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Sunday, August 12, 2012

What the hell were you doing so long?

About two months ago, I woke up in the middle of the night with a heavy bout of coughing lasting about 15-20 minutes. It was weird because I had no cold or sore throat. And again I dismissed it as insignificant as there was no expectoration and barring that paroxysm, I slept comfortably through the night. Then it recurred again the next night. This time, however there was wheezing. Loud, audible wheezing. This may be because I am a medical student, because ideally I should have run to the emergency, but as I had no dyspnoea, I was actually experimenting with myself. Initially admiring how classical, textbook description the musical sounds were! Then seeing if got accentuated on lying in a lateral position or supine or prone, etc. etc. In retrospection, it seems that we sort of get divided into two components, the doctor and the lay human. Today as I recollect and write about it, I am very astonished as to how aloof I had become with myself on that particular night. And, needless to say it recurred again the next night, with increased severity of course.

That was when my mother started worrying why I wasn't consulting someone. Partly because I had a differential in mind, and also as I had two terminal papers to appear the next two days, I wanted to get through them undisturbed.

When the papers were finished I got my CBC done. There was eosinophilia. Expected. But, the eosinophil count was 92!!! And then for a moment I was stumped. Call it final year syndrome, or just the generic ZEBRA SYNDROME that GSites have, I was almost certain that it was Non-Hodgkin's. The more plausible tropical pulmonary eosinophilia was totally ruled out, because as I have read, symptoms appear when eosinophils are in the 30s and also there was no way I could have caught a parasite. And just to confirm the count I went through the smear myself. I even got another smear made just to ensure the lab hadn't mixed up samples.

Next day was a Saturday. I ran for a senior consultant when he was on his rounds. Told him of my symptoms. He examined me and prescribed Hetrazan for 21 days. But I was a little apprehensive, so I told him that the count was 92. To that he replied, "There is never a count of 92. You should have misread the report!" I told him that I had seen the smear, but didn't mention my self diagnosis for perhaps I was too afraid that it may turn out to be true. Nonetheless, I trusted his expertise, did the course and after two months the counts have normalised.

Point being, one may say, as even I think now, how foolish of me to have stretched the initial symptoms for three days. Many a times, there are patients we see and think, 'what the hell were you doing so long?'. They have no answer, as even I have no answer. Perhaps I was busy enjoying the nocturnal symphony!

Surely, I am not going to repeat such daredevilry ever again in my life!

But what I observe in myself are two distinctly identified patient behaviour patterns - One who tries to avert consultation till he can and second, who is then submissive to his doctor. Funny, because I thought being a doctor I would make better decisions, but it turns out to be otherwise!