Come morning, and the sun peeping playfully through my clinic window found me sitting morosely at my desk. It was the healthy season and people outside were going about their jobs, or buying unnecessary things from shopping malls, or taking their pesky kids to amusement parks, and generally having a whale of a time. Nobody seemed to be suffering from fever or even a spot of cold. Such is the proclivity of doctors – they are happy only when they are relieving the burden of disease off the backs of a suffering mankind. Plagues, pestilences and epidemics make them delirious with joy.
Just when it seemed to me that the black shadow of health is going to drive off the light of disease entirely off the face of the earth, Mrs. P entered my clinic and the pall of gloom lifted. Mrs. P is the sort of woman that makes gravity happy to pull her towards itself. I said with a cheeriness that seemed a little excessive even to me:
“Hi Mrs. P, what can I do for you?”
“Hi doc, its my heart again.”
I looked at her heart. It reminded me of a piece of jewellery that I had in an unguarded moment bought for my wife and she had remarked that the case was more beautiful than its content. That about summarized my appraisal of Mrs. P’s heart. I was lost in its contemplation when I sensed that old coot Hippocrates turning in his grave (the very chap who’s oath has made the enjoyment of life well-nigh impossible for doctors) and gathering myself I put on my best professional manner.
“What about your heart Mrs. P?”
“Oh, it just seems to beat, you know.” Previous readers of the blog will recollect that this peculiar malady seems to afflict her with remarkable regularity.
“Always?” I asked with a look of deep concern.
“Yes doctor, always.”
“I see,” I said grimly.
“Is it serious?” Her big eyes became bigger and her lips parted like a newly blossomed – oh, there’s old Hippocrates frowning again!
“Let me examine you first.” I said solemnly.
I took up her dainty wrist and examined her pulse.
“Is my pulse ok doc?” Hers was alright, it was my pulse that needed attention at the moment.
I listened to her heart with a stethoscope and cursed Laennec. Before he had invented the stethoscope, direct auscultation was the method used to listen to a damsel’s heart (see illustration). But then Laennec had a brainwave and took the fun out of auscultation. Talk about technology taking over medicine and ruining doctors’ clinical skills
So I examined her heart until Hippocrates said it was enough, and she batted her eyelids and asked:
“So doc, what’s the verdict?”
I hate to let my patients down, but I’m sworn to speak the truth (only in the course of my professional duties you understand; the rest of the time I’m as free to lie and cheat as my fellow humans).
“Well Mrs. P, as on a previous occasion, I’m still forced to say that I can find nothing wrong with your heart,” I said.
“Then why does my heart beat doctor?”
“A common and harmless ailment Mrs. P, of no pathological significance whatsoever. Just don’t pay it any attention.”
I could see that she was disappointed. She had expected great feats of diagnosis from me and all I could come up with was this. So I hastened to add:
“Your heart’s fine Mrs. P, but something is wrong with you. You show unmistakable signs of the malady.”
She brightened up immediately.
“I knew it. What is it, doc? Please don’t hide anything from me.”
“Mrs. P, you seem to be showing unmistakable signs of that modern scourge – stress.”
She sighed and dropped her head.
“Everything alright at home? Cordial relations with your mom-in-law?” I had seen enough soaps on TV in my wife’s company to surmise the cause of stress in a young married healthy woman.
“Oh, she’s a sweet old lady.” She said like a martyred Venus, and I knew that I had hit the mark.
“A very sweet old lady, doc.” She added. Uh, uh, things must be pretty bad between the two of them, I thought.
“Well Mrs. P, the next time you feel your heart beat, just take a deep breath and hold to ten. Could you show me how you are going to do it?”
She sat upright and I watched as the earth’s atmosphere gratefully rushed inside her lungs and her thorax swelled and after ten seconds the tide subsided.
“That’s good Mrs. P, very good. Do you mind doing that again?” Damn you Hippocrates, I’m only doing my job.
She did it again, and I made her stop after that. Somehow her exercising was making me feel giddy.
“That’s all you need to do Mrs. P. Keep it up for a month and then tell me how you feel.”
“Thank you so much doctor. And you’re sure I don’t need further testing for my heart. An echocardiography for instance?”
“Oh no Mrs. P, I’m quite sure, goodbye.” Whatever Hippocrates might have to say on the subject, he would be a fool to think that I would let the echo guy have all the fun!