Tuesday, November 26, 2019

Public Transport Gymnastics

Hailing from small town in Western Ghats, meant very rarely available public transport & distances that were not so much far. So as I grew out of callipers(steel), knee surgeries which hyper-extended both of my hamstrings, resulting in loss of control & very frequent locking of both of my knees in hyper-extension; I gradually started walking ever longer distances for endurance. 4 yrs of disciplined efforts at building the endurance paid off, I started relishing my long walks to & fro college 4.2 km one-way on secluded stretch of road. The walks while drained me to the point of physical exhaustion also provided me with a chance to introspect to defuse my anger and bitterness for being pitied, ignored, or ridiculed, which, unfortunately was disturbingly common occurrence.

Got through the turbulent teenage & college education at the same time with flying colours when I landed a job in bigger city. With it came different set of problems, my parents were not at all ready to let me live away from them. After roping in all of my entire extended family & thousand arguments & another million tantrums later, finally got a nod on the condition that I live with my paternal aunt who very graciously agreed to take care of me & look over me. (For those of you who are unfamiliar with the context, Indian kids live with their parents till either of them dies or in case of girls till they get married off).

Unfortunately for me, that meant taking 2 buses just to reach the office. This Ordeal made me wonder who designed the red buses that ply on Indian roads as public transport? and with which demographic in mind? I have never seen even a tall man climb the bus without using the support of hand rails, ergo it is only designed for young men with all 4 limbs working in perfect order.  The lowest step to climb in bus is so high that knee of leg reaching the step used to touch my chin.  Believe it or not at 5ft, I am as tall as an average Indian women. Same goes for insides too, the support railing is so high most women would not be able to reach it unless they have Chimp-long arms. This high step climb into bus required me to swing myself up using the 2 door-side handrails to get in, unfortunately these double bar gymnastics did take a little more time for me than needed by others to board the bus. 

While the public transport was feasible it was not accessible/practical at all. The bus stops had no queues, people shoved & pushed to get ahead; most testing of all bus drivers & conductors would not allow me to board from front door. Front door boarding was right of access for physically handicapped & infirm, but the awareness & implementation of the law was infinitesimally minimal. I persistently complained at the interchange every time with the bus number & statement that the driver did not allow me to board from the front door. The clerk at the complaint desk mostly laughed it off till he got annoyed & then literally told me to bugger off saying "I was asking too much of privilege which I do not deserve".


In mean while I figured out that if I start sufficiently early as in an hour before the rush hour I can board the bus, optimistically considered I might even improve my speed of gymnastics to climb too after everyday practise. Boarding the bus from back door, meant the conductor would ring the bell every single time before both of my feet were inside the bus, as I was a slow person who always boarded at last to avoid being pushed underneath the bus by the crowd in hurry.

Eventually I decided, on walking the second leg of the commute instead of trying to board bus at the busy interchange. This gave me back the very chance of catharsis, I so loved. But the distance in the second leg was longer than what I was used to walking & besides this I was throwing up my breakfast everyday due to motion sickness induced by riding the bus. This routine caused a significant drop in my weight in a month which was always a concern for my health as per doctors'. After nearly missing being run-over by bus by falling down while climbing in, I finally convinced my parents to let me live close enough to office so that I can walk to office, instead of taking public transport.

2 weeks later I moved in as a paying guest with a kind family, they also ran a catering service. In the evenings the living room of the house served as makeshift dining hall. I credit my stay here for re-introducing me to my hobby of reading that I had given up under the guise of studying. I first took to reading whilst being admitted to the hospitals, as post-op pain would not let me sleep, sort of made a record of reading 50+ pocket books in 3 months from Tom Sawyer, Black beauty to Sherlock Holmes. The master piece The hound of Baskerville, hooked me on to the series & weird similarities in thought process of the protagonist & mine made me feel a tad too proud.

what would it take for you to hear me ?

Please refer to previous article in series to get the context

Flashbacks of painful surgeries & even more painful physiotherapy from childhood were not happy memories, but they do induce a feeling of strength akin to "I came out of that with flying colours, I can definitely survive this". So while I lay binge watching "Brain games" post knee wiring op, because pain would not let me sleep. There was a weird feeling of being ignored, one that I had compartmentalized as "not being taken seriously as a child". Flashbacks of feeling ignored kept coming back with hospitalization memories, I could not quite figure out why though.

During the night round of doctors, one resident (read Doctor still learning) came & asked where my close relative in attending was. I informed my bro has down downstairs for dinner. I tried striking a conversation trying to figure out what was being prescribed & why. Casually boasting how I have insane amount of pain tolerance which is why I would prefer no painkillers, but I could not shrug off the feeling of being ignored. She ( unfortunately ) interrupted me looking up from sheet she was scribbling on & demanded I ask my brother to sign the sheet once he is back. Once again I tried explaining that he is my kid brother & I can sign the treatment sheet myself since I am not being treated for insanity, which, resulted in her walking out on me mid-sentence with the sheet in her hand.

The morning after though, the feeling of being ignored was distinctly replaced by feeling of unending doom & nausea that made me throw up all contents of my breakfast. I tried telling the nurses who came with meal time meds that something in the medicines is upsetting my stomach badly, but again I was ignored. In mean while the entire team of doctors & surgeons treating me tried telling me how not being able to stand on my non-operated leg, pain is all in my head & I would never be able walk if I do not stand on it now (those who have read my previous post might remember that the other leg too was fractured at 3 places but was not assumed to be so, because I was not crying badly in pain instead just collapsing because it refused to take my entire weight).

The "eat meal - take meds - throw-up everything" cycle continued for another couple of days till I felt really weak & my palms started turning yellow. I could connect throwing up & yellowing of palms to jaundice & I decided to request the surgeon, to test me for it. When he ignored my request I knew it was time to throw tantrum to be heard. I refused to take meds until the staff showed me the contents, too my horror, I was being dosed 600 mg paracetamol 4 times a day. My weight at that point of time was 51.5kg. https://www.drugs.com/paracetamol.html

Despite being overzealous in explaining I have huge pain tolerance to every single doctor I met, I was actually being poisoned by totally unnecessary painkiller. Acetaminophen aka Paracetamol is a painkiller with questionable efficacy compared against placebo  .

So, it was not all in my head after all, the feeling of being ignored was real as the doctors were not just ignoring me, my opinions, my observations but my observable symptoms of paracetamol poisoning. While proving over-dosage was upsetting my stomach gave me the vindication, the recovery from hepatic toxicity was a very long journey.

Googling returned horrific stories on how gender bias affects healthcare
https://www.bbc.com/future/article/20180523-how-gender-bias-affects-your-healthcare
https://www.forbes.com/sites/brucelee/2019/07/06/medicine-has-an-implicit-bias-problem-what-needs-to-be-done
https://www.theguardian.com/lifeandstyle/2017/nov/20/healthcare-gender-bias-women-pain
https://www.theguardian.com/society/2017/sep/06/listen-to-women-uk-doctors-issued-with-first-guidance-on-endometriosis
https://www.health.harvard.edu/blog/women-and-pain-disparities-in-experience-and-treatment-2017100912562
https://www.prevention.com/health/a26100121/misdiagnosed-women
https://text.npr.org/s.php?sId=782466541
https://www.webmd.com/women/news/20180607/why-women-are-getting-misdiagnosed