That year I was preparing for my post graduate examination after completion of the stipendiary training in medical college. Post graduate trainees in Calcutta, those days, did not get any salary; so I’d taken up a job as the residential medical officer in an upcoming cancer hospital on the outskirts of Calcutta. The job fitted the bill well for a temporary one. Not well remunerated but with a quarter to stay and food from the hospital kitchen, it was cushy enough to allow me the time and solitude to study and to attend special classes when a local practitioner kept watch. The hospital was yet to take its full shape and consisted of only two wards – male and female, with twenty odd beds in each ward, in a small nice country house type building with thatched ceiling under a sloped metal roof. Other buildings to house the regular departments were coming up scattered around a big pond in the centre of an astonishingly vast compound that merged with the surrounding open lands on three sides. A metalloid road skirted the front side through which a public bus shuttled once every hour from morning to evening.
It was winter when I took up my duties there. The days were all bright and sunny and many of the patients would come out of the wards to sit around the pond and bask in the morning and afternoon sun of winter. The inmates were almost all from far off places. Patients who did not have a place to stay in Calcutta and the relatives visiting them would usually stay the whole day. Together they made quite a gathering, lazing in the sun.. The hospital staff, especially the elderly manager who did not have much work to do, joined in for a small talk but never dithered from doling out serious medical advice. Their experience, they thought, adequately compensated for their lack of medical training. Pretty soon I found myself drawn into the chitchats; those were turning out to be refreshing diversions from cramming the tedious details of human anatomy and surgical procedures. Besides, after the sheltered existence in a medical college, it was my first brush with the outside world. Still being wide eyed and inexperienced in the ways of an adult world, these sessions somewhat enchanted me. The hospital for its part served at that time more like a hospice than a regular treatment centre and had many long staying inmates. I grew familiar with some of them, knowing them more than a bed number or even a case history can tell.
I remember one elderly lady, unmarried or a child widow, a freedom fighter herself and relative of another famous leader. For some reason she had been staying put in that hospital for some unexplained ailment and was all set to do that for the remaining time of her life. She though pretended otherwise and wasted no time to inform any new comer how arrangements were all in place for her to go home soon. Every few months her nephew would come from Germany, a man somehow connected with The Helpage India, which had some interest in the development of the hospital. Every now and then she would catch hold of me and discuss about her impending discharge. We would talk about what she must do or not do when she went back home. Then she would complain of a new symptom and I would have to solemnly inform her that it would not be possible to discharge her any time soon till that problem had been sorted out. She would be very annoyed and threaten to go on hunger strike till all the staff would assemble around her- the nurses, the maid, the cook – and pacify her. She liked me partly because I belonged to the same caste as she, the Baidyas and because I gave her a very patient hearing always.
A fiftyish old man used to come to attend his elder brother, who was suffering from colon cancer and required medical intervention every week for a dose of chemotherapy. A bachelor with no family of his own, that man bore the burden of his young nephews. We met often and grew quite friendly. On the days he came, the man accompanied me for a walk to a tea stall that was a mile away, at the highway crossing. It was the bus stop for long routes. The hospital kitchen that served our food observed some strict rationing. For tea, it was a rule of three cups per day. One with morning breakfast at eight, then at eleven when the non-residential office staff came, and lastly at four in the afternoon with two biscuits. So, every day after completing my evening round and meeting the relatives, before going back to my quarters for my study, I walked down to the tea stall. On some days he walked with me.
I learnt that he was now retired. I could guess that he had worked mostly overseas in jobs related to marine activities. He told stories about distant shores and lands and about the men and women there. But he never told me what he actually did or what stations in life he occupied. I would, for my turn, tell him about cancer, gregariously pouring out my newly acquired wisdom and knowledge. Asked once which cancer was most difficult to treat, I mentioned lungs cancer and a few others. A couple of weeks later, he asked me the same question again and in particular wanted to know more about lungs cancer.
Almost three decades ago, cancer treatment was not what it is today. From my undigested knowledge and experience in caring for mostly terminal patients, I perhaps presented a picture grimmer than what it was. That evening he did not walk back with me to the hospital but said he would board a bus from there itself. As we waited for his bus I asked for a second round of tea to be served. I told him I how I missed a cup of hot coffee or tea when I study till late during those cold nights. He looked at me with a stare that was at the same time affectionate and amused.
“Has it occurred to you,” he asked, “that there is a very simple solution to your problem? Buy a thermos flask and get it filled here when you go back. .”
“Yes, I can do that but I have to first find out how much would one cost.” I said patting the purse on my hip pocket, which in those days had not much to pat on.
Just then his bus arrived. As he proceeded to board the bus, he looked back and shouted, “I will get one for you.” He moved his hand and fingers with a gesture to indicate that he would do that when he came next time.
I did not see him for some time after that evening as his brother was not admitted again. I don’t remember why. Perhaps he had completed his course of chemotherapy, perhaps for some other reason, and as patients come and go, I forgot about them. About two months later, as I was hurrying to enter the ward for the afternoon round, having been out whole day for my class, I heard someone calling me. It was the son of that man suffering from colonic carcinoma, nephew of the ex-marine. I thought his father had been admitted again, but no, this time it was his uncle.
“Kaku (paternal uncle) had been ill for some time. He had seen a doctor a couple of times but refused to give it serious attention. My mother suspected something, had seen blood stains on Kaku’s shirts and told us Kaku was spitting blood. But he denied; he said the stains were the beetle leaf juice he had become addicted to lately. But for the last two or three days he developed severe breathing issues and we had him shifted to a local nursing home. After some tests, the doctors diagnosed a lung cancer. And quite well progressed, they think.”
The man was placed in the last bed of the row on the window side but I could see from the door of the ward that that he was quite distressed. An X-ray plate of his lungs, white on one side, ominously hung on the window pane with a piece of sticking plaster. The local physician had already set up a drip and had him readied for a pleural tap to take out the fluid collected around his lungs. That was not allowing him to breathe. He was just waiting for me. Obviously the man was not in a position to talk; neither did I encourage him to divulge what had happened. We drained him, put him under sedation, and kept him overnight with oxygen. Next morning I found him better. He was mostly sleeping throughout the day. His nephew came in the afternoon with an old X-ray plate and a prescription.
“Ma found these amongst his things this morning.” The X-ray plate was two months old. It clearly showed a lesion in the left lung and the prescription dated around that time had two entries. One was that of for some general medicines for chest congestion and an advice for an X-ray chest, the second one referred him to a cancer hospital.
By afternoon the nurses had propped him up on the bed. He was able to talk. He was also alert enough to understand the unspoken question in my lips. He shrugged; then bending his head towards me as far as he could, he said, “It wouldn’t have made any difference. Lung cancers, you told me, cannot be treated.”
His disease had progressed enough for any effective treatment. The man did not want to stay in the hospital either. He discharged himself in favour of the nursing home near their home.
Much later as I began to meet patients and their relatives in my own independent practice, I realised that often by being cocksure about our knowledge and handing out half-baked information, we do more harm than good. Had I not been so candid to him about lungs cancer and prophesied about dismal outcomes, he perhaps would have sought treatment at the right time and might have gained some more time to live.
There is another reason for me to remember him.
A month or so later his nephew came to see me. ‘This’, he said handing me a box shaped package wrapped in a newspaper; “Kaku had asked me to bring to you. Could not come earlier… his last rites… father was not well also.”
The package contained a beautiful blue bodied flask showing an eagle perched over a globe.