This is another story from the past. 40 years ago, when this lady and her family became my patients this area which is now considered a posh up market locality, was ill served even with basic civic amenities. The roads were ill lit and badly surfaced, commuting to the city was tough with very few buses coming into the extension and shopping had to be done with a few poorly stocked stores. There were few villages around though, which had existed probably for centuries and my clinic was one of the very few which provided the basic medical services.
The lady whose story I am writing is now past 70 years. Then, 40 years ago when I first met with her, she was a strapping fecund woman in her early thirties, happily producing children. [She ended up having six boys and one girl]. The first encounter was a house call which ended as a surgical emergency, diagnosed in fading light one grimy rainy night with no facility even for a proper examination. The clinical diagnosis of gall bladder infection proved correct and a surgical removal of her gall bladder cured her.
This episode made her my patient and later my friend for life. Except for her husband, the whole of the family and later on even her grand children became my patients. The family has done well financially over the years.
In addition to the ravages of age, she has developed hypertension, a leaking aortic [heart] valve, severe diabetes with neuropathy and seasonal bronchial asthma. Needless to say, her visits to me have become more frequent now than before.
When she visited me some months ago, she was not looking good and after the consultation was over, she said very diffidently, ‘Doctor, I will not be able to pay your fee’, and then broke down with fits of huge sobs. I keep quiet in such situations and allow the person to finish with the crying. I have learnt that they all come out with what they have come to say and then it is easy to manage. After a while she wiped her tears and said, ‘my husband says I spend too much money on doctors and visits to the hospitals and it is better that I die’. This took me by surprise. Here is wealthy family which has a palatial house with assistants, cook and two cars with drivers and an ongoing flourishing business. And this woman who is the lady of the house has been told to die because her medical expenses are unaffordable. Surely there is some mistake somewhere. I told her as much. She said, ‘Doctor, you don’t know the truth. What I have had to put up in the last fifty years with that man. Never was a day he has asked me what I wanted or how I am doing, even now my illness is an irritant to him and he really feels that I should die as I have lived beyond my utility to him and his children’. I said a few words of sympathy and told her to come as long as she wants and not to worry about paying.
That was some six months ago. That proud woman who used to come every month has not turned up since. One of these days I will hear the sad news of her natural or unnatural death.
Some say with a smile,
Some with flowers,
Some others with fruits,
Most others don't have words to say.
All are your patients.
You are, my dear GP,
A fortunate man.