Einstein propagated his theory of special relativity in 1905 and general relativity in 1916. These dealt with space time. A moving clock ticks slower than a stationary clock. This was the concept of time dilatation. It is an interesting concept and I have also observed variables in the perception of time. This made me propagate my own theory of relativity of time. Mind you this theory is a theory of perception rather than an actual physical phenomenon. I took the liberty of calling of giving it the pompous title of ‘Wilkinson’s Theory of Relativity of Time’.
1.Work expands to fill the available time:- We all have heard about the saying “the maximum is achieved at the eleventh hour”. This is especially true for studies, if we have say x days for preparation for an exam, our preparation in earnest will only begin on x-(x-1) day or in simpler words a day before the exam. We always feel we have plenty of time on day x and even when we attempt studying on that day the adrenalin does not kick in sufficiently and even if we stare at the books are mind maybe miles away. This holds true in almost every task where we have a number of days to complete, invariably the eleventh hour is when the maximum is achieved.
2.Perception of the length of time is inversely proportional to your age:- This is a practical concept which everyone would have experienced. When you were studying in first standard a year seemed so long. Then as you progressed a year began to shrink. As you age a year doesn’t seem so long. This can be explained by the fact that when you in first standard a year, you would be around 5 years old and a year represents 1/5th of your entire life. As you age this fraction decreases so for me it is now 1/53rd of my life. Therefore my perception of a year has shrunk inversely to my age. If I ever reach the century mark the fraction would have shrunk further.
3.Perception of time either shrinks or dilates related to the task at hand:- Have you ever run on a treadmill and realised how long a second can be? Or waited at a traffic signal for what seemed an interminable long wait but was actually only a minute. In contrast when we are commuting to our work place and are late, how fast the needles of the clock seem to move. Going on your first date is an example of both, time creeps to the appointed time of meeting and the date finishes off in an instance. Time crawls when you have a distasteful task at hand and flies when you are enjoying yourself. The irony!
Readers are warned that this is a scatological piece.
While travelling abroad the Desis is exposed to the use of toilet paper. Not that they are ignorant about the use, but it is considered ‘Angrezon ki chochlebaazi’ (Idiosyncrasies of the white man).
In one of the medical schools I trained in, there was a British operation theatre nurse. She was the ‘propah’ Britisher and one day she happened to spot a senior Anaesthetist resting his behind on one of the shelfs in the operation theatre where the autoclaved material is kept. She immediately reprimanded him him “Doctor____ could you kindly remove your unsterile posterior from the vicinity of the sterile material.” The Anaesthetist was famous for his wit and immediately reparted, “Sister we wash them, we don’t wipe them.” Needless to say ‘Sister’ was speechless and the onlookers could barely suppress their smiles.
Every region of India has their version of fiery food. The state of Assam is famous for it’s ‘Bhoot Jhalokha’ green chilli which earlier held the record of being the hottest in the world. In South, Andhra cooking is very fiery, with every morsel a sip of water is mandatory and inspite of which your buccal mucosa still feels like it’s on fire.
My home town of Nagpur has it’s own unique ‘Saoji Cusine’, which is very famous for being fiery. Many people who come from out of town want to taste this cooking. If you ask a local he will say it’s ‘g__d faar’ cooking (literally means ‘Ass tearing’). The reason you will soon be apparent.
Saoji cooking is classified into 3 grades depending on it’s fire:
After eating your mouth is on fire.
After eating in the morning there is a burning pain in the epigastrium indicating your stomach is on fire.
When you go to the toilet in the morning your Ass is on fire.
To this a wag added two additional grades for what emerges.
4. The pig’s mouth is on fire.
5. The pig’s Ass is on fire.
Legend has it’s that the white man visited Nagpur. He was puzzled when he saw the use of water for cleaning as opposed to the more civilised toilet paper.
He also was brave enough to experiment with grade 3. Saoji food. Next morning his Ass was on fire. Wiping only made it worse as the rough paper abraded the sensitive skin aggravating the burning sensation. Relief finally came when he took a mug of water and poured it on his posterior. This was a moment of relief and enlightenment, for now he knew why Indians preferred to wash than to wipe.
