I recall Rashmi as a playful, chubby baby of one & half years age brought to my clinic sometimes in December 2000. Accompanied by her parents & few “well wishers”, she certainly looked a very quiet & disciplined child for her age. The reason for consulting me was obvious: this little girl had an anomaly over her face. Her left eye was visibly smaller than the right one ever since her birth. In addition, she was a premature child.
Unaware about the implications of this facial asymmetry, the parents were primarily concerned with its cosmetic aspect. “After all…”, said one of the well wisher of the family, “she is a girl! Who would marry her, doc sa’ab”. I requested these “uncles” to leave the room so that I could have some quality time with the parents who needed to see the problem in correct perspective with fewer distractions.
“I must examine her under anaesthesia”, I explained after having discussed the need for a proper evaluation. The smaller of the two eyes could have a significant refractive error necessitating early introduction of glasses to ensure proper functional development of her retina. Not treated this way, there would be every chance of this eye becoming “lazy” or “amblyopic” as it is called in medical jargon. The child could eventually develop a squint.
As a premature baby, she was also prone to ROP (“the retinopathy of prematurity”) , although I felt it was unlikely in this particular child.
On the day of the examination, she happily allowed to be escorted to the operation theatre in a nurse’s lap. She drew her head up curiously as the anesthetist approached her with a small scalp vein set soon to be introduced in one of her veins. As the doctor pushed it in, the child looked in utter disbelief as if trying to say “You too, Brutus!”. Minutes later, she was fast asleep under the effect of the intravenous drug.
The examination was soon over & the child was in the recovery room. The parents were explained that the child would need another visit a few days later, a set of spectacles & there after, periodic check ups.
Out of no where, turned in a “well wisher”. Agitated they indeed were, since their hapless child had not been fed since early morning.
The well wisher was annoyed as the glasses were not prescribed immediately.
“We would better take her else where!” came the decree from the well wishing uncle.
I tried to pacify the parents in vain that we already have enough information about the child, but the uncle had struck!
That was the last time I saw Rashmi.
I don’t know which centre they took the child to. The child would have been through a repeat examination under anesthesia, with more punctures in her skin.
The moral of the story for Indian attendants is as follows:
(1) Let the doctor deal!
(2) Beware of the well wishers turning in at the very last moment. They would often like to have a prominent role in the management and would like to make up for their delayed entry in the scene.
Moral for Indian doctors:
(1) Try to communicate to the parents, take them in confidence in the very beginning.
(2) If there are too many well wishers, ask the parents to decide who would be there for discussion regarding the management.
Unaware about the implications of this facial asymmetry, the parents were primarily concerned with its cosmetic aspect. “After all…”, said one of the well wisher of the family, “she is a girl! Who would marry her, doc sa’ab”. I requested these “uncles” to leave the room so that I could have some quality time with the parents who needed to see the problem in correct perspective with fewer distractions.
“I must examine her under anaesthesia”, I explained after having discussed the need for a proper evaluation. The smaller of the two eyes could have a significant refractive error necessitating early introduction of glasses to ensure proper functional development of her retina. Not treated this way, there would be every chance of this eye becoming “lazy” or “amblyopic” as it is called in medical jargon. The child could eventually develop a squint.
As a premature baby, she was also prone to ROP (“the retinopathy of prematurity”) , although I felt it was unlikely in this particular child.
On the day of the examination, she happily allowed to be escorted to the operation theatre in a nurse’s lap. She drew her head up curiously as the anesthetist approached her with a small scalp vein set soon to be introduced in one of her veins. As the doctor pushed it in, the child looked in utter disbelief as if trying to say “You too, Brutus!”. Minutes later, she was fast asleep under the effect of the intravenous drug.
The examination was soon over & the child was in the recovery room. The parents were explained that the child would need another visit a few days later, a set of spectacles & there after, periodic check ups.
Out of no where, turned in a “well wisher”. Agitated they indeed were, since their hapless child had not been fed since early morning.
The well wisher was annoyed as the glasses were not prescribed immediately.
“We would better take her else where!” came the decree from the well wishing uncle.
I tried to pacify the parents in vain that we already have enough information about the child, but the uncle had struck!
That was the last time I saw Rashmi.
I don’t know which centre they took the child to. The child would have been through a repeat examination under anesthesia, with more punctures in her skin.
The moral of the story for Indian attendants is as follows:
(1) Let the doctor deal!
(2) Beware of the well wishers turning in at the very last moment. They would often like to have a prominent role in the management and would like to make up for their delayed entry in the scene.
Moral for Indian doctors:
(1) Try to communicate to the parents, take them in confidence in the very beginning.
(2) If there are too many well wishers, ask the parents to decide who would be there for discussion regarding the management.
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