The Thing With Small Things

January 12, 2018
Art or Science? The dubious duality of Medicine
February 20, 2020

The Thing With Small Things

Small things, be it good things or bad things, touch our lives in a rather BIG way! We often ignore small joys of life, although the essence of life depends on them. Similarly, although we know how to deal with big problems, we are clueless about small troubles. We all know where to go when one has a bigger health issue like jaundice, joint pain, blood pressure etc. However, when someone heals a wound in his hand, but is left with an extremely painful nodule in the scar, he becomes a medical nomad. The idea behind writing this blog is to bring awareness about this small yet significant medical condition called ‘Neuroma’.

Nerves are specialized cable-like structures that carry signals between brain and other body parts. Because we need a precise and sensitive feel in our hands, there are more numerous, sensitive nerve-networks in our palms and fingers. This advantage turns into trouble in the event of an injury. A sizable twig of a cut nerve, if loses a chance to find the other cut end, can get enmeshed in the developing scar. The ‘life’ in the nerve attempts to ‘grow’ but only ends up as a ball of raw nerve stump. This grain-sized nodule then creates havoc. As you know by now, this nodule has open nerve-ends, just like an open live electric wire. Whenever it gets even the lightest of touch, the nerve cells fire so intensely, that the brain perceives it as severe pain. The casual touching of neighboring fingers or a stimulus so gentle as a breeze can trigger feelings of an electric shock. The impulse is strong enough to wake him from sleep. The sickening feeling discourages the patient to even take the hand out and use rest of the fingers.

Sounds like science fiction? Not at all. This is but a common knowledge in specialized medical literature and I deal with neuromas routinely. What’s more, I have seen the said nerves and will show you today.

At this point, the patient’s suffering starts. The rare medical entity of ‘neuroma’ is sadly not understood by a lot of medical and paramedical service providers except a few specialties. Hence, the patient often gets neither the right treatment nor the right referral. Besides, this being a ‘small’ disease albeit a very annoying one, doesn’t call for aggressive search for the right treatment. The patient often suffers in silence for a very long time.

Plastic surgery being the problem-solving specialty that it is, treats this enigmatic distress. Under anaesthesia, we isolate the nerve that is forming the painful nodule; excise the nodule and bury the free end of the nerve into a nearby muscle or a bone. The idea is to keep the nerve-end away from skin and scar. The ghost of a nerve, permanently locked away from the surface of realm! Although there are other treatment modalities, this has worked well over time.

The photographs enclosed are that of two gentlemen whom I treated recently. (I hope the visuals are not too distressing for non-medical readers. Kindly use your discretion).  Sadly, it took them more than a year each to reach me. From the moment the surgery was done, they are relieved of a small, yet almost incapacitating nuisance right in their hands.

And as for the stimulus that triggered writing about small things today, it is this beautiful poem that I received on whatsapp. Thanks be to the unknown poet.



बहुत दिन बाि पकड़ में आई…

थोड़ी सी खुशी…तो पूछ लिया,

“कहााँ रहती हो आजकि….ज्यािा लमिती नही?”,

“यही तो हूाँ” जवाब लमिा।

“बहुत भाव खाती हो…कुछ सीखो अपनी बहन से…

…हर िूसरे दिन आती है लमिने हमसे परेशानी”।

“आती तो मैं भी हूूं…िेककन आप ध्यान नही िेते”।

“अच्छा? कहााँ थी तुम जब पड़ोसी ने नई गाड़ी िी?”

“आपकी बेटी की टेस्ट ररपोटट पढ़ रही थी…

जजस बीमारी का डर था वो नही ननकिी…वही खड़ी चैन की साूंस िे रही थी”।

कुछ शमटसार तो हुए हम

िेककन हार नही मानी

“और तब कहााँ थी जब ररश्तेिार ने बड़ा घर बनाया?”

“तब आपके बेटे की जेब मे थी…उसकी पहिी कमाई बन कर”।

“और तब कहााँ थी…”

अगिी लशकायत होंठो पे थी जब उसने टोंक दिया बीच मे।

“मैं रहती हूाँ..…

कभी आपकी पोनतयों की ककिकाूंररयो में,

कभी रास्ते मे लमि जाती हूूं एक बबछड़े िोस्त के रूप में,

कभी एक अच्छी किल्म िेखते हुए,

कभी गुम कर लमिी हुई बालियों में,

कभी घरवािों की तालियों में,

कभी मानसून की पहिी बाररश में,

कभी रेडडयो पे पुराने गाूंने में,

िरअसि…थोड़ा थोड़ा बाूंट िेती हूाँ, खुि को

छोटे छोटे पिों में….उनके अहसासों में

िगता है चश्मे का नूंबर बढ़ गया है आपके

लसिट बड़ी चीज़ो में ही ढूूंढते हो मुझे

वहााँ भी आती हूूं मैं…िेककन कभी कभी

खैर…अब तो पता मािूम हो गया ना मेरा

अब ढूूंढ िेना मुझे

िेककन हााँ…चश्मे का नूंबर बििवा के”।।

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