Many years have gone by since the incidence narrated here occurred but it is still fresh in my memory not because of the nature or rarity of presentation of the illness but the aftermath of it.
The middle aged well groomed lady was brought by her son and daughter in law because she had been having chest pains for the past couple of months. They had brought with them a sheaf of papers which had investigation reports and prescriptions from doctors whom she had already consulted.
I wanted to examine her. At the best of times examination of an Indian woman properly for a male doctor is difficult and it is more so with women belonging to some orthodox communities and this was one of them. With extreme reluctance she removed the outer black covering of her body. There were three more to go. It took another five minutes to convince her to remove at least one ore of them. She wanted her own son to go out before she divested herself of this second garment. She would not go any further and I had to make do with this. So I proceeded to examine her. On her left chest where I normally place the head of my stethoscope, beneath her blouse, I could not hear her heart sounds because of a hard object.
Our women have this habit of carrying a small mini purse inside their left bra. This is for right handed women and for lefties it is the other side. They consider this a safe and easily accessible place to keep their money I told the lady to please take this purse out so that I can proceed with my examination. She said she carried no purse!
What she had was cancer of the left breast which had already fairly advanced. Sadly her right breast too showed a less advanced tumor. I called the son inside, and to the three of them I explained the problem and convinced them to see my oncology team. That they disregarded my advice and went elsewhere is another matter.
You are wondering how we allowed this lady to go undiagnosed for so long. Often they don’t allow proper examination and this is the main cause and we doctors too don’t insist for the fear of offending them. I could detect it because it was already pretty big and difficult to miss. I too would have missed it had she come when it was small and refused a proper examination as she must have with other doctors.
I heard later that she passed away in a few months time.
Some years later an elderly gentleman came to consult with me. I don’t remember what his problem was. After the consultation was over, before he took leave he told me that he was the husband of the lady who had cancer of the breast and I was the one who spotted it first. I thought he was going to thank me. Instead he said, doctor, ‘my wife is no more, but when you told the bad news to my children and not tome who is her husband it hurt me very much, this I want you to know’.
This left me stunned, taking my silence for apology the old man left.
I did not even know he was outside waiting when the lady was being examined. The children had taken over and who should I tell? Had I known he was outside would I have called him in and told him? I don’t know. It is always easy to break the bad news to the young relations than the old ones. But he was right. He was her husband he should have been the first person to know. But why rake the issue after so many years?
Human ego and vanity presents in many ways and this is one such example. I only hoped that the resentment he had carried for so long went after he made his point. A sort of catharsis would you say?