A Trial by Fire

      A beautiful, intelligent, articulate young colleague walked into my room this morning. She had just come back after her maternity leave. She was glowing. I inquired about her baby daughter and at once her face lit up with love, warmth and happiness. She responded – “She’s fine, ma’am.” Even after all these years as a Paediatrician, the beauty of the bond between a mother and her child never ceases to amaze me. 

      After a few minutes of talking about her little one, she suddenly said, “Ma’am, can we start an Early Childhood Intervention Center at our institution?” These centers cater to infants and toddlers at risk for delayed development. In the joy of the new arrival, I had forgotten the fact that her older child is autistic. About two years ago, she’d come to me to discuss the issues she had been facing with her son. She thought he needed treatment for his hyperactive behavior but when I gently tried to take a detailed history from her, in her distraught state, I realized that the child had problems with language and social skills. I had to ask her whether she’d thought of autism as a possible diagnosis.

      I can still recall her face. She looked stunned. A few weeks later, she called to say that her son had been formally diagnosed with autism at a very good center and that she was planning to start therapy.

      She had to take a year off because therapy for autism is immersive and prolonged. This child had been diagnosed late and hence would need more intensive treatment. Amidst the denial and the trauma, she also had to face accusations of all sorts from the extended family. She had to miss out on her career progression. A very tough time all around.

      I would keep in touch from time to time and would find her swinging between hope and despair. One fine day she called to say that he was showing improvement. Not dramatic but definitely showing slow improvement. She sounded better.

      This morning she spoke passionately about starting an intervention center at our institution. The young mother said something that was profoundly moving “There must be a reason that I have to go through such a trial but precisely because of this, I want other families to benefit from an early diagnosis and therapy for their child. I was very depressed earlier, but now with the birth of my daughter, I feel so much more hopeful. Besides, I am one of the lucky ones to be able to afford treatment. It is prohibitively expensive outside. So ma’am, please let us start this center here. Even if it takes a few years, it will be worth the effort. I’ve been wanting to tell you for some time now. Please, let’s do this.”

      I looked at her with amazement and respect. In the midst of her pain, there was a purpose. The clarity of purpose was so very evident.

      I, on my part, promised to write out a proposal for the start of the services at our hospital and also to create awareness about the condition among our patients and their families. I realized that we could impact so many families positively as ours is a government institution and services are free.

      She looked excited at the prospect and took her leave. Just before leaving she said wistfully, “Ma’am, I should’ve helped my son earlier. I did go to my Paediatrician but somehow we did not pick it up early and lost valuable time.”

      After she left, I wondered about all the cases that I must have “missed” diagnosing in my career. Medicine is a very fallible science, obviously because we humans practice it. However meticulous be the training and however extensive the experience, the only truth is that all of us doctors make mistakes. Some mistakes prove to be fatal too.

      In our college days, we would joke about it during our internship saying that we should choose Forensic Medicine as a specialization! At least our mistakes would not kill anyone.

      Coming back to autism, the words of a bright, young Developmental Paediatrician friend of mine come to mind. He deals with children with challenges all the time and is one of the most “zen” people I know. An old soul in a young body. He always tells me that there is a huge difference between bluntly saying “There’s no cure for your child’s problem,” and “Your child can be helped to do many things with good therapy, and good follow up, that a peer of his age would do.” Words, that we choose to say matter.

      I’d like to end with the lines that inspire him and keep him going. Utterly beautiful lines. 

      Irrespective of the roles we play, we are all embarking on a journey of life to reach a common destination – “a happy and contented life”

      We must all remember that the direction taken to reach this destination may be different for different people – that does not make the journey any less significant.

      For all the people who have children with challenges and those who work with challenged children, I would only say – “Keep walking with faith and hope.”

      My pranams at the lotus feet of Gurudev 🙏.       

      P. S.: My apologies if I seem to be “inundating” all of you on this forum with my posts. I am going through what is called “hypergraphia” – the bizarre counterpart of writer’s block :).