I had the opportunity of treating one such patient. He had lived in Pakistan and spoke some Urdu. He kept on telling me about about the burning there “jal raha hai”. When I examined the said area, there was a realistic lipstick mark tattoo on the right cheek of his buttock. Literally conveying ‘kiss my Ass’. He was suffering from acute fissure-in-ano.
The earliest mention of the use of toilet paper was by the Chinese. They also specified that paper with writing on it should not be used. Various other objects from pebbles by the Hebrews, sticks by the Turks and sponges by the Romans were used. The Americans before the availability of commercial toilet paper used pages from Seers Roebuck catalogue before it began printing on glossy paper then it became unsuitable for wiping. The Farmer’s Almanac, even had a hole at one corner so it could be hung from a nail on the wall of the toilet and pages could be conveniently torn. They knew their predictions were crap! However with the advent of modern sewage lines these had to be abandoned for the use of modern toilet paper, made with short filaments and degraded easily avoiding clogging of the sewage line.
The European have the bidet and bidet showers. The Indian subcontinent has the ubiquitous ‘lota’. Incidentally the slang for sycophants in Pakistan is lota.
In the National Cadet Corp camps, where they instill military training on school children they have a lota parade in the morning at the break of dawn.
But for the unaccustomed wiping leaves an itchy, unclean feeling. Medically this is known as pruritis ani. The person surreptitiously reaching for their behind when the itch becomes unbearable.
A NRI has fully integrated with his adopted country when ceases washing and commences wiping.
Before my memory fails me or I go to my heavenly abode let me retell another story of our sojourn in CMC.
This story dates to circa 1979 when we were 2nd Juniors and finally exposed to the actual medical studies like anatomy, physiology and biochemistry. We loved to find some clinical application to the dry subjects we were learning especially anatomy.
As all of you recollect we were divided into groups of 4, two per side of the body and one read the Cunningham Manual aloud while the other dissected. The portion being covered was the lower limb and the star of my story was R.M.K and his dissection partner was ‘Johns’ (I am trying to use generic names to avoid identification of the characters). The area of dissection was the lower limb more specifically the gluteal region and R.M.K. was dissecting and Johns reading. One vignette was read by Johns, “weakness in the gluteus medius muscle will give rise to a waddling gait”. This stuck in R.M.K.’s mind and when we broke for lunch he carefully observed the gaits of our classmates. His eyeball then zoomed on one particular member of the fairer sex who though otherwise extremely petite, had a derriere which did not quite fit the description of ‘petite’. The gait resembled a ship rolling on the ocean and reminded you of the Mitch Miller song, “She’s got a pair of hips just like two battleships……….”. A bulb light up in R.M.K’s mind and immediately he went up to her and stuttered “you got a waddling gait, you must be having weakness in the gluteus medius”. As you can imagine the lady in question was totally flabbergasted and didn’t know how to react. She turned to Johns who was in the vicinity looking sheepish and said “Johns scold him!” Poor R.M.K.! A remark made in all innocence with no malevolent intent!
This story dates back to Circa 1985 when I was a ‘wet behind the ear’ fresh MBBS graduate. I was working in a Hospital as a Junior Doctor.
I was on call every alternate night and during these call nights I had to attend to all patients presenting in the casualty and all emergencies in the wards. I had a room in the Hospital Guest House which was fairly decent.
In those days getting a landline connection took 4 years, forget about
cell phones. So calls were written in a notebook by the nurse on duty and hand delivered to the Doctor on call. These were predictably worded like, “Respected Dr. on call,
A patient with fever has presented to the casualty so kindly come and see.” There is a joke whether true or not but it’s part of folklore, once the duty Doctors got this call, “Respected Dr. on call, A patient has presented in the casualty unable to pass urine. So please come and pass urine.”
