The next morning Badal da was on time. Members of the reception committee of the Corporate Hospital were all ready to receive him. They, first of all, sucked around half a litre of his blood. Then they also collected his urine sample and did an ECG.
A nurse came and asked him to remove his clothes and to wear a white gown. After wearing the robe, he felt like he was still naked. Why they make such gowns which reveal my body parts more than covering it, he thought
A doctor came with a pen and paper. He sat down in front of him.
"Good morning Mr. Badal. I am Dr. Sushil. I will take a detailed history. Now tell me in detail, what is your problem?"
Badal da started, "See, my boss wants me to opt for VRS……"
The doctor stopped him in the middle and said with a smile, "Mr. Badal, please tell me your medical problems."
"OK, fine," Badal da took out a neatly typed sheet. This time he was quite prepared. After all, he had paid ten thousand rupees and could not afford to miss out on any of his problems, however minor that may be.
He was about to start reading when he was again interrupted, and the doctor very humbly told him to answer only the questions that he asked.
For the next fifteen minutes, he kept on answering questions. Most of them were not relevant to his real problem. But he did not object or question them in return. Suddenly the doctor stood up and started examining him from head to toe. Then he took out a small hammer covered with some rubber material. He started striking all the joints of his body one after another. After each strike, he would carefully observe the joint. Badal da was wondering why the doctor is so much interested in my joints.
"Doctor, I am sorry to interrupt, but I don't have any joint problem. All my problems are in my stomach," he said.
“You have asked for the Master Test. So we are examining you from head to toe. We want to be sure that all your systems are functioning normally.”
The doctor replied and started drumming his chest and abdomen with his thick fingers like the way Dr. Mukhopadhyay was doing. Then he pulled out a stethoscope from his coat pocket and tried to hear some sound coming from inside his chest and also from the abdomen. Lastly, he said, "Hmm."
"Could you find any defect in me, doctor?"
He smiled back and said, "Everything seems to be all right.
Then one after another, many persons in white coats came and examined different parts of his body. In the next two hours, he was utterly exhausted. One looked into his eyes. The other one peeped into his ears and down his throat with the help of an instrument.
Then a surgeon came and without asking any question examined his abdomen, pulled up his gown, and asked him to cough. Then he did the same thing to him what Dr. Mukhopadhyay had done. If he knew the surgeon would do it, he would have told him that Dr. Mukhopadhyay had already explored his interior. But it was too late now. I will be more alert next time any doctor asks me to turn my back towards him, he decided.
"Could you find any defect in me, doctor?" Badal da asked the surgeon
"Your physical examination is complete," the surgeon answered, and he walked away.
Badal da panicked. After the physical examination, what are they going to do – a chemical examination or what?
An attendant came and asked him to sit in a wheelchair and wheeled him through the crowded OPD. Many people looked at him with pity. By looking at the staring faces, he too started feeling that he was a very ill person.
They reached a dark room crowded with equipments. Badal da was asked to lie down on a narrow table. A masked man appeared and uncovered his abdomen. He put some jelly all over his belly and started spreading the jelly with the help of a smooth rod. Badal da felt like giggling. But he held his breath. The masked man instructed, "Keep breathing, please. Yes, very good…. Now hold your breath. .... Well, it is over. Thank you"
This must be an ultrasound examination of my abdomen, he thought.
Someone took him to the next room. Again he was asked to lie down on a similar bed. Another masked man did the same thing with jelly, but this time on the left side of his chest. He was asked to hold breath as long as he could, and then he started massaging his chest with a small stub. Badal da understood it must be the ECHO test. He had heard this term from his colleagues. So they want to know if I have any heart problem. But how can a person with a heart problem have pain in the stomach, he failed to understand.
But then he started wondering why the same person could not do this similar-looking procedure, He thought, maybe to justify ten thousand rupees that they have charged.
When the procedure was over, he was taken to a big elegant chamber. A young lady smiled at him from behind her spectacles and said, "Hi, I am Mona. I am your counsellor. Your Master tests are over. Dr. Varghese has studied your case history, and he suggests that you should do a CECT of your abdomen as well."
“Who is Dr. Varghese by the way?” asked Badal da
"Dr. Varghese is the Gastroenterologist you wanted to see."
“Yes-yes. Do whatever my Gastro Specialist says,” Badal da nodded his head in agreement.
"Sorry, but this test is not included in the Master Test. You have to pay an additional seven thousand rupees for that," Mona said with a smile.
