Life’s Burdens

Life-stories of my patients have convinced me that the burden does not fall equally or even randomly on our shoulders. Some seem to have had far more than their fair share.

A 65 year old gentleman, Dr S, came to see me in my clinic last week with obstinate symptoms of gas, dyspepsia, constipation and bloating that 10 gastroenterologists and 25 types of medicines had not been able to relieve. All his investigations had thrown up normal results.

I realized that there was something that had evaded the attention of my predecessors, and despite my tightly crammed clinic schedule, decided to change track from writing yet another prescription  that was doomed to fail, to looking at him as a distressed fellow-human in need of help.

Very soon, I came to realize that with his growing years, his attention had drifted from being a committed doctor raising a family of 3 cheerful children, to worrying about what would happen to them after his demise. His eldest was a daughter of 40 who had been recently widowed and was staying with him with her children. His next was a 38 years old chronic schizophrenic son, who was so mentally disturbed that he was entirely dependent on him. His 3rd was a “normal” 35 year old son who had his own small business and family, on whom Dr S did not want to pass on his burden. To top it all, his wife of 45 years had recently turned funnily “spiritual” and had left it to her husband to find practical solutions to their family’s problems!

As I listened to his fears and concerns, I wondered what I would have done if I were in his shoes. Words of comfort started sounding hollow and, medicines, I realized, could get him some sleep in the nights, but not provide any meaningful solutions.

But as his underlying distress finally found an expression in my clinic, his dyspeptic symptoms got some relief.

Another 60 year old man who had been suffering from similar “gas” and “bloating” that had remained intractable for 15 years despite consultation with 15 doctors had another touching story. His symptoms had started on an August evening when while returning home from work in the evening, he had seen an unexpected crowd at the entrance, and then on entering, had seen his 25 year old only daughter lying dead on the floor, struck a few minutes back by a speeding car just outside their garden gate. Since then, his life had lost all meaning and his dyspeptic symptoms had taken hold.

Somatic or body symptoms often have their origin in stressful or traumatic life events or situations. Labelled as “Psycho-somatic”, they often manifest through symptoms related to the gut, head, heart or genital organs. Their solution lies not in scoffing them off as “all-in-the-head” but to a deeper understanding of life’s travails and traumas, worries and challenges.

As published in HT City ( Hindustan Times) dated 28 April, 2013.