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Stories of Rehabilitation: Metamorphosis

butterfly on flower
Dr. Asish Kumar Kundu

Dr. Asish Kumar Kundu

Physical Medicine & Rehabilitation Specialist
My Other Posts
  • April 24, 2020
  • 8:03 am
  • 7 Comments

The dirty disheveled brat,

With running nose

Dripping on to his lips.

Wiping it clean with the back of her hand

My child, she utters, with adoring eyes.

It’s a mystery beyond all mysteries

 The first sight was shocking and repulsive. I flinched, hopefully not too obviously, when the child turned in its mother’s lap to look towards me. The face was almost non-human.

The two sides of the face were asymmetrical. There was no ear on one side and the eye on the other side was small and lifeless. The nose was broad and one angle of the mouth was raised higher than the other. The lower jaw was pushed backwards, and to top it all the head was small and there was virtually no neck.

Both feet were also deformed.

My first fleeting thought – before rationality took over – was  here was an ugly looking child, more ugly than I ever had occasion to see. I shifted my gaze to look at the parents – both short and plump with good natured round faces – a little elderly, considering that their only child was four years old. They were looking intently at me, as though trying to read my thoughts.

“Could you please tell me his problems and could I see his medical file?”I averted their gaze. Hardened though I am with years of handling kids with various types of congenital anomalies, I was uneasy and buried myself in the thick fat file.

The child had a medical history that could be a very interesting study for a medical student. The file was dotted with beautiful obscure medical terms like microcephaly (small head) with short neck, retrognathia (deformity of lower jaw), absence of one facial muscle, bilateral talipes equinovarus (deformed feet like those of a horse), multiple renal cysts (changes in the kidney), absent auricle (one ear absent),  hemivertebra in the thoracic spine (deformed spine) and partial corpus callosum agenesis (a part of the brain not developed).

No doubt it was a miracle the child was alive. And his name was Teesta.

  • *                           *

From Mangan bazaar in North Sikkim, we started downhill within the restricted area to reach the forest guesthouse. It was dark outside, the hovering headlightsof the jeep down the winding path throwing up flashing glimpses of the dense foliage. Above the splattering of raindrops and the screech of tires, a faint sound appeared like the distant rumblings of the sea, increasing in intensity as we proceeded. It was the roar of the mighty Teesta.

I had officially joined the nature study camp for children at Mangan as an observer, but the truth is I had wanted to hover around the camp to look after the wellbeing of my seven year old son, one of those over enthusiastic campers.

Our tents were pitched on a sprawling lawn close to the river bed, where the two rivulets – La Chengu and La Chenchu _ merged (tied the nuptial knot, as per the local lepchas) to form the Teesta. Here I spent the next five days, trying to understand the unfathomable.

Those days are long past but for me the Teesta still remains the symbol of life – a vibrant, throbbing, pulsating life.

*                         *

“We had a late marriage and then we did not have any issue for a long time,” the father continued in his slow, drawling and somewhat effeminate voice. “And then Teesta came.”

Embarrassed smiles appeared on both their faces. “You see, we have so many fond memories of this river that we had decided on the name Teesta, whether a boy or a girl.”

The struggles for Teesta started the day he was born.

Tiny little thing, the doctors said that his anal canal was blocked and an emergency surgery was performed on the very first day. From then on he passed stools through a hole in the abdomen, which was subsequently repaired two years later.

He was born with a problem in the left eye and in spite of all efforts, his vision in that eye was completely lost.

How much more could a child suffer and survive?

I looked out through the open window and watched the children playing on the lush green lawn – all disabled in some way or the other, but having great fun, climbing on swings and slides and running around. Would Teesta ever be able to do that? Was it an irony that the child was named Teesta?

*                        *

The parents were waiting for my verdict. I hovered over my indecision and started, “The reports suggest a very gloomy picture. All the defects can possibly be sorted out to an extent except those of the brain, which can cause serious problems including severe mental retardation.”

The parents nodded knowledgeably. I presumed they by this time had read more about corpus callosum than I had.

“But,” I continued gravely, “young kids have brains with enormous amounts of plasticity. My experience tells me that many of those who appear to be hopeless in early life show remarkable improvement later on.”

I offered to give it a try, but hurriedly pointed out that it would be a long and tough process. The parents agreed.

However, the important issue was whether Teesta’s intelligence was normal. “Oh yes, absolutely normal.” Though I did not say as much, I very much doubted their words – all parents tend to overlook their children’s deficiencies.

Anyway we agreed to proceed.

*                         *

“My dear children, these are caterpillars,” the melodious voice of bug-uncle droned on, while incessant rain mingled with the roar of the turbulent Teesta to create a music of its own.

The nature camp at Mangan had to reschedule its programme because of the downpour. Star grazing was out of question in this weather and sky-uncle had to take a back seat among the forty-five odd kids inside the guesthouse to learn a little more about insects.

“Nasty, isn’t it – a greenish worm covered with thorny hairs sluggishly moving along, eating away small bits of leaf. People usually avoid its touch and consider it a nuisance. Mother nature, however, does not think so. She showers her love on this tiny little insect and blesses it to blossom into something beautiful.

“If you also look kindly on this ridiculous looking worm, in a few days it will change into a pupa. Wait and watch and bestow your wholehearted love and suddenly one day you will see the loveliest of butterflies with the rainbow on its wings in search of a colourful flower to rest on.

“Had you hated the caterpillar and crushed it with your feet, you would never have a butterfly.

The children listened spellbound to their favourite bug- uncle while the rain drummed on above the rumble of the Teesta.

*                      *

Rehabilitation is a long drawn process where a team of professionals plays different roles in a well-orchestrated manner to achieve certain goals.I called my whole team along with the parents and planned a few short and long term targets.

The days went by and the parents regularly brought Teesta to our rehabilitation centre.

Over time I noticed and my teammates confirmed, Teesta was not only bright and intelligent, but also very mischievous. It was fun working with him,and even though he had only started vocalizing, was already imitating, to everyone’s delight except mine, his new found grandpa –me!

Just one year had passed when Teesta was brought to my examination room for a reassessment and review. By this time he had started walking with a little support, and at my insistence had been admitted to a regular nursey school where, I was told, he had adjusted very well.

Sitting gravely by his mother’s side he grasped my examination hammer and while reassuring her, “Don’t you worry, it won’t hurt,” looked slyly at me and played a very powerful doctor role by giving her knee a huge tap – bang! “Ouch,” cried his mother in pain.

I looked up to see a mischievous child peeping at me and was startled. His twinkling grinning face had me mesmerized. I suddenly realized I hardly remembered seeing such a beautiful looking child, ever.

It ried to recollect my first impression of the child – but there was almost a void.

Who or what had changed, Teesta or me?

*                          *

And across its hurdles, the taunting, laughing, roaring Teesta flows on.

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7 Responses

  1. Smarajit says:
    April 24, 2020 at 4:07 pm

    It’s a good story.Hiwever I don’t think uttering all those medical terms has added any value.You explained features(what you did,)and it’s probably prognosis quite elaborately which I think is sufficient.
    Secondly at the end you could have added tro lines more to help envisage readers what things has changed in the kids behaviour and approach in addition to one incident what you shared.

    Reply
  2. Asish Kumar Kundu says:
    April 25, 2020 at 3:38 pm

    Swarajit
    I am still confused as to whether the metamorphosis was in me or the child. Read Kafka.
    As for the medical terms, I think when the parents understood those, the readers also have a responsibility ti know.
    Asish

    Reply
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