The hospital was mainly staffed by student nurses doing their training and night duties were done almost exclusively by these students. Majority of them were from Kerala with highly accented Hindi. They came bearing the call in pairs. I am a night owl and once I sleep I have difficulty in getting up so I would normally remain awake late during call days. Foot falls on the path leading to the guest house would herald an impending call. This is followed by louder foot falls in the corridor as soon as they enter the guest house, then a momentary silence outside my door, some mumbled conversation in Malayalam followed by giggles and then a tentative knock. I open the door and promptly the call book was thrust into my hand. Predictably it read, “Respected Dr. on call, A patient with bleeding has come to the casualty so kindly come and see. “Kahan se bleeding ho raha hai?”(from where is the bleeding?) I ask irritably, “Pata nahin” (don’t know), comes the reply followed by further giggling. Now I am ready to explode but better sense prevails and I pacify myself with thoughts like “forgive them for they know not the language” and “be kind to dumb animals.” I hand back the call book to them and say “Okay.” Which they promptly hand back saying “Call sign kar do (sign the call). ” I almost have an apoplectic fit but control myself and sign the book. Then I change from my night clothes cursing the loss of sleep and the patient for bleeding at this time of the night.
The walk from my room to the casualty is fairly long and during this walk my mind goes through the possible case scenarios. The patient may have got cut accidently or having blood in stools or maybe vomiting blood. On reaching the casualty I am shown a young lady, she is obviously from a poor socioeconomic status. Her saree and jewellery suggested she is newly wed and her head demurely covered with her saree pallu. I ask her what her problem was, in reply she looks down and adjusted her head cover to completely cover her face. Meanwhile another elder lady amongst the retinue of relatives accompanying her piped in, “isko BP ki bimari hai” (she is sufferng from BP), further confusing matters. Finally a sensible lady amongst the accompanying crowd presumably her Mother-in-law, said “sachi baat yeh hai ki inki nai shaadi hai” (the truth is they are newly wed), pointing out to her son who seemed to give a self satisfied smirk back at me. “Aaj isko bahut khoon beha raha hai” (she is bleeding excessively today). I then examined the patient, her sanitary napkin was soaked with blood and more blood was trickling from the vagina. I knew I was out of my depth so I sent a call to the gynaecologist. Meanwhile I asked the patient how this had happened? The patient in absence of her in-laws was more vocal, “gandhe kaam kar rahe the” (we were doing dirty things).
The gynaecologist was a middle aged spinster who like all middle aged unmarried gynaecologist was crabby. They tend to vent their irritation on their patients. Perhaps an undercurrent of envy ran in them of not have gone through these natural stages in life but being forced to witness others enjoying it. After scolding the relatives for not coming earlier and generally not taking care of the patient, she examined the patient. “Yeh toh post-coital bleeding hai (this is post-coital bleeding)!” She tells me. Inform the anaesthetist and prepare her for exploration.
The Anaesthetist was the reigning Queen Bee of the Hospital, known as ‘Kalra Bai’ to all and sundry but not on her face. She lived in the hospital campus and her quarters were so strategically located that she had to barely walk a few feet to reach the operation theatre complex. During the day her anaesthesia was interspersed by visits to her kitchen. She would do the fine juggling act perfectly between the anaesthetised patient and the required number of ceetees of the pressure cooker. The food in her house was always perfectly cooked. She was a fount of information about everything from solar cookers which she had installed to various fabrics and where it was available. We were bombarded by her monologue whenever we were operating. She never wasted her time, after the patient was anaesthetised she always had some needle work or handicraft she was working on in her bag.
After Kalra Bai was informed and the patient was taken into the operation theatre. I scrubbed up to assist the gynaecologist. Under anaesthesia we could examine the patient properly. The tear began from the introitus on to the left lateral wall of the vagina, upto the cervix and went halfway around the circumference of the cervix. The gynaecologist efficiently sutured the entire tear with catgut. I had not seen so much destruction from an act of love. I asked the gynaecologist whether this was possible in the normal course, to which she replied “Yes if the lubrication is not adequate.”
But I was not convinced, especially since we had gone through all the possible sexual perversions in forensic medicine. It even has a scientific name ‘polyembolokoilamania’, meaning insertion of foreign objects into the vagina. In this case the husband appeared to be the guilty party, which explained his smirk.
A case scenario emerged in my mind, the husband is a sadist in addition is impotent. In this pre-viagra era he compensated for his lack of rigidity by using a ‘danda’ (staff).
