In January 1991, we were to attend the clinics for the first time at Maulana Azad Medical College. We all had waited for the day keenly, finally it had come, our batch was divided into the groups of 10-12 students and each batch was posted in the different departments, my batch was posted in the department of Medicine. We were twelve in number; we donned the white aprons, armed with the newly bought stethoscope, knee hammer, tuning fork and Hutchinson’s text book of clinical examination, marched down the corridors of the LNJP hospital and reached the wards.
After a brief introduction with the Senior Resident, we were asked to examine the patients, we were to take the detail history of their illness which included the presenting complains, history of presenting complains, past history, occupational history, family history, social history so on. Brimming with the newly acquired knowledge we were on cloud nine and were under impression that with in no time we will be the healing masters.
During our posting one day the senior resident allotted us a case of paralysis of both lower limbs for examination, patient was a young man. All twelve of us went to his bed and surrounded him, seeing so many of us he looked uncomfortable, we told him that we will be doing a complete clinical examination to understand his disease, but he refused, and said he just want treatment and no examination, as he was already been examined by many; senior resident, postgraduate students, interns, the final year MBBS students, but there was no improvement in his symptoms, and now we, the immature looking dozen were going to help him get rid of his disease, no way he said and asked us to leave him alone, but we were not there to relent, we had a bhramastra, one of us told him that he will be discharged from the hospital there and then, hearing this his father who quiet till now started begging not to do so and he asked his son to let us examine him, finally he gave in, we stood victorious, patting ourselves how well we have used the weapon. As we did not want to miss out anything, we consulted the book also, he slowly and monotonously, narrated us how he started losing power in his limbs, how the slippers slipped out of his limbs without his knowledge and so on. Now it was time to start the examination, all twelve of us wanted to examine him individually , we behaved like the dirty dozens, he was just like an object for us and we played with him the way we wanted, eliciting reflexes with knee hammer, poking his sole with a pointed object, assessing his perception to feel etc., his ordeal went for about one and a half hours and during this session he mumbled again and again “I just want to walk, make me stand, make me walk”, but we barely gave importance to his mumblings and left for the case presentation and other classes.
Now after three and half years when I was an intern, one day in evening while playing tennis I bent forward too much to reach the ball, and as a result suffered a sudden excruciating pain in my back and fell down on the court, my friends took me to the hospital where I was prescribed some pain killers and was advised to take complete bed rest. In next 2-3 days the back pain started subsiding but I developed a shooting pain in my left lower limb; it was sciatica, so a MRI was suggested by the neurosurgeon, which revealed the ominous; two severely prolapsed lumber discs, the neurosurgeon suggested surgery.
In November 1994 I under went surgery at GB Pant Hospital, and post surgery I suffered the loss of sensation and power in my both lower limbs, something had gone wrong but no one had clue what went wrong, according to the operating surgeon, none of the nerve was dissected. “It could be due to the acute spinal shock”, he said and expected the situation to improve over next seventy two hours, but there was no improvement after the passage of the stipulated time, I lay there paralyzed on the bed. I was in the state of shock; my soles could not feel anything and my limbs did not move at all and when with support they tried to make me walk, the slippers slipped out of my feet, without my knowledge. Lying on bed I just kept watching nurses, doctors, ward boys, my friends and everybody else walking. Even in my dreams I saw myself jogging and running, so desperate was I to get rid of the situation.
One day I was just staring the roof trying to locate almighty, to ask him about my mistakes of past as the result of which I was made to suffer, suddenly fainted memory of the first neurology case whom we examined flashed across my mind, I could recall that patient’s mumble, “I want to walk, make me walk”, now the circle had turn full way and it was now my turn. I also wanted to shout at the top of my voice “I want to walk, please make me walk”. I was filled with remorse for my mean behavior of that day and asked almighty to forgive me. Finally God listened to my prayers and I made a full recovery after six months of sufferings, but the important lesson was learnt in the process; never to treat patients just like objects with good clinical findings, they are humans with sufferings and lot of anxieties, needing our utmost attention, so as doctors we should be tender and soft enough to get them rid of their apprehensions also, apart from the treatment.
Puneet Tyagi M.D.