Katterikuppam, ExPeCtaTions

It was almost like a jungle inside the factory premises. That part of factory made the ‘non factory’ part having a school, a temple, residential buildings, play grounds and a canteen; all for the workers and their family. But they appeared as a isolated buildings inside a jungle. We reached residential area which appeared like a electronic gadget zone in the jungle.

We went to Bir bahadur dai’s home first ( it came first on the way). As I’d never met him, the introduction session went longer ( kasko chora, kasko nati, pahad ghar kaha, mawali ko tyo gaun ko falano lai chinchau etc etc will definitely make things late!!)

Bhauju prepared cold lemon juice and served. It was refreshing. So without any hesitation, I asked for more for record 4 times....total 5 glasses of lemon juice.




We were talking bout different things altogether when he said
“Babu mero dhaaD ko samasya dehaunu thiyo.” (I’d some back problem and had to consult a doctor.)
“Tara ma ta 2nd yr matrai ho. Maile kasari bhanna sakula ra?” (I’m just 2nd yr student. How can I opine on that?”
“Tehi pani.. Yesso ek choti herdina paryo.” (But still...)
How could I’ve said anything about his case?? I never ever had any orthopedic postings. Still I obliged, for his sake. So I asked for the old reports and scans( rather than proceeding through history and all those stuff). A recent MRI taken in Chennai had reported L5 IVDP (intervertebral disc prolapse) with a hemangioma at previously operated site.

Hemangioma in spinal cord reminded me of an episode of House M.D. A young guy with severe twitchings of limbs and excruciating pain was diagnosed with spinal cord hemangioma. Beside that my all ideas were blank. And I enquired about twitchings and pain.
No twitchings at all.. Pain was present but not the excruciating type. It was chronic and he’d adapted with that. So only way to satisfy myself was House M.D. rarely shows general cases( i.e. always shows rare cases or rare manifestations).
But one things puzzled me. Claudication like symptom. He complained of pain in right calf muscles even after walking very short distance. His right leg was cold and had definite generalized muscle wasting. Claudication normally means abnormality in blood supply to limbs which is usually due to vascular pathologies like Atherosclerosis. He had no such history or family history.

Can L5 IVDP and previous surgery (he’d severe back pain and doctors told him to get operated. He obliged without knowing the name of his ailment!!) with forming hemangioma have any relation to this claudication like symptom?? I still don’t know. Thought to talk to some guys here, but haven’t yet.
I leave him asking him to meet Dr. Patro, our orthopedic HOD.


Next we went to baburamji’s house. He happened to know my cousins. We were again talking about the usual stuffs, when he called his son and asked me to assess his growth and development. Having seen so many cases of mild to severe malnutrition and specific nutrient deficiencies, this around 12 years old boy was very normal; in my thought.
“He is 16 years old and came here after writing SLC. We consulted with many doctors, made pooja and what not but he didnt grow”
Though the child was shorter for age, it was still all right for me as he was physically fit and mentally fine.
“What do you opine for this child?”
Ohh!!!! again... I have been telling people that I am just 2nd year student. Why cant the understand that I aint a doc, I am just a student. I was amazed and furious for their expectations. They must have had consulted other big guns of the field and when they failed to diagnose or treat, they ask me to opine!!

But on other hand, looking at their face also, I couldn’t say “sorry this aint my job.”
I told them “Stature isnot a problem at all I he is mentally active and he can grow later anytime.”
I asked about his brother. Though he also was shorter than normals, he was taller than his brother.
“Hey comm’on man. That aint a problem at all. Even my brother is taller than me.” I just hope this consoled him to some extent.


By then, I had started to want returning back. At least no more cases please was what I was saying to myself. After all I am just a 2nd yr medical student who practically knows nothing other than names of some diseases and some conditions. I am like a 2 years ld child in medicine after all who knows just few words to utter and nothing else. But they wont understand it seems!

And when I was about to leave (practically tying my shoe laces), “There was a child of my nephew. 2 years old son. Bleeds after just small scratching.”
This case got me interested as this was what I could talk about! If not Hemophilia, it at least must be von Willebrand or any of he bleeding diathesis. But committing myself there could have been dangerous. So I just said, “Ask him to come to JIPMER, I’ll ask a professor to examine him” only to realise later that the child was in Nepal now. Anyway I gotta move and I did so.