Monday, December 21, 2009

Riding a Bicycle

He would not come in when it was his turn. Other patients came and went but he sat there in the waiting area with head held in his hands [common gesture among worried Indian patients]. I went out and called him in. He came in with great reluctance. I asked him what his problem is. He said,’ Nayak sent me here.’ This was no answer to my question. I repeated my query. He broke into a sweat and started to stammer. The answer came in bits and pieces. ‘I went cycling to Yelhanka [small township then way out of town and now an important suburb] two days ago and since then I have this severe burning when I pass urine’, he said. Few more questions got me the information I needed. He also had the urge to frequently urinate and also was discharging pus from his urinary opening. The diagnosis of Gonorrhea, a type of easily treatable, acute venereal disease was easy.

The story of pedaling a bicycle for long hours was a lie and the patient wanted me to treat him without going into the sordid details of how he got it. Those days, thirty years ago, I was rather pig headed and did not appreciate the fact that patients often lie not because they want to but to save their faces. I insisted on the truth and he persisted on his bicycling story. I refrained from asking him whether the cycle he rode was male or female. I told him unless he told me the truth; I cannot treat him and told him to find another doctor who would treat him. ‘But saar,’ Nayak told me to see you only.’

Here I must tell you about this Nayak. Nayak is one of early patients and was a travelling sales man for a paint making company [he recently retired as one of the top guns in the business]. His travels took him to different parts of the state and later when he rose up in his profession, to different parts of the country and even abroad. During his travels he would stay in hotels and guest houses and was not beyond picking up a skirt if he found one to his liking. He would occasionally end up with the kind of problem this young friend of his was having now. He made no bones of what he did and how he got it, took the medication and got better and stayed so till the next event. This experienced man had correctly spotted his young friends problem for what it is and had advised him to see me.

‘Riding a bicycle will not get you this disease and unless you tell me the truth I will not be able to treat you’. The young man stood his ground for a while and then wiping his sweaty face went out of the clinic. I got on with my work and soon forgot the episode.

Two hours later came Mr Nayak,’ How are you doc, now don’t worry, I have not got my old problem, but my young friend has got it, I know he told you some cock and bull story and you threw him out, you know how ashamed these fellows are to tell the truth, you please treat this katthe [Donkey] a common word used to describe dumb fools’ He said in one breath.’ But he has gone’, I said. ‘Where will he go? He is here with me’ Nayak said and called out loudly for the youth to come in.

A less shamefaced young man of the morning came in. He was now spared of telling me the details of his misadventure. I gave him an injection of penicillin. Those days [even now but at a much higher dosage] it worked like magic. Within a few days he got completely cured. He is still my patient, now a sedate and respectable family man.

A word about gonorrhea. Before the advent of penicillin this was a dreaded disease and would leave the urinary passage scarred. This [stricture urethra] would result in obstruction to the flow and to ease the obstruction the doctors of yester years would periodically pass a metal tube down the passage to open the passage and irrigate the area and bladder with mercuric chloride solution, an antiseptic. I remember, during my college days, doing this procedure on some relics of pre penicillin days. So the saying those days when one saw these unfortunates was,’ five minutes with Venus, lifelong with Mercury’!

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