March 06, 2006

Throw away the boot

When I was younger, so much younger than today, family and friends began to notice that I stood a little awkwardly. It was most obvious in photographs, where I would invariably stand with one leg out to the side. They also found I ran a little oddly, even though I was active and loved playing outside.

Eventually an older aunt and my mother lay me down and actually measured my legs. By a couple of inches, one was shorter than the other. My mother took me to a well-known Bombay doctor, who confirmed the difference in the lengths and said that I must have had a mild attack of polio. (Polio was, of course, much more of a threat then than it is now). To make up those inches, he said, I would have to wear a boot with a thick sole.

So I began wearing this heavy boot, and I was clearly unhappy with it. I couldn't run around much anymore; instead, I stumbled here and there. My parents were dismayed, but then this is what the well-known doctor had recommended.

About then, the family moved to Aurangabad. Friends there suggested to my mother that she take me a local doctor. A surgeon by training, he was making something of a name for himself treating orthopaedic problems.

When he saw me, he asked: "Is he an active child?"

"Yes", said my mother.

"Then throw away the boot and don't mention the problem to him."

I don't remember this meeting, nor those words. But when I look back, I know they changed my life. I grew up playing every game I could, even getting sort of good at tennis and basketball (my cricket career, though, is limited to a first-ball dismissal and one wicket). I have run races short and long. I swim and have done a lot of hiking. And not once in all the years since we threw that boot away have I been conscious of any problem with my legs. (Apart from the occasional injury). People tell me I have a very slight stoop to one side when I walk, compensation for those inches. But that, I don't mind at all -- someone once compared it to the gait of the tennis maestro Stefan Edberg. (Which was one reason I married that someone).

Of course, my parents eventually did tell me about this episode from my childhood. I have always wanted to meet the doctor who turned my life around. It took me forty years, but last week in Nagpur, I finally did. In the meantime, he has won for himself a deal of quiet admiration in some circles, and in 2002, a Padmashri.

That's Dr Vikram Marwah of Seoni in what's now MP, resident of Nagpur for years. At over 80, he still sees patients. He says many people don't like coming to him, because he prescribes simple solutions, and suggests that they learn to live with their particular problem rather than expecting complete cures. People don't like hearing that kind of wisdom. Still, there are enough people who have come to appreciate his ordinary common sense, his can-do attitude.

For years, he applied those qualities at week-long camps he held in various parts of rural Maharashtra. ("Not the Rotary-Lion kind of camps," he says with a twinkle, "not those one-day things where you do some work and go home to have a beer"). Polio victims, kids with deformities, they would flock to these camps, drawn by Marwah's three-As approach to his work.

"Treatment," he tells me, "should be Available. Appropriate. Affordable." With each "A", a finger rises from his fist.

"After all," he goes on, "what's the use of fixing fractures if you're going to charge Rs 20,000 for it? Who can afford that?"

In the same vein, Marwah describes some of his ideas for simple solutions to orthopaedic problems. One stays in my mind: an artificial leg he once made using, of all things, a cycle stand. "At that time," he says with with yet another twinkle, "you could get a stand for Rs 3.75!" Affordable, oh yes.

Marwah takes me to the little hospital he has run for some 25 years, to meet a clutch of poorer children he identified at his most recent rural camp. Three have club feet, several have burn deformities that have curled up their fingers or toes, cases like those on down the line. The next day, his team will operate on them, apply plastic surgery to the burn injuries, also on down the line.

And as I mingle with them, I wonder what it must be like for a kid to get back his fingers, or to be able to walk with feet straight ahead for the first time in her 8-year-old life. In just over 24 hours, these ten kids will have exactly that feeling.

To my surprise, I am almost envious. I would love to experience that new outlook on life, that delicious freedom from disability.

But I have experienced it. This very doctor once gave me that very feeling.


Sunil said...

it's remarkable how in India you keep finding so many remarkable doctors, amidst a lot of mediocrity.

Very nice post....

Prerona said...

wonderful post! really wonderful and inspirational! Thank you - sincerely :)

m. said...

thank you. that was such a touching post.

KL said...

Are you that famous Dilip D'Souza who writes columns often for Rediff. Actually, you used to write often for Rediff, nowadays I don't see much. So, I guess I have to visit your blog often.

Anonymous said...

"When I was younger, so much younger than today.."

Nicely written dilip, and I guess Dr. Marwah is one reason you've "never needed anybody's help in any way" since then eh?

"Treatment," he tells me, "should be Available. Appropriate. Affordable."

Apt mantra - wish more health care professionals took this seriously..

Kiruba Shankar said...

Brilliantly written. And very touching indeed.

km said...

Great post, Dilip.

And damn you, Lod, for stealing that line :))

Anonymous said...

I enjoyed reading about the doctor-and about the way you walk. My father walks like that too, as he had polio when he was a child. He played cricket. I never saw him with a boot.

Rahul Siddharthan said...

Sunil -

it's remarkable how in India you keep finding so many remarkable doctors, amidst a lot of mediocrity.

I don't think Indian doctors are in the least mediocre. And there's a very good reason -- they see so many more cases than western doctors that their diagnosis tends to be much better. This is particularly true in the educational phase. Medical students in the west get very little hands-on experience, both because of fewer patients and because of a greater reluctance to give students responsibility.

I know several horror stories of medical misdiagnosis in the west (US and Europe). There was one boy whose symptoms, when described to me, seemed obvious -- thyroid malfunction -- and I have no medical background. But the Dutch doctors didn't diagnose it, didn't even test for it, for three years. When they finally did, his recovery was remarkable.

It is true that Indian doctors tend to over-prescribe. On the other hand, Indian patients want prescriptions. I know doctors who prescribe arcane-sounding pills that turn out to be just vitamin B, because their patients won't trust them if they say "nothing wrong with you, just eat a healthy diet".

Dilip D'Souza said...

Rahul, I'm glad you said what you did. I think there are plenty of excellent Indian doctors. With Marwah, what struck me was his down-to-earth, practical outlook on his work.

kl, while I would argue with that "f" word you use, I am the DD who writes for rediff. I'm less regular there now than I used to be, which reminds me that I owe them a column as of last week...

The rest of you -- Sunil, Prerona, m (I know your name), Kiruba, icarus, km -- thanks! Always good when something I write touches chords out there.

Mumbaigirl, so your dad walks like Stefan Edberg too? Did your ma tell him that?

And lod, now these days are gone and I'm not so self-assured, what do I tell you? My independence seems to vanish in the haze!

Anonymous said...


IdeaSmith said...

Amazing post. I'm going to link back to this one.