Doctor’s Diary Dr.M.K.Debnath “The Dyeing Young man” Soon after I completed my training as the ‘House officer’, I was compelled to engage in private medical practice in a small settlement near Kolkata airport. I was working very hard to establish myself as a fresh medical graduate, which was very tough. Though, I was trained in both General Medicine and Psychiatry, I chose to practice General medicine, as I knew, without a post graduate degree in Psychiatry, I won’t be able to make a good practice in that field. One night, when I returned home exhausted, my father told me about a distant relative of mine that he was very sick and may not survive for long. I wondered, because he was a young man in his late teens and the last time when I met him, I found him in very good health. My father mentioned to me that he asked the young man’s father to bring him at our house the next morning, so that I can have a look at him and decide what to do with him. When I inquired from my father about what really has happened to the young man, he told me that, he stopped eating any solid food for about three months and he hardly slept in last two weeks. My father also mentioned that he was grossly malnourished, emaciated and looked like a dead man from a distance. I was not expecting any further details from him . Next day, as soon as I returned home from my clinic at lunch break, my wife rushed me to our room and said, “Please, send him to hospital; I do not want him to die at our home.” I glanced at the young man who was lying on a bed in the next room. He was motionless, his eyes were fixed and he breathed very slowly. He was emaciated to the extent that anyone who will look at him will think that he will die any moment. After observing him, I went to the father of the young man who was having a chat with my father after finishing his lunch. I was made to understand that, he hoped that, I will make some arrangements for the young man to be examined and treated by a physician who I think can make some sorts of diagnosis and get the young man well again. I told him that to make that decision, who I should refer him to, I need to know the detailed history. The history of his present illness goes like the following- About four months ago he left home very early in the morning to avail the first train to Kolkata. This was what he did on a daily basis as he worked as a tailor in a garment factory (In those days, there was no tailoring machine that ran on electricity and one has to paddle, which was very strenuous to do for a long time.). He forgot to take his breakfast before he left. He was brought back home by two of his co-worker in the evening. They said that, while paddling the machine, he just fainted suddenly. He was seen by a quack medicine man, who suggested that it was just ‘gas’ and gave some medicine. He got his consciousness back very soon but felt tired and his employer sent him back home. After coming home, he was given food but he felt a chocking sensation in his throat. Since then he felt gradual difficulty in swallowing solid food. This increased day by day and presently he hardly could drink liquid food. He was taken to many physicians in and around the area where they lived. During those 4 months he was admitted in a Sub divisional hospital for 21 days. There, the doctors could not find any pathology for his condition. Six weeks ago he was admitted in a reputed hospital (where I was trained) for one month and was discharged from there two weeks ago. There also he was seen by many specialists and no pathology was found for his illness. His father told me, “We know that he is going to die but wish to know what his illness that he is dying from? If you know any good doctor who can make that diagnosis, may be he can try to save the life of my son.” He was very upset and started crying. His other son who sat near him also became very emotional. Talking a bit further with this brother of the patient, I came to understand that, even the day before this incident he was totally fit and fine. I felt very sad. I had no word known with which I could have console this father and brother. He was my relative too. I had some fond memories with him from our past interaction. I left the room and started my lunch. While having my lunch I kept thinking about this case. A young man without any previous history of any illness or failing health suddenly became ill and could not swallow solid food and then gradually had difficulty in swallowing liquid food. These points towards many dread full illness. But again it happened suddenly and in spite of so many checks and examination by many specialists nothing revealed to pin point any pathology. My mind started thinking to so many possibilities. While I took my lunch I thought and thought until my mind flashed with a possibility. Though I was not hundred percent sure but my mind was illuminated. I finished my lunch and asked my wife to bring some milk in a glass. In my room I took out a tablet from my medicine kit, broke it half and powdered it with the help of a spoon. My wife brought the milk and