Remember Givraj Sen, the handsome young man from Kanai who was burned as a boy? The cook who would love to have doctors give him a new ear?
Well, Mr. Rathore took Givraj to Jaipur, three hours away, to meet with a plastic surgeon. The surgeon said Givraj doesn’t have enough flesh on his head, near where his ear should be, in order to construct a new ear. They can help him, though, and offered to do skin grafting from his leg to his neck. This will give him increased functionality—the tightened skin has been limiting his range of movement—and improved appearance. With the resilience of youth, he jumps.
“Can we do it today?”
The family decided it might be more convenient to wait until Karen, their visitor from the US, leaves so that they can better support him. Doctors tell Givraj to have a family member from the village come to help care for him in the hospital after surgery.
And he is not the only one from the little village facing big medical problems. The very day of our clinic a Mr. Singh, in his late fifties, falls down with uncontrollable tremors in his leg. He had been experiencing occasional vertigo, and a decrease in hearing in his right ear. Months ago a doctor in the town 20 kilometers away gave him pills for the vertigo, and he tried to ignore that, along with the weakness that came upon him occasionally. Just one more thing along with the crop failure, to worry about. The tremor however, was a new and terrifying symptom. What to do?
Come to the medical camp in Kanai Kalla!
As with Givraj’s plastic surgery needs, mystifying tremors and weakness are, as they say, “beyond the scope” of our little clinic. Our medical coordinator, however, refers him to Jaipur, and neurologists. With a population of three and-a-half-million and as the capital of Rajasthan, the largest Indian state, Jaipur is a major city with modern medical care. Mr. Rathore brought both Mr. Singh and Givraj to Jaipur for consultations. Mr. Rathore’s little diesel Ford—most cars are diesel here—was fully occupied for their journey to Jaipur.
Big surprise, for me, is how quickly appointments could be scheduled. Within two and a half days, Mr. Singh has an MRI and consultations with two neurosurgeons, an ear nose and throat specialist, plus a general practitioner.
The big shock, for him, is the result of these appointments. Mr. Singh has a brain tumor, a left sided acoustic schwannoma, which is in the inner ear growing into his cerebellum. Small comfort to him that the tumor, at 2.3 centimeters by 3 centimeters, is not cancerous. It will require brain surgery to remove it.
It will also require surgical and medical fees of about $2,700.
That’s all? I thought, for brain surgery and a hospital stay? It might as well be $2.7 million dollars. As a farmer Mr. Singh is too poor to afford medical insurance, but not quite poor enough for the “Bahmashah card”, similar to a medicaid card, that will pay for his medical care. It is left to him, and his family, to figure out payment.
The two neurosurgeons agree on the surgery and excellent prognosis. Following surgery he has a 95% chance of making a full recovery. A four percent chance of some nerve damage to his face. One percent chance of death. They disagree on the urgency; one says surgery as soon as possible, the second one says as soon as convenient.
Mr. Singh wants to finish the clean up in his fields—he’s got the current crop harvested– and get winter wheat planted so that while he is recuperating from surgery the new crop will be growing. He expects that process to take two to three weeks, which puts him at Devali—the biggest holiday in the Hindu calendar, roughly equivalent in importance to Christmas. He agonizes about how to tell his wife about his condition. How to tell his mother, who is in her upper eighties? His son, who is 19? Should he sell his land to pay for the surgery? But then how will he earn even the modest living he does. The economy is depressed and even if he does sell his land it will bring far less than it should.
“He is crying constantly,” says Goldie.
“I’m not surprised,” I say. “I would expect that.”
“Not in India. We don’t cry in India.”
Two days ago Givraj Sen had surgery. Plastic surgeons in Jaipur took skin from his right thigh and placed in on his neck, hoping to improve both his functionality—the scarred skin in that area was contracting and limiting his range of motion—and also to improve his appearance.
What does not require improvement is Givraj’s good spirits.
When he saw me in Jaipur Givraj made an airplane motion with his hand, to show that he planned to visit me in America someday.
I hope he does.