Skip to main content

Life’s Burdens

Life-stories of my patients have convinced me that the burden does not fall equally or even randomly on our shoulders. Some seem to have had far more than their fair share.
A 65 year old gentleman, Dr S, came to see me in my clinic last week with obstinate symptoms of gas, dyspepsia, constipation and bloating that 10 gastroenterologists and 25 types of medicines had not been able to relieve. All his investigations had thrown up normal results.
I realized that there was something that had evaded the attention of my predecessors, and despite my tightly crammed clinic schedule, decided to change track from writing yet another prescription  that was doomed to fail, to looking at him as a distressed fellow-human in need of help.
Very soon, I came to realize that with his growing years, his attention had drifted from being a committed doctor raising a family of 3 cheerful children, to worrying about what would happen to them after his demise. His eldest was a daughter of 40who had been recently widowed and was staying with him with her children. His next was a 38 years old chronic schizophrenic son, who was so mentally disturbed that he was entirely dependent on him. His 3rd was a “normal” 35 year old son who had his own small business and family, on whom Dr S did not want to pass on his burden. To top it all, his wife of 45 years had recently turned funnily “spiritual” and had left it to her husband to find practical solutions to their family’s problems!
As I listened to his fears and concerns, I wondered what I would have done if I were in his shoes. Words of comfort started sounding hollow and, medicines, I realized, could get him some sleep in the nights, but not provide any meaningful solutions.
But as his underlying distress finally found an expression in my clinic, his dyspeptic symptoms got some relief.
Another 60 year old man who had been suffering from similar “gas” and “bloating” that had remained intractable for 15 years despite consultation with 15 doctor shad another touching story. His symptoms had started on an August evening when while returning home from work in the evening, he had seen an unexpected crowd at the entrance, and then on entering, had seen his 25 year old only daughter lying dead on the floor, struck a few minutes back by a speeding car just outside their garden gate. Since then, his life had lost all meaning and his dyspeptic symptoms had taken hold.

Somatic or body symptoms often have their origin in stressful or traumatic life events or situations. Labelled as “Psycho-somatic”, they often manifest through symptoms related to the gut, head, heart or genital organs. Their solution lies not in scoffing them off as “all-in-the-head” but to a deeper understanding of life’s travails and traumas, worries and challenges.
As published in HT City ( Hindustan Times) dated 28 April, 2013.

Comments

Popular posts from this blog

Food Fads in Liver Disorders

In an attempt at trying to do well to those they love, spouses and parents often enforce diets on patients of liver diseases that often turn out to be detrimental. The commonest food fad is pale insipid boiled cabbage being doled out to nauseous patients suffering from hepatitis that makes them puke even more.  The liver, in a way, is a buzzing manufacturing unit that requires lots of energy to keep its multiple functions going. And it derives all this from the food we eat. During disease, such as during an attack of jaundice, when many of the liver cells get killed, the liver attemptsdamage control by trying to regenerate quickly. For its cells to multiply however, it requires a generous supply of energy that comes from carbohydrates, and protein, the building block for its cells and tissues. Boiled green vegetables unfortunately have neither of these. Hence the situation often progresses to that of a starved liver unable to recuperate due to cut-off food supply.

Bad Dreams, Disturbed Sleep

  A good night’s sleep, so essential to rest your body and mind, and restore ‘energy” and vitality, is becoming a casualty for many these days. Last week a 58 year old lady complained that she woke up with a startle in the middle of the night dreaming of “drugs”, something she had never been exposed to all her life. Another reported a nightmare in which he felt someone was “strangulating” him by tightening something around his neck, till he woke up feeling choked! Yet another reported dreaming that he was in an ICU of a hospital with PPE draped figures surrounding his bed while he was being prepared to be hooked to a ventilator. Bad dreams can be disturbing to say the least. One wakes up with a startle or in sweat, feeling disturbed and uneasy, and feeling drained. The mood in the morning is usually uneasy and snappy. Creative thinking has usually gone for a toss…postponed to yet another day when one feels more cheerful and positive.   Several factors could be contributing to “

The Doctor’s Dress

The familiar white coat worn by physicians as their distinctive dress for over 100 years, has started generating  murmurs  of controversy. It is not uncommon to find the blood pressure to be higher when measured by a white-coat-wearing-doctor in the hospital or clinic than the readings obtained at home by relatives.  This is due to the anxiety that the white coat and the hospital setting evokes in patients, and has been termed “White Coat Hypertension”. Mature clinicians often routinely subtract a few points from these measurements when entering records in case charts or calculating the dose of anti-hypertensive medications to be prescribed. The white coat scares children too.  Kids often express their dislike for this dress by crying and screaming and by denying access to their bellies or chest for examination by paediatricians in this attire. Many pediatricians across the world have folded up their white coats and taken to informal colourful dressing to get closer to thei