Parshu Shrestha
“Do you know, nani has got a lump in her right breast? She says it hurts.”
Pramesh had just arrived home when his wife said this. It rang in his ears like a clanking bell. His vision blurred, and everything around him disappeared. His legs, limp and weak, could not hold him anymore. His throat, parched and dry, could not produce voice, and his heart started pounding so heavily that he felt it would come out through his mouth. The evening painted a gloomy color around him.
“How big is it?” Pramesh asked his wife in a faint voice after a while’s punctuation. “How long has she had it?”
“She knew about it only yesterday, says she, when she had a pain in her right breast. It’s the size of a plum.”
The next day, Pramesh reached to a local clinic with his daughter. He paid five hundred rupees to get a ticket to consult with a gynecologist from Biratnagar. Pramesh was trembling inside with imagination what the specialist would say to him after checking his daughter’s tumor.
“Looks like a benign one; however, we can be sure only after the report.” The doctor said examining the tumor with her hands and prescribed for an ultrasound.
The father paid the bill, twenty-four hundred rupees, at the counter, and led the daughter to the ultrasound room with a red receipt. While Sumana was having her breasts screened by the radiologist, her father was nervously waiting outside. “What if my daughter has really got breast cancer?” He was anxious.
After a while’s wait, the radiologist gave his report to Pramesh. He opened the envelope, and read the report immediately before taking it to the gynecologist.
The result said: Fibroadenoma
He searched the meaning of the medical term in Google. At the top of the search result, he found written on his mobile screen: ‘Fibroadenomas are common benign (non-cancerous) breast tumors made up of both glandular tissue and stromal (connective) tissue. Fibroadenomas are most common in women in their 20s and 30s, but they can be found in women of any age. …’
However, just below it was the section ‘People also ask’ in which the first line with an arrow turned downward (˅) had a question: Can fibroadenoma turn into cancer?
Pramesh touched the line with his right thumb on his mobile screen. It said: “The large majority of fibroadenomas will not turn into breast cancer. However, it is possible for complex fibroadenomas to become cancerous. This type of lump is less common and faster growing than simple fibroadenomas and contains changes such as cell overgrowth (hyperplasia) and calcium deposits.”
Pramesh heaved a deep sigh to express his relief from tension. At least, he thought, he did not need to worry so much.
The doctor said that it was not necessary to worry as it was a normal woman problem. She wrote a name of Vitamin-E capsule in her prescription card, one capsule a day every evening before bed. Sumana would have to consume the medicine for six weeks.
Six weeks passed, one after the other; however, the tumor did not disappear from Sumana’s right breast. Rather it became a little bigger, she reported. Then, the trouble started.
Sunidhi took her daughter to BP Koirala Institute of Health Sciences (BPKIHS) in Dharan, for further examination. To her horror, the doctor advised her to go for her daughter’s breast surgery as immediately as possible. The doctor also told her that surgery was the only way for removing the lump from Sumana’s right breast.
The couple was not convinced, so they decided to take her to Nobel Hospital, Biratnagar, once. Pramesh took his daughter to a gyno-doctor who recommended her to the surgery OPD. The surgeon who checked the lump in Sumana’s breast wrote in the prescription for various tests, viz. video x-ray, blood tests, etc. He said that immediate surgery was needed.
Pramesh now understood that there was no other way out of the problem. He now decided to submit to his fate. He completed all the tests as per the doctor’s demand and also got an appointment for the surgery. It would be possible after four days.
At home, as the father and the daughter arrived, and told others about the appointment with the doctor for surgery, the mother and the grandmother started weeping. They were already too afraid to think about it anything properly. Sunidhi phoned her mother who advised them to take Sumana to B. P. Koirala Memorial Cancer Hospital in Bharatpur, Chitwan, as quickly as possible.
“Even if it is a cancer,” she said, “she will get proper and quick treatment.”