“Can you remove some unnecessary tests from the Master Test list and include this test? So far, they have peeped into my body through all the apertures for no reason. I only have the stomach problem. If you want some test done, that the Gastro doctor requires, then please do away with other tests.” Badal ‘da tried to convince his counsellor.
Mona smiled back, "You can very well understand. We cannot do this, sir. Master Test is a subsidized package of whole body check-ups, and we are bound to do all the tests that are included in the package. You wanted to include one gastro consultation in the package. Now your consultant has asked for a CECT Abdomen. I suggest sir that you should do the test, otherwise how can your doctor diagnose and treat your condition?"
“Yes-yes, I can understand everything,” said Badal ‘da, “But I have not brought any cash with me.”
Mona was quick to respond, “Sir, your record says you have paid earlier through internet banking. Here is my computer.”
Badal da immediately replied innocently, "RBI says not to use other's computers for a transaction through internet banking. You do the test. I will pay you later.”
“But unless you pay for the test, we cannot do the test. I am sorry to say. But no problem, you can make a card payment, "She took out a posh machine from the drawer of the table.
“I haven’t brought my card.”
"But then you need this test, sir," Mona looked puzzled.
“I don’t need the test. It is my Gastro specialist who needs this test.”
"Please try to understand, sir. You have some stomach problems, and without CECT Abdomen, your doctor will not be able to diagnose your condition correctly. So you will waste the money you spent so far.
Badal da was not the person who would waste his money. He paid the amount through internet banking and got the test done.
After all the tests, Badal da was served a sumptuous breakfast. He ate everything. I must recover as much as I can. I have paid a large sum of money to the hospital, he said to himself.
But he could not see his Gastro Specialist that day. He was asked to come on Saturday, by which time all the reports would be available, and the doctor would finally look at the Case Workup and write the prescription.
This irritated Badal da. He raised his voice and said, “But I am in agony. Please give me something for some temporary relief.”
Dr. Sushil rushed inside. After a while, he brought a piece of paper with the name of medicine written on it, “Dr. Verghese said you could take this medicine three times daily till he sees you on Saturday morning.”
"I cannot come in the morning. I will come at five-thirty in the evening......at the earliest,” Badal da said with displeasure. He was quite agitated with the proceedings so far.
Mona came rushing inside the room and consoled him, “Mr. Badal, let me try if I can get you an appointment in the evening. I will inform you on the phone. Now you can leave.”
It was eleven-thirty when Badal da came out of the hospital. He went straight to his office. He made his biometric attendance and entered his office. He saw that Swati looked little upset.
She told him that the boss shouted at her for agreeing to his Casual Leave application. Badal da was already quite irritated. He stormed into Mr. Trilok's chamber and blurted, "I wanted to ask you if someone has got some urgent work, can he go on casual leave or not?"
But when Mr. Trilok saw him, his face lit up, “Oh, you have come back? Good-good. I was looking for you since morning. Come sit down. Let’s discuss your analysis on the clustering of quarters with similar kind of extensions around the Central Market."
Badal da was completely confused. He sat down. Mr. Trilok picked up the intercom and ordered Nirmal to bring two cups of tea from the canteen in the new kettle.
"Yes, Mr. Badal today is Board Meeting at three, and I want to present your analysis in the meeting. I was upset when I found you were on leave because I need to understand the analysis myself before I present it in the meeting."
"Sir," Badal da's anger suddenly diffused, "I had some urgent work in the bank. I finished it early. So I came back."
“Very good, now let’s discuss.”
They discussed till lunchtime. Badal da stayed back because he had had a substantial breakfast and did not feel like taking anything. He ordered biscuits and tea and told Swati everything about Dr. Desai and Dr. Varghese.
When Nirmal arrived with the tea and biscuits, he saw Ms. Swati laughing with gusto. Her whole body was shaking and her eyes were full of tears. She wiped her tears and said, “You are an impossible guy Mr. Badal. Have you counted how much money did you lose since last evening?”
Nirmal had seen for the first time Ms. Swati laughing heartily. He shrugged his shoulders and went away with surprised looks.
"But please tell me," Swati continued, "Have you taken medicine prescribed by Dr. Desai or not? I have heard that otherwise, he is also a good doctor."
“I am not taking medicines of a doctor who looks at his patients as if he is looking at a five hundred Rupees note. Moreover, he gets cuts from the pathology fellow for the tests he prescribes,” Badal da said crossly.
Again Swati started laughing, “If you don’t take medicine, how will you be cured. Moreover, did the doctor tell you to get your tests done from that chap? He must be lying also. Isn’t it?”
