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The ‘difficult’ patient

During the BC (Before COVID) era, the outpatient department of neurology in our hospital was a busy place with patients thronging its every nook and corner. The doctor, on the other hand, possessed only a table and a chair as his own.

As a first year resident, I was usually among the first doctors to attend the OPD. Around six months into my residency, I started to notice an old man among the first patients sitting right in front of my table. He looked cunningly cheerful and always flaunted a bright smile exposing his dentures.

As soon as I took my seat, he would give his opening statement, "Why are you late doctor? We were waiting for a long time." This was appreciated well by the audience around, by their smiles and giggles, elevating him to the status of a common man’s hero who had the steel nerves to question authority. I would find myself in a pickle, failing to find a comeback that is strong enough to win the argument and soft enough not to ruffle his feathers.

During history-taking and examination, he would go about telling his experiences here. After I make the diagnosis and prescribe medicines, he would yield his killing blow, "Doctor, have you prescribed costly medicines that are not available here?" This would again be rewarded with giggles and nods.

This was a common practice during his monthly visits. I would always reply to his taunts with a helpless smile, but the cauldron was boiling inside. When the first patient of the day destroyed you, it was usually difficult to continue the day on a high note.

After the floods that wreaked havoc in Kerala, when the OPD was slowly regaining its strength, I kept searching for this old man among the patients. I wondered what had happened to him and whether he had relocated. I started looking for the man who had teased and irritated me, but deep inside, I missed his smile. I understood a doctor-patient relationship was born during the chaos.

It was about two months later that I again saw him, a sight which filled in me with so much joy that I felt his teasing was as harmless as that between friends pulling each other’s legs. He was keeping well but had to miss the appointments for personal reasons. After his routine medications were written and before he could speak, I answered with a grin, "Yes, all these medicines are available here."

The unforgettable day came soon after during our usual chit chat. He said, "Doctor, I come early because I want to see you and not any senior doctor. I am satisfied only after I see you and talk to you." The audience heard it, was astonished and their head nods had less vigour. That day was an eye opener for me.

A patient whom I once disliked, whom I considered irritable actually loved me a lot as a doctor. I understood that the doctor-patient relationship is a sophisticated slow-growing love which cannot be matched by money or rewards. Such relations have become sparse in this time due to unnecessary tangles of greed, legality and consumer mentality.

I now understand that though his teeth were artificial, his smiles were truly from the heart with an icing of warmth and love. Though I frantically search for his face in the OPD during these COVID times, I am sure he will survive this pandemic and once again greet me with his smile and dentures.

jidhinraj@gmail.com

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Printable version | Nov 28, 2020 10:57:17 PM | https://www.thehindu.com/opinion/open-page/the-difficult-patient/article32880664.ece

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