Cancer Tales: Chapter 3: The White Vulture

© Dr Sujeet Kumar

Its tuesday and a OPD day for us, Dr Ankit leaves for OPD after saying this to his juniors working in ward. While on the way he reminds himself of “be empathetic to poor patients and pliable for rich patients”- the mantra which he got from his seniors.

After a while, Ankit found himself steering himself across the OPD lobby through sea of patients and their attendants to reach the OPD room were he settled on his chair and without wasting time pulled up the patient record file and said: Token no 455

Ankit examined the patient and went across the outside reports which already said the 5 year old child had Leukemia and some further investigation were needed.

Mother was squatting besides her 5 year old son who was sitting calmly with fear filled eyes on a stool chair. Beside them stood the father – a 35 year old man with unkempt hair, grown up beards dressed in chequered maroon shirt and a brown trouser with dirt smeared all around buttock region.

Ankit fixes his gaze to father and starts explaining: Look he has blood cancer and treatment will be costly but chances to salvage him are good because this form of childhood cancer has very good outcome.

Meanwhile the father also squats beside the patients stool chair.
Ankit starts making estimate form of 6 Lakh rupees for govt aid which economically backward people were entitled for treatment of blood cancer. While his hands were busy increasing no of 0 in the estimate form in front of 6, he spoke: You must be having income certificate of less than 35000, so you just need to deposit this form in your MLA and MP office and you will get 3-6 Lakh rupees for treatment of your child.

The father squatting until now starts pulling himself up and in process pats on his buttock with both the palms.
Dust blew across Ankit’s face and he sneezed, even before the sneeze had settled he spoke: Why are you spreading dirt, stop patting your trousers, they are full of dirt, your child will get infection.

Father replied: Sorry sir, this is “dirt of poverty”, we the poor tend to acquire it, this time it stuck to my trouser while spending 6 hours in queue, squatting and shifting in inches every 15-20 min.
While his father spoke the child focused on the tetrapack of fruit juice kept on table.
His father continued: Sir if my local MLA has got to do anything with this process, then i will surely get the money. MLA is from my village only and more importantly he is from my caste only (closes his eyes and takes a sigh of relief).

In mean time child’s gaze was doing to and fro from tertrapack to mothers eye and back to tetrapack and the mother was holding child hands tight as if saying – don’t do this my child.
Ankit: Govt has been generous in this regard and hope you will get the aid. So let’s admit him..and picked the tetrapack and shifted it to child saying, he must be hungry waiting for his turn since morning.
Child didn’t waste a minute and snapped the tetrapack from Ankits hand.

Father: Yes, I have 30-40k and hope that will suffice till the govt aid arrives.
Ankit wrote on prescription: Admit in A09 G-Block and signed it, be there at 4 pm for admission.

Next is No 456, called Ankit

Ankit held his head downards as if taking rest, waiting for the next patients arrival.
His downward gaze catched attention of a pure white Adidas shoes of an approaching patient. For a moment Ankit refined his gaze to make sure it was Adidas and not Abibas, Alidas and some thing else which he was used to see in his OPD clinics. As the gaze went up he noticed, the trouser was pure white, the belly hanged out in a pure white shirt with thick gold chain dangling in neck. The horizontal folds on shirt and trouser indicated the fabric was pure linen. His mind went into guessing mode: A politician ? May be some one rich .. but why did he wait for his token number to be called.
Meanwhile the patients file was swiftly shifted by Ankits senior Dr Suresh sitting across the table to his side and he said to patient, come this side.

Ankit started seeing next patient but his ears were onto what was happening across the table probably with a hope to learn something about “be empathetic to poor patients and pliable for rich patients” mantra.

OPD finished at 4 PM and Ankit left OPD directly as he had to catch flight to his home as he was going for a three day leave – a luxary which he got after his juniors had joined.

After three days: Ward A09 G Block, Cubicle 1
Bed 5: (same poor man which Ankit had counselled in OPD): Child looks fine, what about your finances ?
Sir, I have submitted the form and in matter of 5 days it will be in patients account.
Ankit: It can’t be that quick.
Father: My MLA has promised it while saying “you are my brother from same caste, you voted me to power so i have moral responsibility to rescue your child from jaws of death”. Your child is my child, just give me 5 days.
Father continued: Sir bed 6 has received govt aid in just two days so why can’t i ?

Ankit turned his head to right and saw an old man, lying on bed with no attendant on bedside chair.
Ankit walks over to bed 6: Uncle how are you ?
In a matter of second he saw someone clad in white linen from neck to feet approaching towards the bed, the feet had Adidas and the neck had the gold chain.
Oh, same man from OPD, Ankit recalled, but how did he receive govt aid for cancer patients which is mean for poor with yearly income less than 35000. The clothes and apparel that he is wearing would cross 35000 mark, leave alone yearly income?

Ankit was too curious to hold himself back from asking and he asked the “linen clad man” how did you manage to get the govt aid (after a pause he added) so quickly ?
Although the question he wanted to ask was “how and why did he got govt aid”, but Ankit purposefully changed it “how so quickly” just not to offend that man. Back in his mind Ankit was expecting similar answer from him for both the types of question.

He started saying, when you don’t have fixed salary coming to your account every month then no one knows how much you earn. Our family may have petrol pump but it’s not on my fathers name, he earns nothing and it’s so easy to show that he lives separately from us. Effectively he is so poor that he cant even afford to eat two times meal. (while speaking he had typical smile of accomplishment)
Ankit in his mind: Oh god, this could have been some one else money, it would have saved someone’s else’s life. He felt dejected but smiled back at man (who still had that smile) and left the cubicle to go to duty room.

After a while a young couple arrived in duty room, probably in early thirties. Ankit immediately recognized them as bed 11 parents – the 3 year old girl child with Leukemia.
Girls father: Sir, we are exhausted now, we have nothing left to spend. I am a govt school teacher on contractual stipend of 25000/month. I have spent all my savings of 1 year. We don’t have option other than to let her die, we are still young and can always have other child. (Before the sentence was finished both parents eyes were full of tears )
Mother left the room, wiping her eyes with sari but the father continued speaking, we want to take her home. Please discharge her.

Girls father – a physics teacher, holds himself in the room after taking few steps towards room exit and explains: Sir middle class is like aerodynamically designed front end of aircraft. All the govt funds gets safely diverted from us to reach the back end of society were govt tries to ensure that needy patients benefit from it however there are vultures roaming free and some part of this money gets “vultured”. This is our money but don’t get to see it. The father left the room after saying this.

Ankit immediately imagines something in sky “A pure white vulture with thick gold chain in neck and bed 11 girl held tight in its beak” the parents “middle class parents” standing on earth with teary eyes and swollen face. The father consoling the mother saying, we can always have other child.

Ankit somehow managed to prevent the overflow of tears by widening the eyes and rapidly blinking it, but his eyes were still fixed on “The White Vulture”. He thought, Poor have the sympathy from system, rich have the muscle to arm twist the system and middle class can only watch all this happening – like a paralyzed patient who can only turn his gaze to surroundings but can’t react much.

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