A young medical student recounts her first week of medical college life and an indelibel expression- not in the wards or the hospital or the labs, but on a bus journey

In a bustling bus lingered a vacuous seat,
‘She’s impure,’ they proclaimed; indiscreet.
The poor, frail woman shed tear after tear…
‘Don’t sit next to her,’ they warned a sneer.

The wide-eyed young girl looked on in curious worry,
As the fierce conductor tried to make the woman scurry.
The amused passengers laughed on encouragingly,
As he tugged at her bag, her hand, even her dignity…

Spurned by the hospital, in society she had no place,
For she had not the money to be referred to as a ‘case’.
Her sole possessions- her untended disease and her fright,
The doctorless patient drowned in her ceaseless plight…

Melancholia stared deep into the girl’s wide eyes,
They welled with desolation as she heard the helpless cries.
Her dream of becoming a doctor would soon come true.
But oh doctorless patient, what will become of you?

In today’s advanced age of robotic surgery and tele-medicine, there lurks a dark, dark corner that is often overlooked. Neglected, helpless and lost, the story of the doctorless patient is never told…

As I got into a bus to take me home, in my very first week of being a medical student, my mind was buzzing. It had always been my dream to become a doctor, and I was fascinated by the secrets of the human body that were slowly being unveiled before my wide eyes. I felt powerful. ‘One day I will be a doctor, and I will save lives.’ Little did I know that my seemingly mundane daily bus journey would be the source of an important life lesson.

As it is with afternoon buses, the vehicle was packed, with people pushing, pulling and heaving. When I spied a single empty seat, so out of place in its chaotic setting, I hesitated. Pulled down by the weight of my heavy bag, though, I plopped myself down. At once, all eyes were on me. People yelled as if I had sat on a pot of burning coals. ‘Don’t sit there!’

My reflexive reaction was to get up, as one of the passengers began to explain to me, ‘She stinks. We keep telling her not to inconvenience everyone with her unbearable reek, but here she is anyway. She’s dirty. Don’t sit next to her.’ I was appalled. The poor woman wept silently, and I figured that she had heard this monologue before.

Ignoring the aghast passengers around me, I returned to my seat. My Kannada was far from perfect, having never learnt the language before, but I still knew that I couldn’t just leave her that way. ‘What happened?’ I asked her softly. She looked at me strangely, wondering why I was talking to her. An eerie silence enveloped the erstwhile chaotic bus as everyone tried to listen in to what the strange young girl was saying.

For a while, she did not speak- she simply stared at me, perhaps wondering if I would order her to leave like the others. Then the tears flowed freely as she shakily said- ‘My daughter…’ ‘What is it?’ I urged. ‘Don’t talk to her. She’s not a good person,’ the woman in the next seat said. Paying no heed to her, I continued to look at the woman.

‘My daughter is very sick. She has brain cancer. She’s only six years old,’ the woman began. ‘But we have no money to buy her medication or to pay the hospital fees so the doctors are not agreeing to look after her.’ She paused as a barrage of tears stopped her from saying anymore. ‘I don’t want my little girl to die…’

A single tear threatened to escape from the fortress of my eye, but I held it captive. ‘And what happened to you?’ I have diabetes. And I have no control over my urination. The doctors said there was an infection, but I could not afford further treatment or tablets. That’s why I smell so bad. I can’t help it…’ she sobbed uncontrollably.

The powerful feeling that had filled me not so long ago seamlessly transitioned into a heart-wrenching helplessness. I knew that I should not cry, because that would only make her feel worse. In a voice so small I did not even recognize it as my own, I gave her the directions to my medical college and my number so she could call me when I got there. ‘Will I be able to afford it?’ she asked me, and I could only smile sadly in response.

‘Does this happen to you everyday?’ I asked her, unsure whether I really wanted to know. ‘Every single day. The conductors have yelled at me, abused me, physically tried to make me leave… The ladies in the bus laugh at me and look at me like I’m made out of dirt. But it’s alright. Only if I take the bus can I go see my daughter in the hospital, though I guess she can’t stay there for long now…’

‘Take care,’ I said despondently to her as I got off the bus. Tears streamed down my face. These weren’t sad tears- those came later- these were tears of anger. After spending year after year acquiring oceans of knowledge, what was the purpose of any of it if I would not be in a position to use it to help those who needed it the most? Not just poverty, why do caste, sexual orientation, color, gender or any of the ways human beings differ from each other deserve to have a bearing on access to health care?

The doctorless patient haunts me… She knows naught of the greatness of medicine or how far it has come over all these centuries. All she knows is that there is a way to cure her daughter and herself; but the doors are locked for her, and their keys will never find their way into her poverty-stricken hands.

Aiswarya Sasi