Everyone liked that idea. So, the next day Maheshwari, Sumana’s maternal grandmother, arrived in Itahari and they boarded the day-bus to Kathmandu early morning the next day. They reached the cancer hospital at around 3 o’clock in the afternoon.
“Cancer Gate, Cancer Gate,” the bus-helper yelled from the door, “Cancer Gate passengers come to the door.”
As soon as the three had got off, the bus sped away. Pramesh looked around. On one side of the pitched highway was the gate of the (in)famous hospital. There were many mango trees with ripe mangoes along the boundary walls of the hospital on both sides of the main gate. He looked through the gate. The entrance, the pavement, the buildings, and the trees everything inside looked magnificent. However, when he remembered that he was going to enter the gate and get in the line for OPD ticket early morning the next day his mouth became sour. On the other side of the road was a small bazaar with some carts with pineapple and mango vendors, some vegetable hawkers, and a line of medical shops. The scene of the people buying and selling items assured him that the place was not a desolate one.
The granny and her beloved were carrying a luggage bag and walking ahead. Pramesh was carrying his bag with his personal things like shaving machine, pen, diary, towel, sando vest, etc. It was a July afternoon and much hotter than in Itahari. He was feeling sweaty all over his body while he was following his mother-in-law and daughter to an unfamiliar destination.
They left the highway to walk along a roughly graveled path, and reached a four-story building newly made. On the ground floor, a lady was cooking something in the kitchen, fenced with small iron rods. She saw them, and came out near to them.
“Are you the one who phoned me just a while ago?” asked she.
“Yes.” Said Maheshwari, “My neighbor had given your number to me.”
The lady welcomed them. Some men were watching World Cup Football match on TV. Pramesh had nothing to do, so he also gazed on it while Maheshwari and Sumana followed the lady.
After a while, Maheshwari came back with broad smile in her face. She called him in.
“The room’s ok,” she said, “Let’s go up.”
The concrete stairway was a bit narrow and difficult to climb. The room was small (about 8X8), a bit claustrophobic. However, it looked new due to the fresh wall painting. There was only one ceiling fan which circulated hot air inside the room. The only window was not for opening at night because of the fear of occasional incidents of theft. Somebody might peep through or push their hand into the room for stealing the things inside. There was a kitchen rack with all necessary utensils in one corner. Beside it was a small wooden table on which there was a gas stove. The room looked as if somebody had already well-settled there. There were two single low beds ready for sleep.
They were tired, physically as well as mentally. Therefore, after taking bath, Maheshwari and Sumana lay on one bed and Pramesh on another. The room was hot though the ceiling fan was moving at its best speed. Bharatpur was much hotter than Itahari. Pramesh was sweating even though he was lying on bed.
He woke up at around six in the evening. His body was in pain, and his head felt heavy. He looked around. Sumana was asleep in bed. Maheshwari was cooking dinner.
She knew he was awoken, and she smiled at him. He got up, and went out to wash his face. She told him to wake up Sumana, but she did not budge; she turned to another side. She took another half hour to get up. Maybe it was hunger that made the food so tasty! All three liked it.
The ceiling fan was moving lazily, but the room was filled with hot air. The three Itaharians were finding it difficult to adjust their bodies in the sweltering heat and were feeling as if they were inside a greenhouse that has no escape for air. It would be better not to open the window panes because otherwise more hot air from outside would gush into. Surprisingly, there were no mosquitoes. Otherwise, they would surely add to this nuisance.
Maheshwori went to the apartment on the same floor where the houseowner resided and informed him about the plight they were going through. After a while, he came in and fitted the ceiling fan and replaced the old capacitor with a new one so that the fan started moving faster and they felt a bit relieved.
Next morning, Pramesh got up early and went on morning walk. He liked it very much as he had a chance to roam around and see many new places. While he reached the hospital gate, some people were picking up the mangoes ripe-dropped from the trees. He also tried to find some and searched on the ground around the grove for a while, but most good ones had already been picked up.
