‘Saar [slr], it is again paining’ he said.
I did not remember seeing him.
I asked him,' when was it that he last saw me’.
He said ‘five years ago’.
‘Have you brought any of my records? I asked.
‘No saar, I lost it’ he said.
‘Where is the pain?’ I asked.
‘Same place as last time’.
So here is a person who expects me to remember the place of his pain that occurred 5 years ago. I told him.
‘Sorry’ he said but won’t tell me the place of his pain.
I insist on knowing.
‘There, where I pass motions’ he said, pointing to his neither region.
This place of motion passing needs some explanation. In the heavily vernacularised English, motions mean moving the bowel and the place where this occurs is anus. So this patient is having pain in his anus.
The first hurdle in this intricate art of history taking has been won.
Now comes the next step of the battle.
‘Do you have the pain all the time or only when you pass motions?’ [I speak his language]
‘What saar?’ He asks.
I repeat he question.
‘Both times’ he says.
So he has it all the time.
I ask him, 'does it become worse when you pass motions? ‘Yes Saar, very very much, I cry and shout with pain, wife comes running.’
This wife comes running part is to impress me the severity of pain.
I am now duly impressed that this man does indeed have severe pain and needs urgent attention.
I ask him to undress so that I can have a good look at the place he is having motions.
‘Saar last time you have seen saar’ he pleads.
This man thinks that I am some super doctor who has the memory of seeing ‘his place where he passes motions’ 5 years ago.
I tell him the need to examine him again
‘Last time you give motion making medicine and I became ok. You give this time also’ [this motion making medicine is a mild laxative given in painful anal conditions and he thinks if he gets a prescription for that he can avoid the unpleasantness of examination].
Like many other young men and women he is shy to show the part. This reluctance is cultural and was much more so in the past than it is now. But I still get an occasional young man like the present one.
A see saw battle ensues with I trying to pull his trousers down and he trying to hitch them up.
Ultimately I succeed and to our mutual relief the consultation gets over and he gets his motion going medicine.
He had anal fissure, a fairly common condition and easily treatable.
On golf ball
My friend and avid golfer, Jnandev Kamath, has sent this poem. I think my golfer readers will enjoy reading this.
In My Hand I Hold A Ball,
White And Dimpled, Rather Small.
Oh, How Bland It Does Appear,
This Harmless Looking Little Sphere.
By Its Size I Could Not Guess,
The Awesome Strength It Does Possess.
But Since I Fell Beneath Its Spell,
I've Wandered Through The Fires Of Hell.
My Life Has Not Been Quite The Same,
Since I Chose To Play This Stupid Game.
It Rules My Mind For Hours On End,
A Fortune It Has Made Me Spend.
It Has Made Me Yell, Curse And Cry,
I Hate Myself And Want To Die.
It Promises A Thing Called Par,
If I Can Hit It Straight And Far.
To Master Such A Tiny Ball,
Should Not Be Very Hard At All.
But My Desires The Ball Refuses,
And Does Exactly As It Chooses.
It Hooks And Slices, Dribbles And Dies,
And Even Disappears Before My Eyes.
Often It Will Have A Whim,
To Hit A Tree Or Take A Swim.
With Miles Of Grass On Which To Land,
Finds A Tiny Patch Of Sand.
Then Has Me Offering Up My Soul,
If Only It Would Find The Hole.
It's Made Me Whimper Like A Pup,
And Swear That I Will Give It Up.
And Take To Drink To Ease My Sorrow,
But The Ball Knows ... I'll Be Back Tomorrow.