A Keloid is a condition of proliferation of fibroblasts, collagen fibrils & immature blood vessels usually on a pre-existing scar. It extends into the normal tissues & continues to grow years after injury---- I go over the definition in my mind the moment she tells me her complaint.
She is my Spot Case.
My last hurdle in the Surgery Clinicals.
I poke around a bit more on her scarred neck & upper chest.
She sits meekly, obliges when I tell her to turn her head or raise her chin & politely answers my questions:::
Yes, it itches she affirms.
Yes, it's growing.
Yes, it's been over 9 months now since the day she was burned.
No, there's no difficulty in moving her neck.
And so on....
I write down the diagnosis on my answer script.
Then I sit down on the lonely bedside stool & go over all my answers trying to figure out where I might have gotten something wrong...
My long case had been a 57 years old male with obstructive jaundice. A lot can be asked from that one.
I go over all the Differential Diagnosis in my head & frame my Clinical Diagnosis as I will say it to the examiners in the viva voce round that's gonna come up in about 5mins time.
I glance at my wristwatch.
Time's ticking steadily.
My heart picks up pace.
Shoot! It's the last day of Internal Assessments.
Surgery Clinicals done & am a free agent again.
I will go to my fav fast food joint the min this ordeal's over, I vow.
And boy!!! am I gonna party tonight!!!
I smile at the thought.
She smiles back---my Spot Case.
I had forgotten all about her for a moment.
Oh crap! the exam's isn't over just yet, I remind myself!
Still too early to start celebrating old girl, I scold.
"What's your name?" I ask. Just for the sake of it.
Knowing pretty well I didn't have to give the examiners the name of my Spot Case or for that matter the case history.
Only the diagnosis & answers to a couple of pertinent theoretical questions will be all that would be required.
"Sheouli" she answers, eyes sparkling.
She's a pretty girl, I realise.
She used to be that is....I correct myself.
I look at her anew.
Maybe only a couple of years older than myself I guess.
Her long hair is parted down the middle & plaited on either side of her small oval face.
Vermillion applied neatly at the part.
"You are married" I observe.
"Oh yes" she smiles back
"Infact, I am a proud mommy to a very beautiful 1 year old daughter" she giggles.
I look at my wristwatch.
It's past the 5 mins.
Where's the examiner?
I want this bloody exam to be over & done with.
I am tired of this nerve-wrecking wait.
I want to sleep...sleep in peace.
Haven't slept well since...well, since before the exams
Oh! what woe....I am the most wretched creature alive!!!
I tap my feet impatiently.
She is still smiling.
Eyes still sparkling.
She wants to talk about her daughter.
"Congratulation" I say " So, she's with her father now?"
I make inane conversation.
"No" she replies
"With her grandfather."
"Oh! father's at work?"
"No....no, he's not here.
He left me when I met with my accident.
Khushi was tiny then" she informs, smile still intact.
"Oh" I falter
"Oh, I am sorry."
"No, it's all right" she reassures me.
"So....so, how did all this happen?" I indicate the postburn contractures of her hands.
Her fingers are all fused together.
"I was warming Khushi's milk on the stove one moment & the next my pallu was on fire---it took only a few minutes" she smiles.
"Good thing is Khushi's cradle wasn't in the room" she perks up.
I am at a loss.
I nod.
"And your husband?"
I just can't stop myself.
"At work.
Papa says he was there when they admitted me into the hospital that night.
I wouldn't know...I didn't come around until a long time afterwards.
He left Khushi with Papa the next day.
We haven't heard from him since."
She is still smiling.
"Time's up!" announces the post-grad surgical resident as he hurries into the gloomy cabin & snatches away my answer script.
"Go down the corridor, second door on your left at the end---Dr. Mishra is ready for you now" he shoos me away.
"Best of luck" calls out my Spot Case.
"May you achieve all the success & joy in life.
You'll make a wonderful doctor someday" she smiles.
I scream.
Silently.
-Dr. Priyanka Angelina Xess
