Tenderer than a petal, harder than a stone
I had finished examining Shyam Lal. While he was exiting, Shobavati was helped in by her husband. Just as Shyam Lal left the room, his son turned back to ask me, "Doctor Sahib, what are the chances for my father?"
"Chances?" I was not sure what exactly he wanted to know.
"I mean, how long does he go on like this. He seems to make no headway. What is the prognosis?"
Shyam Lal was a patient of chronic renal failure from long-standing diabetes and hypertension. Besides his diabetes being quite brittle and difficult to manage and his blood pressure resistant to a combination of three antihypertensive drugs, he was prone to repeated urinary tract infections from an enlargement of the prostate that gave him fever and chills. As a result, his renal status was deteriorating fast.
"Well, his prognosis does not seem encouraging. His renal function is dwindling fast; he has chronic kidney disease stage four. As of now, he is carrying on without dialysis, but it will have to begin sooner than later. If we make a shunt now, it will come handy when dialysis becomes necessary.
"Is he in immediate danger, Doctor Sahib? How long do you think my father will survive, with or without dialysis?" he finally asked without mincing words.
"I can't say with any degree of certitude. Humans are tenderer than a petal, harder than a stone. That is what my mother used to say, and I agree with her after my long experience as a doctor. Apparently healthy looking people fall dead from a sudden heart attack or a brain hemorrhage, while chronic patients linger on from one year to another," I replied.
He felt rather confused, but asked no more and left before I could elaborate on his father's condition.
Shobavati was listening to this dialogue with interest, nodding her head while she waited to be examined. She smiled, her artificial teeth flashing in her small mouth, as she looked meaningfully, appreciatively at me, and asked in a slow, hesitant speech, "Doctor Sahib, you were explaining the nature of our bodies. What do you think of me? Am I a stone or a tender petal?"
Shobavati, seventy five, was my regular patient for several years. This time she had come for pain in her left arm that made her miserable. She could not raise the arm above the shoulder level. Nights were especially difficult; turning in bed woke her up with a sharp pain. Combing her hair was impossible; she had to take help. A case of chronic acid dyspepsia, she had been nursing knee pain from osteoarthritis for several years. Eight years earlier, she had developed complete heart block for which she was fitted with a pacemaker. Three years later, revision pacemaker was necessitated when she developed lead infection in the first pacemaker. She sustained her first stroke a year later, which gave her weakness in her left arm and a speech defect. The weakness resolved to a great extent but the shoulder started hurting while the slight speech disorder persisted. She sustained another stroke the previous year which left her with partial loss of function in her right hand.
In spite of her multiple problems Shobavati retained her poise and charm. She was pretty at her age, her eager brown eyes sparkled in her rather sunken orbs, the dejhour dangled delicately from her ears as she moved her head. She looked the quintessential Kashmir Pandit matriarch.
"Well, Shobavati, you certainly are a tender petal, attractive and delicate," I replied. Looking at her husband who was watching with interest, I asked, "Don't you agree, sir?" He gave an uncertain smile.
"Thank you, Doctor Sahib, but you flatter me in trying to humor me. I am no tender petal, but I sure am harder than granite. Look how each disease chips a piece off me. Yet I go on living. I diminish, but I refuse to perish."
"You are poetic, Shobavati. And a great fighter as well," I replied.
She gave a shy but grateful smile.
"But how long do I have to suffer? When do you think my time will come?"
"Our life span is predetermined," I replied, "I tell you this in spite of being a man of science. When the end has to come, a small whiff of air may blow a person away. Like the leaf from a tree that has stood storms but falls with a gentle breeze. Your time will come when it has to."
"I hope it comes soon. I have been putting up with one scourge after another. My nights are restless; my husband has to remain awake when I cry in pain. I sailed through those heart attacks when I would just pass off for no reason until I was given the pacemaker. I had my kidney removed way back for a huge stone that gave me infections. I did not think of it again. My uterus and ovaries were scooped out of my abdomen when I was still young; yet I survived with dignity. The biliary colic that made me toss with pain is a distant memory after the gall bladder was removed. The paralysis did not make me as miserable as the shoulder."
"You really are like a precious stone, a diamond that has been chiseled from time to time to get the best cut that makes you scintillate." I said laughing.
"In the process I am getting lighter every time I lose a chip."
"Yes, you are light like a flower, and hard like a diamond," I continued with the banter.
"Not without purpose, Doctor Sahib. I have sent my parts in advance. I believe it has made me light for the final journey. The pall bearers will have an easy time carrying me."
I laughed aloud and replied appreciatively, "You are full of wit."
"I am, but the pain in my arm has plagued my existence. I think, finally it will kill me."
"Come on, it is just a frozen shoulder; that never killed anyone."
"But, as you said, it does not need a hurricane for a tender petal to fall down?"
"Everything at its time, dear Shobavati," I said, helping her out of the chair.