The consults sometimes spilled over beyond Dermatology.
When some of the patients took their clothes off, their body odour that filled the room was overwhelming. The tragedy was that they were oblivious of their BO and the social kill-joy it could be. They had no idea how to prevent or manage BO. Many of them were young office-goers in Chennai, one of the hottest and most humid metros in India. They traveled for hours commuting and they worked hard trying to get ahead in their careers, in a severely competitive dog-eat-dog world, I used to feel so sad for them. My maternal instincts would surface and I would sit them down for the Shave / Deodorant / 2 baths a day / with change of inner wear Discussion.
Sometimes their inner wear would not match the smart clothes they wore and I would tell them what my Mum used to tell me . Make sure you wear clean knickers. You never know when you will have an accident and you will be lying on the road with your legs up in the air, in public view. They were sweet kids and many were far from home. They never took offense. They welcomed any TLC they received. In fact they responded rather gratefully, did the changes and came back smiling. Bless them.
Size was another bummer. Synthetics, tight clothes and perspiration do not go well together in a hot and humid climate. Its the perfect milieu for Fungus infections. Someone who needed an underwired 42 D cup would squash everything into a 38 A cup and wonder why she was not able to get rid of the fungus infection between her breasts. Underwired bras are now available across Chennai from The Naidu Hall in T.Nagar to The Marks and Spencers in the Mall. They have Fitting Assistants who are willing to help the young novice out shopping for clothes. This has changed the life of many a young girl.
Power dressing requires closed footwear. Closed shoes and stale socks are a deadly combination in hot and humid weather. Put them all together and watch the fungus grow in the webs of the toes. So, if you want to treat the fungal infection effectively without recurrence, start with advice on occlusive socks and closed footwear. Back to the 2 baths a day, foot deodorants and change your socks Discussion
Many of these kids ate junk at the fast food joints as they lived far from their homes with little or no cooking or survival skills. Some lived in hostels that served unfamiliar diets. The kids from the North took a while to adjust to south Indian cuisine. They were homesick, malnourished and sniffling most of the time, when they were not anchored to the Toilet with the Runs from eating out. The Dermatology consult would end with counseling on nutrition and the prescription would stretch to include treatment for giardia, entamoeba and supplements .
Many patients confided their personal problems once they trusted you over a period of time and repeat visits.Some had settled into relationships of convenience. Some were sexually active but clueless about safe sex and contraception. Agony Aunt was a role that came up from time to time and the years as an OB/GYN was not a waste.
Neither Sam or I are party animals or socialites. We do not club and we do not go visiting. All we did was go to work and go home. Go to work and go home. My patients filled every nook and cranny of my social circle. Dermatology patients usually need repeat visits and if they like you, it is a relationship for life. There is a joke about this. A dermatologist married off his daughter to a young dermatologist . I am not giving you a dowry, young man, he said to the bridegroom. I am giving you 10 patients. They are yours for life.
Make no mistake , I loved my work and I loved all my patients. I miss them all, now that I have moved out of Chennai after practicing for 34 years. I remember them fondly now that I have the luxury of time in a retirement community at the foothills of Kodaikanal. Some take the time and effort to come and see me . I still get calls from some of them. Some send me pictures of their lesions on Whatsapp for a photo diagnosis. Many ring up to ask who they should see if they have a pain in their little toe. They rely on you to refer them to another doctor.
Their faith in your treatment and judgement is touching and extremely humbling.