A priceless touch
‘ Hi doc , how are you doing ? ‘ she said as she walked into my clinic . She didn’t seem to have her usual smile and positive demeanour , I hadn’t seen her like this anytime in the past . I knew something was wrong .
Mrs C , a fit and active lady in her early 70’s would religiously come thrice a year to see me in my clinic in the Orthopaedic department . She had signs of wear and tear of the knee joints , or Osteoarthritis of the knees . The first time ever I saw her was with her husband , and she had only one request – that I would do a detailed examination of her knees before giving her any suggestions on how to tackle the knee pain . I complied . I quickly recollected what all I went through as a medical student and an orthopaedic trainee and said ‘Oh sure Mrs C, not a problem at all . I just need to Look Feel Move and Measure and then we’ll be done with your orthopaedic examination, it’s simple .’ She smiled . I had already seen her xrays and knew she would definitely be in some pain . But as I went through each of the steps in clinical examination , she never winced nor grimaced . I inspected the knee all around including the back , then palpated her joint line and knew she had tenderness which she didn’t let her wrinkled face show , moved both the knees to check the maximum possible movements , and also pulled out the goniometer from my drawer to measure the varus deformity in the knees . I normally don’t do such a detailed examination in the clinic , this was purely to keep her quiet and honour her request . ‘ Well Mrs C , you know you have arthritic knees . Sooner or later you would need a major operation , a total knee replacement , depending on how severe your symptoms are . If you’re not yet ready for a surgery , then we could buy some time with some injections into the knee and some pain killers .’ At this point she gestured to her husband , and she said ‘ Doc , I’m very happy you examined me thoroughly , and thank you for your suggestions . But you know , my husband is under treatment for Colon cancer , and there’s no way I could go through a major knee surgery at this point in time . He’s got only me , and I need to be at my fittest best to be able to support him ‘ ‘ Yes , that’s all the more reason to consider surgery Mrs C . The first few days maybe tough , but being the active lady you are , in no time you will be able to attend to all his needs ‘ ‘ Oh well thank you doc , but your detailed examination as you looked at and palpated my knees is more than enough to keep me going . I can assure you in the last two decades no doctor has ever spent so much time genuinely examining me . Everyone jumps to the xrays and the ECGs and the blood results . Thank you for your time doc , truly appreciate it ‘ I could tell she was genuinely grateful for the few minutes I spent talking to her and examining her in detail , but could not still understand how she could say no to a surgery or at the very least an injection into the joints .
She would come regularly , thrice a year to my clinic . I remember telling my secretary to ask someone else to see her during the follow-ups till she decided to go ahead with surgery , but somehow her file would always end up on my desk , and I would end up seeing her every single time . Sometimes willingly , sometimes not-so-willingly . But I always honoured her request whenever she saw me – look , feel , move and measure . And she would always politely decline any intervention other than continuing with her exercises , along with on and off painkillers .
A couple of years passed , and her arthritis was slowly getting worse each year but she continued to refuse an operation . She would still leave gladly from my clinic after I had done talking to and examining her . And then , I did not see her for 7-8 months . She had missed two appointments , had not reported to the clinic nor called the secretary . I assumed she did not want to come to the hospital because Corona had hit India hard . A strict lockdown had been enforced in March and I knew that was why she wasn’t able to keep her appointments . Guidelines for seeing patients had been issued . Everyone was a potential Corona carrier , and instructions were to keep appointments as short as possible . Plus also do only the basic needed examination and investigations to decrease the exposure time to both us the clinicians and all healthcare workers in the hospital .
And then recently , she turned up at the clinic . I don’t know about her , but I was glad to see her , to know that she was still alive . I immediately recognized her inspite of the mask she was wearing , but she couldn’t recognize me . I don’t blame her , as I was now in my scrubs ,not my usual pre-lockdown formal attire . I had my mask,headcap and visor with a plastic disposable apron on . When I introduced myself , I knew she was very happy . She didn’t seem her usual self this time though . I carefully listened as she spoke . ‘ Hi doc , how are you doing ? Corona has wreaked havoc isn’t it .’ She told me how she lost her husband to the virus , and she herself had had Covid but had pulled through without any major issues . She missed going out for walks with him in the park next to her house . But said she was hoping she would somehow get to see me in the clinic today . With all my protection on and gloved hands , I hurriedly examined her knees this time . Not because I didn’t want to , but coz I wanted her to leave as early as possible , to reduce the exposure time . ‘ You know doc , this Covid has been particularly devastating . A good part of mine and my husbands savings have been spent on his ICU care , which eventually proved futile and ..‘ I interrupted,hoping to finish the consultation very quickly “ yes I can fully understand Mrs C , I’m very sorry to hear about Mr C and what all you’ve been through . Even for the hospital , it has been terrible . All the staff, including me and my orthopaedic colleagues , are taking a pay cut , many construction activities have been put on hold , and we don’t even know when income would come back to pre-covid levels . It may take a year or even longer , experts say . I’m sorry about your savings being lost . Yes this is a terrible disease , I can fully understand ‘
She just sat in her chair , without saying much , but showing no intention of leaving either . ‘ Can you give me about five minutes please to share something with you , I promise I won’t take longer .’ Though I was a bit annoyed , I still managed to say ‘please go ahead Mrs C .’ With a moist voice she said ‘ Yes doc , I fully understand Covid has caused immense financial damage not only to me but to many families , institutes , economies and countries . But you know what , in addition to estimable losses , it has also caused many immeasurable damages too . As for me , my husband’s loss is huge . No amount of money can ever replace his loss . And as for my knees , you have lost your touch doc .’ I was getting a bit frustrated at her choice of words , and was wondering if I should politely show her the door . ‘ The loss of you being unable to go through the usual ritual of examining my knees , for me , is huge . I used to call up the office , find out if you were available or not and only then come to the clinic . I always requested the secretary to allow me to be seen by you . My knees need an operation ,I know that fully well , but everytime you carefully examined me , it was as if they got a lifeline , and I used to feel these knees could go on for longer . And they have managed to , all these years . But thanks to Corona , and I don’t blame you for this , thanks to Covid and the new guidelines , I do understand that you are fully within your rights in wanting to spend as little time as possible with me and my knees . Corona has turned you all in the hospital to delicate darlings and touch-me-nots . I know very soon I would have to come back for an operation , now that I can no longer feel the hands that eased the pain around my knees coz it feels very different with the gloves on . The healing touch that I would always crave for is now a thing of the past . I mean every office,every institute would be able to calculate the financial losses incurred , but for someone like me , this loss is unfathomable doc . It has taken away from me something that I always treasured as you examined me here every few months in this very same clinic- your priceless touch .’
As she left the clinic , holding back her tears , I was wondering if this was an over-reaction or a genuine concern . Knowing Mrs C for the past few years , I have to admit it’s the latter . Estimating losses is possible for many essentials and commodities , but one can make a list of many things for which a price tag cannot be put be it family , the loss of a loved one , memories , travel experiences or special moments and as a doctor I’ve learnt to add one more to this list , thanks to Mrs C and the Covid pandemic – a touch . The touch of a human hand – a caring , genuine, priceless healing touch .