They should have named him mercury but he was called Chotu, fondly by all of us. His real name is Kailash. He is now a prim and proper 12 year old, but when the incident occurred he was around three or four years old. I have tremendous admiration for his mother Arti who being a mid level [now senior] business executive for managing this boy and his less troublesome elder brother, a very sick mother and still successful in her job which also needed constant travel. From the day Chotu saw me after his pediatrician gave up [not really, more so, because it was more convenient to see me] he decided that I am one person with whom he can do whatever he wants and get away with. He also found my clinic a treasure house of material with which he can play. I have a tray which has many odds and ends on it and these he found fascinating. Before his mother could stop him he would pick up a pen or a pencil or even my Knee hammer and throw it on the ground for his mother to pick up. This done he would go to the window and try and close it with a bang. Then he would hop on to the examination couch and curl up so that I cannot examine him unless I straighten him which took all our effort. Would he keep quiet when he was doing all this? He would be shrieking with unadulterated joy. I have never seen a child who got so much of pleasure with so little. These antics of his took more time than actual examination. His favourite position for getting examined was to sit on my lap. No other position was acceptable. If I tried to put him on the table he would jump down or cry loudly. Soon I realized that to get his cooperation I had to make to do with examining him as best as I can in this position of his sitting on my lap with feet dangling. This position he was most cooperative and would open his mouth if asked him to do. But imagine my plight. How would I examine his throat or for that matter his abdomen with him astride on my lap?
Chotu began getting sudden episodes of abdominal pain. He would hold his abdomen and double up with pain. He would also give out loud howls. You have not have had the benefit of listening to Chotu’s howl. It brought the roof down along with the neighbors of the two houses on either side of Chotu’s house. When the concerned neighbors arrived they would find a laughing and smiling Chotu whose pain would have gone by then. Occasionally the same would happen when the panic stricken mother would bring to him to me. I began to suspect whether he like my other child friend like Meghna [see Meghna’s ear pain] is feigning pain to get his mother to bring him to see me and he can have his fun. He would get better whatever I gave him; even a glass of hot water did the trick.
But I was not satisfied. No child would do this repeatedly to attract attention even it meant fun with the grandfatherly doctor. I got an ultrasound scan done. The boy had narrowing at the junction of the funnel like structure which collects the urine [pelvis] that is produced by the kidney and the conduit which brings the urine [ureter] down to the collecting bag [bladder]. When sufficient urine got collected in the pelvis [funnel], it would try to push it down and the portion of the tube where the obstruction was, would not respond due to a defect [present since birth but came to light at this age in Chotu’ s case]. This would result in a colicky pain which could be pretty severe. This was the reason for Chotu's pains.
Dr R is my choice for handling surgical problems of my pediatric patients. Chotu was duly sent to Dr R. Some more tests later it was decided only surgery will provide lasting cure. Chotu came to see me with his mother. First thing Chotu said to me was,‘I don’t like your friend doctor who wants to cut my stomach’. I was very surprised. I thought the boy might be very scared of the surgery. I told him not to worry as it will be painless and he will be pain free after wards. 'I am not afraid' he said with his chest thrust forwards. He said, ‘you come there and do operation’. This kind of confidence is a bit unnerving. I explained to him why Dr R should do it and why I cannot do it. Chotu said, ‘he has coat, shoe, tie and the nurse holds me tight’. Now I knew the reason why my little friend doesn’t like Dr R whose nurse must have held him tight when he was being examined and Dr R must have appeared to be forbidding in his dress.
His mother added,'he has been telling me, ‘take me to chappal doctor', this is what he has been calling you ever since we started visiting the hospital where he is seeing all the doctors dressed in suits’! The boy is comfortable with this grandfatherly doctor with grey hair with his feet in chappals, who allows him to ride on his laps, sit on his table, play with all the odds and ends in the consulting room and thus thinks he is more qualified to operate on him!
Consultants and doctors who work in the hospitals wear either jackets or white coats. This is because of tradition and habit. One consultant friend who came to the golf course on a sweaty hot Sunday afternoon after his hospital rounds was in his full regalia of suit and matching tie. When I asked him how come even on a hot Sunday afternoon he wore a jacket,’ he said,'I feel naked if I did not wear my jacket’!
In contrast I have no such inhibitions. My normal working dress is a half sleeved shirt and trousers with Hawaii chappals [slippers] for the feet. On the rare occasions when I am forced to wear a suit [once or twice a year] I feel like being in a straight jacket!
Nevertheless it was comforting to know, at least my children patients appreciate my dress code!
The boy duly got surgical repair done and became pain free.