. The child had probably died from nothing more complicated than a flu or dehydration or even simply high fever. Yes, either of these can kill a small child and all of these, without exception, are easily manageable by simple measures. That is the great tragedy of such a loss. Thousands of children in rural India succumb to such minor ailments while we pride ourselves on being an Asian tiger, a rising economic power and a nuclear capable nation.

No wonder my colleague had sent them to me so that I could perform the unhappy task of declaring him dead. ‘He is already dead, you came too late’ I mumbled. There was a moment of awkward silence when none of us knew what to do, and then they rose slowly and started to leave wordlessly. At the door the mother paused and for the last time turned around to look at me. As I looked into the eyes of that desperate mother I could feel my heart constricting as if held in an iron vice. That moment I became one with her, feeling her pain, almost choking with it. Then she turned and left. I could still feel her eyes upon me, long after she was gone.

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