So 2022 marks as a year of me graduating and earning my medical degree from Assam Medical College in Dibrugarh, an Assamese town-city, marking itself as the easternmost beacon of India. So the twelve months of my compulsory rotatory internship were packed with abundant experiences and stories. In an amount, I certainly feel would blur my mental hard drive. Yet, among the silver lines of blurring memory, I still remember a patient I met in the Department of Otorhinolaryngology. That department certainly had a faculty; all the AMC alums had stories to tell at the back. We all know what that means. Yet, without any actual disrespect, we all found him to be a strange and unexpected lifesaver for his notes and hard work behind the students preparing for the finals of that subject. But at the end of our internships, his just steps of vigilance made us complain like a chatterbox about him. So this story in my diary revolves around one of his follow-up patients.
Assam does see a significant number of patients having Tuberculosis, Anaemia and Cancer in the throat or in Gall Bladder, an organ in your abdomen, throughout the year in hospitals. Our patient was a nasty case of Laryngeal Carcinoma, cancer in the throat. In general terms, a case aka patient’s condition is very relative and subjective. In academics, a good case may mean poor clinical setup prognosis or, in other words, not so good for patients. In addition to a neglected patient, poor care after treatment certainly means a lot of complications, in other words poorer prognosis but excitingly good or great from an academic point of view. So he was one such post-operative case of a higher staging of laryngeal cancer with a really exhausting operation, as I heard from PGTs discussing among themselves without me as an internee eavesdropping. The neglect by his family in taking care was so much that he already had maggots in his neck. To clear your mind, in any case, you didn’t know what maggots are; plus, if it’s boring to Google out, hear me out. It is common to see these worms in rotting bodies of flesh. But, in the living people, it is undoubtedly the trisection of Neglected discomfort, deranged immunity of that area or body as a whole and, in the end, rotting flesh in a living person. One of the gruesome experiences of slow death that was never silent.
This patient came again at my time to get admitted only after a negative COVID-19 report. Just think what might have time and tide gone through that the family members felt it was time to bring him back to genuine homely care, aka the hospital. No doubt they were having a situation of hand-to-mouth for certain weeks yearly. Yet after further talks with the family, I learnt that they had spent about 2 lakhs or 200 grand after borrowing to get him treated in Guwahati and later in Chennai to only return with acceptance of the prognosis and impending death, which they preponed by their care after successfully postponed at AMC initially. Typically, the sarcasm of our protagonist, Sir, takes to the roof when people come back to AMC, realising that they never felt so easy enough getting treated for the same disease in their health tourism with their spring-tight budget. His response to understanding the newfound exaggeration of past complexity made me awe-struck. Yet, the matter was out of his hands now. The patient was more deteriorated to be solely saved by this department. He thought it was best to take the views of the Palliative Oncology Specialist. Thus formalities were done without further delay for the paperwork asking for opinions.
Now, this is where the matter started getting awkward. The patient was immune-compromised because of his medications and had Diabetes. Really messed up as last time; he and his family still had hope that they did not mess up more than last time. Thanks to modern-day literacy standards and unchanged ignorance of accepting new facts, the patient party often forget to measure the severity of their grave error, just like in this case. Nevertheless, being the curious and excited panda, I wanted to know how his course of treatment would proceed. Two days later, 2 paramedic internees from Assam Cancer Care Foundation came to the department, searching for him to try the necessary steps in response to the request for further opinion and management sent to the palliative oncology department. So when I asked how they planned to bring maggots out for further surgery, they showed me a magically lip-smacking substance, aka sugary branded Nectar-rich Honey. Presumably unable to control my tongue, I let go of the sentence if they plan to kill maggots by Diabetes. To my surprise, I got the fastest yet half-heard and zero-remembered lecture on the benefits of Honey in maggots. No doubt, you can’t drain a disinfectant or simply antiseptic on someone’s throat and expect them to be alive to see a maggot-free life of theirs. At the same time, putting Honey, I at that time thought that we returned back to square one in the evolution of treatment methods in medical science. Medical science is like a chromosome full of helixes; you can figure things out only when it’s time, experience, and enough knowledge and resources. I certainly won’t be able to make any final thoughts of the effectiveness of this therapy as I was allotted COVID ICU duty two days after, but the communication made to the patient and their family at their most vulnerable point and the experience of our still not so beloved Sir to come out of their pattern when mattered is well appreciated. Still, fingers crossed, if I get medical literature that tells me the Honey method works, be it in the distant future, I would be highly jolly.