There was already a long queue of people at the OPD ticket counter in the hospital when Pramesh reached there at 8 in the morning. Somebody informed him that 7 was the opening time for the counter. He also got to know that his patient’s day was only Sunday, not today, Thursday. Oops! They would have to wait for until then. Two days more.
In the afternoon, they decided to sightseeing and photographing. The hospital premises were beautiful with park and various flowers. Using their mobile phone camera, they took many photos at every place they wanted. However, the scorching heat of the sun did not let them enjoy it much.
On Sunday morning, Pramesh got up early and refreshed himself. Maheshwari and Sumana also got up and prepared themselves. Maheshwari prepared breakfast and served them. She also prepared lunch for the afternoon so that when they would return for the hospital they would not have to wait for long. Then, they all walked to hospital that was five minute-walk away from their place of residence.
There was already a long queue of people. Pramesh stood in the line, and the other two sat on the steel settee at the waiting lounge. There were people from all walks of life and represented all regions in Nepal. But they had the same expression in their faces. They all had different stories to tell, but they had the same voice and same tone to tell the stories.
“Go to Room no. 4,” the clerk at the counter said handing him the OPD paper.
He asked some people where that room was, and they showed it to him. It was on the ground floor at the back of the OPD counter. There was also a long queue of people (patients and their relatives). The hospital clerk was used to their crowd and perhaps fed up of their gloomy faces. However, for Pramesh, this was a new situation. Though he had visited many hospitals many times, he had never been so much emotional before. He thought they were not simply patients; they were the people who had lost all their fights for life, and this place was their last straw. But for the hospital clerks they were just patients.
Until an hour ago, Pramesh thought he was an unlucky father who had to visit such a hospital with his only daughter for such a terrible disease. Now, he thought he was just one of the many, perhaps ‘luckier’ than them.
A young girl was on a wheelchair. She was not more than twelve, but looked physically very weak and tired. Her belly was huge. Apparently, she was having a lot of difficulty to breathe and look around. Her ragged and rustic dress suggested that she was an unlucky village girl who could not reach the hospital entrance when she had time enough for her recuperation.
Pramesh couldn’t resist himself, and asked the man who was handling the wheelchair, “What happened to her?”
He let his voice out as softly as possible so that the girl would not feel hurt. The man, who later on was revealed to be the girl’s maternal uncle, answered back sadly, “She had jaundice six months ago, but we could not take enough care of her in the village. As a result, it repeated and became worse.”
Apparently she had had cirrhosis and her liver had bulged like a football.
Pramesh saw his daughter’s face in the girl’s. He imagined himself as the man, helpless and pathetic. Who knows what will happen to his daughter? What if the breast tumor is malicious? It’s only a matter of some months. Then, his daughter’s fate may also change. His fate will also change along with hers.
“Sumana Chaudhary,” the clerk’s shrill voice woke Pramesh up. He ran towards the table to receive the OPD card from her hand. Sumana followed him with sad and nervous eyes.
“What happened to you, nani?”
“Doctor Sa’ab! She’s got a tumour in her right breast. We got to know about it only two months ago. We took her to hospitals in Dharan and Biratnagar, and the doctors at both places prescribed for surgery. Therefore, we came here directly.” Pramesh finished before he stopped to breathe. The doctor who was sitting on a chair in front of him looked like a God for him. He showed all the hospital reports he had collected from the previous doctors.
As the doctor was studying the past report papers, he trembled inside. After a while, the doctor said, “This tumor is ninety-nine percent benign; however, let’s do FNAC. I hope it’ll be negative.”
Pramesh was happy to hear it. “Thank you very much, Dr Sa’ab!” Then, he got up from chair.
The FNAC report came after four days, and it was negative. Pramesh felt as if he was flying in the sky.
“Don’t worry,” the doctor said, “It’s a benign tumor which you can take out at BPKIHS in Dharan.”
The next morning, all three got on the day-bus to Itahari from the ‘Cancer Gate’.