“All right, I promise that I will take medicines prescribed by Dr. Varghese…………provided ………. I am satisfied with him.”
But he did not buy the medicines. How can he write someone a prescription without seeing him?” he said to himself.
In the evening, his daughter rang him up, "Papa, how are you? You wanted to talk to me."
He told her everything. She replied, "Papa, it is your decision. If you think you should continue, then please consult a good physician. You cannot continue to work with your present health condition.”
Badal da told her about his encounter with three physicians in the last two days. She interrupted and said, "Papa, I will tell you, please come to Delhi after my exams are over and get an opinion from the Medical Institute. By the way, I will be very busy with my final exams for the next ten days or so, and I will not be able to take your call. OK, take care and bye."
On Saturday evening, Dr. Varghese, from somewhere behind his thick moustaches, said, "See you are having some problem with your stomach. I have given you some medicine. You take them regularly. Have a good sleep at night. Maintain personal hygiene. Take light and non-spicy food. Go for a walk in the morning. Come to me again after fifteen days."
Badal ‘da looked at the diagnosis. It was FAPS in capital letters. He asked, “What is FAPS? Is it curable?”
“Many people get relief.”
“How long will it take?”
“Some people get cured only in six months,” Dr. Varghese smiled at him.
"ONLY six months??... Doctor, it is difficult for me to spend a single day, and you are saying I may take six months or longer time to get relief."
“No-no-no-no-no," Dr. Varghese explained, "You will have long trouble-free periods provided you take the medicines regularly. But it will keep coming. So do not discontinue medicines when you feel good."
"What do you mean? I have to take these medicines life long?" Badal da became upset.
"I will keep adjusting the dose and maybe one day, you will not need the medicine at all."
“Doctor, please tell me without hesitation, is it cancer?”
"Not at all," Dr. Varghese got up from his chair. It meant the doctor had justified his fee for spending that much time with him.
Badal da asked hurriedly, "Tell me, doctor, which one of my reports is abnormal?"
“All your reports are normal. There is no evidence of any organic diseases,” Dr. Varghese stopped and smiled at him.
“No-no, I didn’t understand,” Badal da became puzzled, “Then how did you diagnose my case?”
“By method of exclusion…. we excluded all other possible diseases. Since all your organs are functioning normally, that means you are suffering from FAPS," Dr. Varghese was wearing his usual smiles on his face. He patted his back and said, "Don't worry, Mr. Badal, you will be all right."
Dr. Varghese walked out of the room and left behind Badal da, wondering what kind of a method is this called ‘Exclusion'? He decided he will find the meaning of the word ‘FAPS' and also this so-called Exclusion method for Diagnoses from Google.
He was taken to the pharmacy. Badal da did not buy medicines as he neither had cash nor the card with him.
He sat down on one of the chairs in the OPD waiting area. Many thoughts crossed his mind – I am suffering from some strange disease called FAPS. …. That means I am a sick person now and I will have to take medicines as long as I live. This was a disturbing thought that he has to take light and spicy food, sleep peacefully at night and go for a morning walk. Huh! How can it be possible for a man who lives alone? And why did he comment on my poor hygiene? I had washed my feet properly in the morning and put talcum powder before wearing a new pair of socks this time.
He touched his tongue with his right-hand index finger and started turning the pages of the thick sheaf of his medical reports with the help of his moistened fingers. He hardly understood anything. But he kept on reading. Lastly, he closed the file and started thinking.
His left index finger went inside his left nostril, and he took out something from inside and started rolling it between the thumb and the index finger.
He started talking to himself. Will I depend on medicines to live? No-no, this can't happen to me. There is something wrong. Tumpa was right. I should go to Delhi. I must get an expert opinion from an unbiased doctor of the Medical Institute.
He called his daughter. Her phone was switched off. He thought for a while and then hesitantly called Swati. He told everything to her in detail. Swati was happy to know that all his reports were in the normal range
She asked him to proceed to Step Four boldly, even if Step Two is incomplete. But he should start taking medicines as soon as possible. He said, "If I start these medicines, then I will have to take them for the whole life. No-no, I will go to Delhi tomorrow for my proper treatment."
On the way back, he stopped at Ghosh Pharmacy and asked Hemant if he found that Magic Pill. He thought if he found that pill, then he may not have to bother to go to Delhi.
On reaching home, he booked his air tickets online, sent a WhatsApp message to Tumpa stating that he was coming to Delhi tomorrow, and then started browsing the web on Google for the term called FAPS.
