In my short career as a Physician there have been too many adventures to comprehend at once. While celebrating half of them and mourning the other half, I try to feel grateful for all of them. And when I don’t, poetry somehow originates to form a mysterious connection with those experiences. In millennial language, I can say that life goes on with a mix of SMH and YOLO.

So I watch myself carefully whenever there is an urge to write. It has become an indicator of unresolved events. The areas I work in and the populations I engage with provide numerous things to reflect on and manifest, though there isn’t always the time to pause and express. So yes, many unresolved events sink without ever being expressed. Many do not even get acknowledged. But whatever passes through the linear process of Pause, Reflect, Express and Manifest helps my conscience grow stronger. And I have come to make peace with the fact that despite being painful at times, this is how it’s going to be for me.

And then there is this one thing which disrupts this process every time. Tuberculosis.

Tuberculosis is undoubtedly the most frequently appearing diagnostic term in medical textbooks, public health literature and modern history of major countries. I think amongst all the true Indian phenomena which are insanely popular across the globe, Tuberculosis gives Mahatma Gandhi a tough competition. Gandhi may have an edge here for facing far greater attempts to be killed. Imagine dealing with such a giant killer everyday in clinics where it seems to be an invisible attendee of every patient.

Tuberculosis seems to have the attention of everyone in the health system, yet manages to wipe out the poor in large numbers. So whenever it walks into my cabin with a patient, I am in a hurry to catch it and it gets a maximum number of quick questions before being ruled out. There isn’t always the time to pause.

Whenever people with frank symptoms start to tell their history, there is always a decade which you can trace for each of the symptoms. Migration, malnutrition, HIV, caste, gender,stress, depression, substance abuse, neglect, isolation, apathy, occupation and what not, each in a unique combination for each patient. When a 30 year old man with a wife and 4 kids brings the pebbles of blood he coughed out in the morning, there is little time to reflect and even if there is, reflection often feels counter-intuitive. It asks us to go against our story of privilege and brings an unimaginable degree of conflict. Such is the intensity with which Tuberculosis presents.

It’s not like I haven’t tried to express what I feel while dealing with people with TB. Tried a thousand times, but words always seem inadequate. It’s not that I am so disappointed by TB that all I see in it is a tragedy. Tragedies are in other illnesses too. But the tragedies in TB look so easily manageable with obvious answers to them and yet society creates a mess around it. So when I will find enough and appropriate words, I will first like to express anger over the fact that despite years of being consumed by Tuberculosis, the affected people never created a movement around it and fought for health rights. At an individual level, all I can express for now in our health centre is a word of empathy for the patient so that he/she can suddenly start trusting the system’s ability and intentions to cure his/her illness.

What about manifesting then? This will need more time perhaps. In my mind I feel the TB stories haven’t been processed to give an element to manifest, like indifference, kindness, acceptance, activism or something else.
Is it at this stage when illnesses like Tuberculosis need to be owned by the community as its failure as well as its hinge around which any development would be envisioned? Community also needs to manifest its role in Tuberculosis right?

Tonight, Tuberculosis still remains largely an unresolved issue in my conscience. Pushes life slightly on the SMH side.

Poetry is yet to originate here.

Dr Vidit Panchal- A Family Physician working with Basic Healthcare Service (BHS) in Udaipur