THE COSTLY DELAY - 1

You may have read this statement somewhere –

‘If you want to know the value of one year, just ask a student who failed a course.

If you want to know the value of one month, ask a mother who gave birth to a premature baby.

If you want to know the value of one hour, ask the lovers waiting to meet.

If you want to know the value of one minute, ask the person who just missed the bus.

If you want to know the value of one second, ask the person who just escaped death in a car accident.

And if you want to know the value of one-hundredth of a second, ask the athlete who won a silver medal in the Olympics.'

Couple of days back, I had two patients who would have done better if they had not delayed coming to us on time. I shall narrate the story of the first patient in this post and in a later post, the story of the second one.

LR is a 55 year old man from a nearby village, Rankikala. Since the last 1 month LR has been sick with vague symptoms. It started off with fever on and off in the evening. He went to the local practitioner (RMP) in our market village, Satbarwa who prescribed him some tablets. He improved for couple of days, after which the fever had come back. In addition, he developed something new – he had episodes of seizures of his right leg alone.

Satbarwa is famous for a Vaid (traditional healer) who is specialized in neurological ailments. I’m told that he uses the extract of garlic to make a concoction which is given as an intramuscular injection. I’ve had quite a lot of patients who vouch for this remedy in the treatment of neurological ailments. However, I’ve noticed that the recovery mainly occurs in patients who had ischemic strokes – which would have healed otherwise too. Since LR felt that having seizures is something related to the nerves, he straightaway went to the vaid at Satbarwa.

Unfortunately, nothing much happened. He still had a fever and cough was worsening. However, he felt that those symptoms are secondary and he needed to get treatment for his seizures. The seizures continued to occur. The Vaid decided that this needed further evaluation and send him to one of the physicians in Daltonganj. The doctor of Daltonganj also treated him for about 2 weeks – before LR decided that there was not much improvement.

LR came to NJH OPD couple of days back – He was frail and it was obvious that he had lost quite a lot weight recently. His pulse was feeble and Blood Pressure was just 80/50. His chart came to my table – as he entered my room, the diagnosis was obvious - Lung abscess. The stink from his breath was unbearable. It was difficult to fathom how one could miss the stink. And from his blood pressure and history of seizures  - possibilities narrowed down to either a disseminated malignancy or disseminated tuberculosis. Sputum AFB turned out positive for tuberculosis. I did an X-Ray which is put up here.

LR's Chest X-Ray

LR had spent almost 10,000 rupees by the time he came to us. He would have done better with a CT Scan Brain. But, he just did not have the money to make a trip to Ranchi leave alone the CT Scan. In addition to the Anti-Tuberculosis treatment, we have also started him on Steroids and Anti-seizure medications.

LR waits with his son for his anti-tuberculosis medicines

I’m confident that he will do well. However, things would have been easier had he turned to us early – which brings us to question on why people avoid coming to people like me in the first place. Money is obviously the major issue is institutions such as ours. However, he would not have had to spent this much if he had come to us straightaway. But, I did not understand why this does not happen, until I heard about ‘agents’ about whom I shall post soon.

My only prayer is that the delay would not turn out to too costly for LR whereby he may lose his life – unlike RD about whom I shall write in my next post (http://jeevankuruvilla.blogspot.com/2011/09/costly-delay-2.html).