To his surprise, every time Google said it meant ‘Frank Anthony Public School'. Then angrily, he typed in the search bar ‘What kind of disease is this FAPS'. And the answer shattered him from within. It said – It is ‘Familial Adenomatous Polyposis’ characterized by cancer of the large intestine.
Badal da’s heart sank and he started staring blankly at the wall.
Oh my god, I have cancer, and I will die soon. Tears welled up in his eyes. He started reading the details of the disease to know how much pain he will have to bear before he dies. In the absence of my children, how will I be able to bear the pain during my last days?
But soon, he got baffled.
Google said that the average age at which an individual develops colon cancer is between 39 to 55 years. In his case, it started at the age of around 57 years. He thought, But then why the hell Dr. Varghese told me that all my organs were functioning normally and that too with a smile ............ to a dying person? Badal da became furious.
Badal da angrily typed – exclusion method of diagnosis on the search bar. Now Wikipedia explained - A diagnosis of exclusion (per exclusionem) is a diagnosis of a medical condition reached by process of elimination, which may be necessary if presence cannot be established with complete confidence from history, examination or testing. Such elimination of other reasonable possibilities is a major component in performing a differential diagnosis.
“What a weird method is this? When you are not confident enough to diagnose a case, then you can conveniently diagnose a case by the method of exclusion,” Badal da murmured.
Then he started reading the next paragraph - The largest category of diagnosis by exclusion is seen among psychiatric disorders where the presence of physical or organic disease must be excluded as a prerequisite for making a functional diagnosis. Diagnosis by exclusion tends to occur where scientific knowledge is scarce, specifically, where the means to verify a diagnosis by an objective method is absent. As a specific diagnosis cannot be confirmed, a fallback position is to exclude that group of known causes that may cause a similar clinical presentation.
Badal da screamed, “Oh, shit-shit-shit. If the doctors cannot diagnose a case, then they declare someone to be suffering from psychiatric disorder? Who gave them this power to denounce somebody and walk away smilingly?”
His head started spinning. If I am suffering from cancer, then I am not a mental case, and if I am a mental case, then I am not suffering from cancer, he thought. He could not decide which one of the two would be better to suffer from. Spending his whole life as a mental case or suffering from cancer for a short time and die.
But how come Hemant's Magic Pill can cure either of these conditions?
He cursed Hemant again and again for not finding him the pill. Because of that, he unnecessarily got into the doctor's trap.
He could not resist himself from calling Swati again. It was eleven-thirty now. Probably she was in her bed. She asked him why he called. Her voice was soft and dreamy.
Badal da, for a moment, forgot why he called. He said to himself, what an attractive and nice lady she is. Should I bother her at this hour?
She said again, "Tell me, Mr. Badal. I am listening.”
“Sorry, I woke you up.”
"No-no, I was just thinking about you," she said in the same dreamy and a bit sexy sounding voice.
Badal da calmed down. He wished she was sitting in front of him.
"Sorry, but I need you…. I mean, I need your help. I am very disturbed,” and then he told her everything.
She burst into laughter. But that sounded like a jingle in Badal da’s ears, “Mr. Badal, you are an impossible guy. Please don’t try to become a Google doctor.”
"Do you think I am crazy, Swati……madam?" asked Badal da. But his voice was calm.
"Oh no, you are a simple-hearted good person," she answered in a convincing tone, "The only problem with you is that you worry a lot. Forget about all medical jargon. Your tests are normal. Don't worry. Tell the boss first thing in the morning that you are ready to face the medical board. Then go to Delhi as we decided. Correct treatment and regular medication will cure you."
“You are right. I have already booked my flight tickets. But my daughter is busy with her final exams. She may not be available to assist me. Moreover, I do not know anyone who can fix an appointment with the right doctor in the Institute.”
"You don't bother. I will arrange everything for you. My daughter and son-in-law are in Delhi. They will receive you and make all the arrangements for you. Now you go to sleep. OK? Goodnight and sleep peacefully. Everything will be all right."
She disconnected. Badal da held his phone close to his ears for a long time. In the end, he smiled and said, "You are too good, Swati," and he closed his eyes.
Swati’s words Goodnight echoed in his ears till he was fast asleep.
So Step Three was completed successfully. All his tests were within normal range, and the Medical Board cannot have any substantial evidence for making a case against him for removal from the job.
But more critical was Step Two – The cure of his medical condition called FAPS.
