Author: Dr. M. Suneetha, Radiation Oncology
After a career spanning two decades in oncology, I thought I had seen it all and nothing would surprise me anymore. I was wrong. When this patient entered my chamber, I was taken aback by the sheer beauty of the young woman; she wore a bright red silk saree, her long hair was in a braid and adorned with white flowers while a large coin-sized bindi completed her traditional look. I was reminded of the grace and beauty of the apsaras, the celestial nymphs of Hindu mythology. Her friend was similarly attired and it was evident they belonged to the same social background.
As I checked her file I found many of the columns had not been filled up. Time and again our teachers, including the legendary Dr Maha Laxman Rao had reminded us of the importance of proper presentation of cases. The empty columns annoyed me to no end and I was about to impart the same lesson to my assistant when he confided in a hushed voice that the patient had refused to give him the required information. The patient also indicated she wanted to speak to me alone and my assistant, upon her insistence, left the room.
The patient had been suffering from excessive bleeding per vaginum for the past one month. She had consulted a local doctor in Karimnagar who diagnosed it as cervical cancer and referred her to our hospital. She was demure and sweet, innocent enough to hope that I would negate the diagnosis of the local doctor. I had guessed something was amiss from the way she was dressed but as an oncologist it was mandatory to note down certain details. Then she revealed she was a “devadasi” – a practice in which young girls are dedicated to the presiding deity of a temple but ultimately they are pushed into flesh trade. Though this has been banned long ago it is still prevalent in parts of India. I fail to understand how a woman dedicated to God, is allowed to fall prey to the lust of men in our society.
Meanwhile, I did all the necessary investigations to diagnose and stage her disease and thankfully, her HIV status was negative. The cervical cancer was in stage II and I explained that she would need 25 fractions of radiation along with weekly chemotherapy and then 3 fractions of internal radiation. She asked me how long she would survive and I replied that there was 70 per cent chance that her cancer would be completely cured. She then wanted to know what should she do to ensure her survival. I was taken aback by her zeal for life. I had imagined a life of immense hardship and bitterness, particularly towards those who had pushed her into this life. It was then I came to know about her 10-year-old son who was in a boarding school, away from the sordid environment his mother had to survive in – to earn
her livelihood. Her only dream revolved around her son and she wanted him to grow up and secure a government job. I was curious to know why she was looking forward to a government job and then I realized she wanted a respectable life for her only son which she presumed would be possible by securing a government job.
She completed her treatment at one go. Internal radiation is quite painful and she was apprehensive but determined enough to complete the treatment. In my long experience I have found patients in pain often call out to their mother or God but she would only murmur “Babu! Babu!” remembering her son – the anchor of her unhappy existence.
Finally, she completed her treatment and on the day of discharge, she asked for my permission to resume work. Usually, I encourage my patients to resume their normal activities once they complete the treatment since it keeps their mind occupied but I didn’t know what to say in this case. I finally told her to wait till her first follow-up which would be in two months since the tissues were still fragile. I also told her that I would try to rehabilitate her through NGOs who work in this field.
After two months, she came for her check-up and then gathered the courage to ask me the same question. I knew it was a matter of livelihood but at the same time I wanted her to leave behind her old profession. I asked her whether she had given any thought to my proposal.
She said, “Madam, I know you have good intentions. But this is the only work I know. It is very difficult to establish ourselves elsewhere because of our past. Some of my friends left this work to find alternate means of livelihood but were unable to do so. And when they again tried to go back to their old life they had already lost their ground. Their stories are horrific. I cannot take a chance because I need to secure my son’s future,” she said in a quiet but determined voice.
Stunned, I did not offer any more advice. I hardly know about the complexities of her world. She regularly came for follow-up care for the next two years but neither I asked her about her work nor did she volunteer any information. The subject was off limit in our conversations.
She was the most beautiful soul I have ever met. Her parents had given her up and instead of serving God she fell prey to the lust of men and despite the worst betrayals she was serene and completely at peace with her world. She knew her trade had led to cancer but never flinched from going back for the sake of her son. She never lost trust in God and whenever she visited me she never failed to bring kumkum and prasadam from the temple. She always stayed true to her dream of ensuring a respectable life for her son. Whenever I think of her I fervently wish that one day, her dream will come true.