left for the kitchen. I mixed the powder with small portion of milk on the spoon and went into the room where the young man was lying. Behind the closed door I fed him that milk with powdered tablet. In my room I drank the rest portion of milk and closed my eyes on the bed. I woke up by the noise of many persons crying at my home and found that my wife was also crying. When I asked for the reason she told me that the young man has died. Shocked, I went into room. I looked at the young man. His eyes were closed. I checked his respiration and pulse and found that they were OK. I came to the verandah where his father, brother and others of my house were sitting. My father was not crying but his face was sad and embarrassed. Seeing me, the father of the young man started crying more loudly and said, “Oh! I thought you will be able to find a good doctor but now you do not need to do anything. He has gone beyond anybody can do anything for him.” ‘Why all of you are crying? He is not dead”, I said. Everyone looked at me with surprise, “I know you are telling me this to console me. No one has seen him with his eyes closed in last 15 days. Now he has closed his eyes forever.” His father said with louder crying spell. “He is sleeping. Come with me”, I left the place and went into the room. Every one followed me. I shook the young man and he opened his eyes and gone back to sleep. “How that is possible”, his father shouted with a pleasant surprise. I did not answer him. My father came to my room and asked, “Have you given any medication?” “No” I said. Without understanding anything my father went back to verandah. It was time for me to go to my clinic. Before leaving I instructed my wife to feed the young man with some bread and milk when he wakes up. My wife is a very good talker and untrained psychotherapist. When I returned home in the night, she was sitting on the verandah with the young man chatting. Dinner was finished and I was informed that he had a very good portion of Milk and bread and was looking fresher. After my dinner I took my wife in confidence and explained to her everything. I instructed her to give the next half of the tablet in the same way that I did before. Within next 4 days the young man got back to his full appetite and he was able to eat everything that was given to him. My wife cooked most of the dishes that we eat in our house hold. On fifth day, he passed stool for the first time in three weeks. He was absolutely normal except some weakness in his body. He was able to walk and eat normally. He was fresh looking. He along with his father left our home by walk to catch a bus to his home. Before living, his father told me, “I know you treated him but did not tell us anything. I am not asking you to accept any fee but at least I wish to pay for the medication.” I said, “I treated him with a tablet that cost only 10 paisa per tablet and I used only five of them. Give 50 paisa to my father if he accepts it.” I laughed and gone. That day, when the incident took place, the young man went to his work in empty stomach and his hard work made him to be hypoglycemic (Blood sugar fall below the normal level). That made him to have a syncope (fainting) . While returning home, two accompanied co-workers talked about the possible cause of his fainting (In a situation like that every one becomes a physician and give their valuable opinion). In those possible causes they were sure about two most possible causes and those were either Tuberculosis or Cancer. The young man while sitting heard all those explanations and got extremely nervous and anxious. As a result he felt chocking sensation. Back at home there was crying, howling etc by the family members and the neighbours, made him more anxious and he was unable to swallow solid food. Daily visits of his relatives, their crying, howling and all the expert opinions augmented his anxiety. More and more doctor’s visit, more and more inability to make any diagnosis reinforced the idea of the young man and his family of a dreadful illness that was so difficult to diagnose. It made his anxiety more intense and after a time he, along with his family members were convinced that he was going to die soon. The visitor’s expert opinion and comments continuously reinforced that anxiety. His lack of nourishment made him weak, bed ridden and lastly constipation and sleeplessness. I just gave him a small dose of tranquilizer which helped him have a good sleep alleviating his anxiety. The less was his anxiety the more was his confidence level and he was able to eat. More ability to eat gave him more confidence and physical strength. This chain positive reaction augmented by small dose of tranquilizer cured him within a very short time. In my professional life, I have had treated successfully many psychologically ill patients. The satisfaction and internal happiness that I got from this one I have never had that again. Till now he keeps in touch with me wherever I am in this big world. **************
Posted on: Tue, 03 Sep 2013 04:27:38 +0000
Trending Topics
Recently Viewed Topics
© 2015