For patients, flirting is often a defence mechanism
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Come quickly, I’m alone in the room with the doctor,” 40-year-old Radha said on the phone to her husband, who happened to visit the washroom just when it was their turn to be seen by me. This was a follow-up appointment to remove sutures after we had extricated a tumour from inside her spinal cord two weeks ago.
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She was a roundish mother of two with long, thick hair plaited in a single braid, not the image of someone who typifies amorous mischief, but I’ve long given up on stereotypes. Her husband of 12 years sat beside her in a bright yellow T-shirt, immune to her disposition, as she leaned forward to tell me a secret. “The first time I saw you was when I decided that you’d do my operation,” she said with a beaming, impish smile. “And why is that?” I asked curiously. “Because you are so handsome!” she whispered with a straight face, while I couldn’t contain my blushing.
I remember what a detailed conversation we had had with the entire family regarding all the complications that could arise out of opening up a spinal cord, removing a 6-cm tumour from within it, and putting everything back together. It was a pretty intense discussion that included the slight possibility of paralysis and loss of bowel and bladder function. “I have two little children,” she reminded me every time I spoke of something that might go wrong. “You also have a husband,” I reminded her. “As long as you are there, I don’t have any worry,” she said, looking at him playfully from the corner of her eye. Why is it that most women worry about their children more than their spouse, while most men prioritise their wives over their kids? Or am I only speaking for myself?
“All the other surgeons I went to were very old… white hair, thick glasses; mazaa nahin aaya,” she confessed. This was the first time my youth has worked in my favour. Most often, people who require brain or spine surgery want someone significantly experienced, and that is unfortunately a surrogate marker for being slightly aged. I often keep a salt-and-pepper stubble so that patients may assume I’m a little older than I am; if it starts getting uncomfortable, I get rid of it.
“When you held my hands to examine me, I knew that I wanted those hands to operate on me,” she toyed. “Thank you for not giving me all this information before surgery, or else I would have been very nervous!” I acknowledged in jest, playing along. “Also, because your surgery was extremely complex and difficult,” I added.
Her tumour grew from within the centre of the spinal cord in her neck and had pushed the cord to its edge, flattening out the fibres responsible for hand and leg function. She realised something was wrong when she noticed a slight weakness of the right hand and wasn’t able to write, eat, or comb her hair. When we opened the spinal cord, it looked like a rugby ball, bulging in the centre and tapering off at its ends, where two fluid-filled cysts marked its boundary. I punctured the cyst and created a plane around the tumour after decompressing its centre so that the pressure on the normal spinal cord was relieved. The tumour was dirty grey, clearly demarcating itself from the angel-like pristine whiteness of the normal spinal cord. We were able to remove it meticulously, preserving motor and sensory function.
“But there is one problem I’ve been having after surgery,” she went on to elucidate. By now, I was convinced that it was going to be unrelated to the actual operation. “I’m not getting any bad thoughts in my mind,” she left me to figure out what she meant, while her husband sat with his head in his palms. I simply had a big smile on my face and encouraged her to elaborate. “Kya bataye sir, sirf bhagwan ki yaad aati hai. No gossiping, no bitching, no sex. Kuch toh life mein excitement honi chahiye!”
“I can’t help you with the gossiping and bitching, but I can give you permission to have sex after two weeks!” I stated, smiling at the twinkle in her eyes. “With your husband!” I added, and her face dropped for effect.
Patients seldom flirt with doctors, and when they do, it is often harmless, at least in my limited experience. They do it to breed familiarity and often to create a distraction from the looming threat of a serious illness. For some, it is unlacing the corset of a coping mechanism, while for others, it is holding up a dagger of defence. “There is no terror like the terror of being known,” Emerson anguished in his journal while trying to navigate a deep and complicated relationship. For most people, flirting is just a personality trait reminding the doctor to keep things light and easy. It’s important for a surgeon to not feel flattered or get carried away because that could hinder decision-making. And if someone were to go down (from a complication, not in the way you’re imagining!) the fun would be instantly replaced by fear. Delicate and difficult.
The women who most often flirt with me are above 70 and mostly single, so I’m just a little surprised when someone my age does masti. I recollect an octogenarian whose hand grip I was once examining. I asked her to hold two of my fingers in the palm of her hand and squeeze. When I was done and told her to let go, she shook her head and said, “I don’t want to,” with such sweetness and longing. We held hands for five minutes, me thinking of my long-gone grandmother and she… God knows who. There is so much tenderness and grace in the vulnerability of the elderly as they express their longing. As physicians and surgeons, all we are really doing is walking our patients home, fathoming our own lives as we are deepening their living.
Before Radha and her husband walked out of the consulting room, she requested that I always be available to answer all her queries, and I, in return, dramatically promised, “I will be with you for the rest of your life!” She clasped my hands in love, entwined my fingers with hers, and amusingly bid her husband goodbye.
The writer is practising neurosurgeon at Wockhardt Hospitals and Honorary Assistant Professor of Neurosurgery at Grant Medical College and Sir JJ Group of Hospitals [email protected]
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