Sunday, November 30, 2008

The Tale of the Big Toe


A couple of days ago, there was a commotion in the town clinic. A brazenly courageous individual went inside the laboratory and stole one mobile phone while the lab personnel was peeking through the microscope. Some kind of an Agatha Christie plot, and though I was on the verge of joining in the search for the usual suspects, I took a step back and concentrated on my medical supervision.

One of the logisticians (logs, in slang) suggested that it might because the lab personnel gave the “wrong result” hence the thievery. It was also at that point when a man came to the triage nurse complaining about pain on his “big toe”. The nurse, poor soul, was still flushed with the robbery, couldn't understand what the man wants: he is saying big toe, but he is pointing at his groin! So she probed further: "How about your other toes?"


"My toes in my feet are fine," he said.


"But you said you have a pain in your big toe. Do you want to see a doctor or shall I see you toe myself?" she offered.


The man who is in his 50's almost collapsed. In a very conservative place as Manipur, where churches and Christian values abound (sometimes much too much), it is "forbidden"to talk about the privates. Men do not go to clinics and be treated for sexually transmitted infections because of fear that a woman doctor would "touch" their penises. In this context (Christian teaching plus tradional beliefs) it is very difficult to talk about sex, discuss about it publicly and come to the clinic for consultation.


It has become a bit of a challenge to invite men to come to the clinic and avail of the free consultations and the medicines we have. In October of this year, we have but 2 cases of male sexually transmitted infections and about 200 times more listed as mere urinary tract infections.

Despite the huge economic boom in modern India and the modernization of what was deemed as rural, traditional beliefs and culture still exist in every nook and cranny.


Going back to the guy with the big toe, I happened to be in the records room and have overheard the commotion. I obviously do not speak Manipuri, but with the old man's gestures, it was obvious that he has either sexually or mental problems.


The great sleuth stepped in. I found it more pleasant to intervene in this than look for the cell phone. Anyways, I called one of the male doctors and have him talked with the old dude. Indeed, the guy has been having pain when he urinates! He has been having bloody urine for the past months and has been having discharge for a longer time. He was the examined and was given medicines by the doctor.


I was just outside of the main clinic, listening to the epic of the lost mobile phone when the Big Toe Guy came out and thanked me. As he was about to stepped of the clinic, I asked, if our doctor did a rectal exam ( makes sense because it could be also a prostatic problem). The man smiled, came back and asked our guard what I was asking.


The guard explained that I planned to have the doctor "examine" his anus. The old man, took three steps back and then started to run. The staff who were present just laughed like they never laughed before.


I am glad though, that we manage to solve his big toe problem.

I am just going to stop this for now, I may have to see what my big toe needs.

PS. We had no clue what happened to the phone.

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