Part of series of articles published in IMAX (monthly journal of IMA Rajkot) based on real life heart touching experiences-2014

A teacher teaches a lesson and then takes test but life tests us in many ways and then gives a lesson. Life is the greatest university where the lessons never end; you have to keep on giving the tests and may end up without any qualification ever!!! Many such incidences occur around us, we just need to keep open our eyes, ears, heart, mind and soul.

I would like to share one such incident which I am not able to forget even after eleven long years.

After completing my MD, I was working as a day-time consultant at a small town near Ahmedabad, while my husband was pursuing his MCh at VS hospital.

There was a teenage boy, Mahesh, working at a tea stall nearby the hospital I worked. I had seen him occasionally while he served tea in the afternoon to other consultants and staff. As I was not a tea addict, I had no opportunity to interact with him personally.  Sometimes he used to stare from outside my chamber. Once I called him and asked him why he was working and not studying?

Mahesh described his long struggle in few broken sentences. He was the eldest brother in a family of five children. His father has died when he was 8 years old due to some illness, which I suspect to be tuberculosis from whatever details he could recall. His mother had to go out to sell seasonal fruits to feed the family. He was the care taker of the younger sibs, smallest one being just 1year old at that time. How can he study?  On completing 10 years he started working at the tea stall, as a washer boy.  He is now 13 years old and has been promoted as a service boy, of course with increment in salary. His achievement sparkled in his eyes.

The casual stare that we exchanged got converted into a regular smile every day. Once he didn’t appear for a couple of days. On inquiring one of the ayaben who happened to live near his house I could learn that his younger brother was terminally ill and the local practitioner has said he could not be saved now. It was the place where local practitioners were neither MBBS nor a DHMS or a BAMS or a paramedical person but were the so called quacks. I asked the ayaben to insist him to bring his brother to our hospital promising I would not charge a penny. (He had once told me that I charged exhurbiantly. New case was Rs 70/- and follow up was Rs 30/-at that time.)

Next day morning he came, accompanied by his mother who was carrying a mass of skeleton in her hands. He was Ramesh, aged 11 years and weighed 11 kg!!!  Being treated by one of the quacks for fever and anorexia since one year was the only history given. On examining, there was almost a cadaver with severe wasting, gross hepatosplenomegaly and massive generalized lymphadenopathy. It took me no time to realize that I was helpless without admission and investigations at such a peripheral centre. I was also sure that the poor illiterate family will not be able to handle the harshness and hardships of formalities in Civil Hospital.  The best place I could think of was the pediatric surgery department of V S Hospital, Ahmedabad, where my husband was a second year resident. I gave some money and full assurance that they will be attended personally and free of cost.  Only thing I could not guarantee was life because I feared the worst diagnosis. (Malignancy)

After many visits and investigations, to everyone’s relief the diagnosis confirmed was disseminated Koch’s. Ramesh was put on AKT and signs of improvement appeared soon. Other sibs too were screened and put on prophylaxis as needed.  Ramesh came for regular follow-up with his mother.

During the follow up visits I got more chance to interact with the family.  The mother told me one day to give some tonics for Mahesh too as he was not eating properly and skipping his meals, many a times. I sent her saying that I will check him.   But Mahesh refused for examination with the stubbornness of a teenager. As usual I had an idea that he would be spending some of his salary on packed or junk foods and that might be the reason of his  not eating properly at home. After much persuasion and a promise of keeping the secret I was able to bring out the truth, bitter enough for anyone to digest. Mahesh’s employer used to provide him unlimited lunch with the limited salary. To make a saving at home, he used to eat how much he could but only once in a day!   Think of a growing teenager in the age of  maximum calorie requirements  and working on toes full day to meet the ends and suppressing his appetite at home to make a little saving anyhow…..

How could I explain to Mahesh’s mother the reason of his not eating at home?  Within few months we left the place. I don’t know the whereabouts of Mahesh and his family but I still cannot get out the innocent face of Mahesh from my mind. Mahesh was a mother to his sibs at the age of 8; he was the father in the family earning at 10 and at 13 he was making a saving for family by sacrificing his meals.

Why life has to teach him such harsh lessons at such a small age? Who could be blamed for this? His parents for bringing him to this world, or his own ill fate for being born in such a family. Is life training him in hard work and tolerance for a better tomorrow?  Or torturing him so that one day he would end up entering the world of delinquency. So many questions without answers!!!

Dr Neema Sitapara

MD (Ped), PGDip. (Adolescent Pediatrics)