For non-pediatricians, Pediatrics appears to be a rather challenging –
if not demanding – branch of medical practice. I remember the days when
we used to have Grand Rounds of the wards during which the entire
medical faculty of our college would descend on the pediatric wing to
check out our little patients. Those were days when echocardiography was
still not in vogue (the year was 1981) and soon, the senior
cardiologists would be at their wits end, wondering how on earth one
asks a two-year-old child to hold his breath and let them auscultate the
murmur to their usual satisfaction. How the hell can you examine such
children? – a senior professor fumed, just as the uncooperative toddler
yanked his glasses right off his face! We of course grinned in amusement
and told him that we manage to do the needful between the breaths and
the cries.
Of course, pediatricians love the job and the perks
that come with it – being in contact with young children (and young
parents!) for the entire length of their careers – even when they grow
old, probably being the most rewarding of them all. The pediatric
clientele is like none other – we know that children can be brutally
frank and outrageously funny. But they are also the most loyal patients
– if they may indeed be called so. What better sight than having one of
them proudly enter with their own child now for vaccination to the
doctor under whose care they blossomed into adults – the joy is truly
unmatched for both.
Practising in Allahabad with a mix of urban and rural
patients can have its funny moments. Several years back a family from a
remote village brought their child for treatment. "Kya umar hai
bacche ki?" (what is the age of your child?), I asked. "Ab apay
samajh lein sahib, humka nahin pata" (You interpret yourself, I
don’t know), he replied. Without saying anything, I asked him to make
his child stand on the weighing machine upon which he looked at his wife
in amazement and said "Kaisi kaisi machine aay gayi hai aaj kal –
kitni umar nikli sahib?" (What machines have been invented these
days – so what is the age of my child according to the machine, sir?) .
On another occasion, I was surprised to hear a howl of protest from a
young girl while my assistant was explaining the prescription to her.
She kept on repeating "Hum itni badi capsule nahin kha sakte" (I
can’t swallow such a large capsule) but in front of her there was just
the prescription. Perplexed, we asked her which capsule she was talking
about and she pointed to the paperweight on top of the prescription
which was in the shape of a capsule!
I have an aquarium in my chamber – it acts as a great
pacifier for crying children. In fact the family physician who used to
treat me when I was a child had one in his chamber and I remember how
much I would enjoy looking at the colorful fish swimming around, while
waiting to be examined. It has a soothing effect on a child who might
otherwise be apprehensive when entering the doctor’s chamber and many of
my regular children make a beeline straight to the aquarium, exchanging
notes on the wellbeing of its occupants with my assistant. The more
meticulous ones (the one’s destined to become IIT graduates later on in
life, I suppose) even keep a tab on the numbers – "there were nine of
them last time but now there are only seven – what happened to the other
two?" they ask. But aquarium watching can have its funny moments too as
I discovered once when a small child of about three years stood in front
of the aquarium, hands in his pockets watching the fish swim, apparently
transfixed and mesmerized by the sight. Or so we thought till he turned
around and announced to his mother in Bengali "Aami khabo!" (I
want to eat them)!
Over a period of time, pediatricians get used to all
kinds of children in their office – the cranky, crying, cheerful,
hyperactive and serious, and love them all. Probably, the pediatrician’s
brain finds a way of dealing with unwelcome noise and activity by simply
blocking them off at the thalamic level, but the one small child who
really scares the pediatrician is the silent child. A child crying
lustily is such a comfort (right from birth) but a silent, sick child
who does not cry sets the alarm bells ringing like none other for all
pediatricians – much like Sherlock Holme’s legendary dog that did not
bark!.