I decided to do some investigations of my own. So I waited for the next day and for an opportune moment when there were no relatives with the patent. After the niceties of enquiring about her health, I mentioned that there was considerable damage. Then I again placed the question, how did it happen? The reply from the patient was “Bataya na Doctor, gandhe kaam kar rahe the (I already told you Doctor, we were doing dirty things).
If she had said “we were having sex,” I would have questioned her no further, however she chose to state it euphemistically.
The word ‘sex’ is taboo and is considered dirty. However the ‘dirty things’ could also mean perversions. So I persisted in my questioning, “kya gandhe kaam kar rahe the?” (What dirty things were you doing?) Her reply was “jo shaadi ke baad karte” (what is done after marriage). This should have satisfied me but I was so convinced that there was perversion involved I persisted in my questioning. Now I framed my question in a more direct manner to avoid an ambiguous answer, “kya lakdi istemaal kiya?” (Did he use a stick?)
The patient had the most incredulous expression on her face which changed briefly to pity, “kya Doctor aap itne nadaan ho, aap ko yeh bhi nahi pata ki shaadi ke baad kya karte. Kabhi lakdi istemaal karte?” (Are you so innocent Doctor that you don’t know what is done after marriage. How can he use a stick?).
I beat a hasty retreat and remembered the quotation in Bailey & Love, “The ward is your library and the patients are your teachers.”
When I was growing up owning a bicycle was a big thing let alone a motorcycle. Now that was a pipe dream! Those were simpler times and a plain vanilla bicycle was an object of envy.There was a wide variety of bicycles brands to choose from, Raleigh, Atlas, Humber, Norton, Avon, Hercules, BSA and of course Hero. Most of these brands have gone the dinosaur way or consumed by their competitor. Though there was not a lot to choose from one bicycle or the other. They were all solidly built and came in varying shades of black! A few were in olive green and all had the solid hand brakes dating back to th British Raj. Only BSA manufactured what they called a ‘sport’s bike’, which had caliper brakes, some variations in colour and a more sporty look. Boy’s would ‘pimp up’ their ride by adding additional reflectors, some tassles to the handle grip. One of my friends made his seat higher by extending the rod which connects the seat and cycle. He also had to raise the handle bar by not only increasing the length of the bar but by giving the handle an inverted Omega shape’ a la chopper like handles made popular by the 1969 movie ‘Easy Rider’. He also changed the colour and got it painted a shimmering orange. There was a unique problem those days associated with the fashion of the times. Those were the days of bell bottom trousers. No self respecting boy would be caught without a 32“ bells. Yes the cuff of the pant measured a whopping 32″ and worn along with 3″ block heels. The problem is that the cuff would get caught in the sprocket of the pedal shaft while pedalling, resulting in tears in the cuff. Bicycle clips, also called trouser clips, which were small C-shaped pieces of thin flexible metal worn around the ankle when cycling in trousers. They were designed to prevent the bottom of the trousers from becoming caught in the chain or crank mechanism, and from being covered in oil and dirt.
Motorcycles were another thing altogether, in those days the reigning king was the Bullet 350cc manufactured by Royal Enfield. the company originally British started out as a weapons manufacturer.The legacy of weapons manufactureris reflected in the logo, a cannon, and their motto “Made like a gun, goes like a bullet”. It is still available in varying avatars now and hold the all time record of the oldest motorcycle brand in the world still in production.The engine gave a deep throated dhug! dhug! Of a four stroke engine. Very heavy so handling it required a certain amount of skill, otherwise you tilt it to one side and unless you had strong legs, it ended up falling on one side and the entire weight of the bike on your leg. Anticipating such mishaps the motorcycle was fitted with an engine guard in front and an optional leg guards in the middle. In case the bike did fall those two tubular projections prevented the entire weight of the bike falling on your legs. A good insurance policy especially for a spindly legged teenager like me. Then there was the Jawa or it’s later avatar the Yedzi. This was made with Czechoslovakian collaboration by the Ideal Jawa company in Mysore.The catchphrase for the bikes sold by the firm was “Forever bike forever value”.It was a 250cc motorcycle and much lighter than the Bullet and the engine gave a puny phut! phut! sound. In a Royal Enfield the gears were on the right side and the brakes on the left whereas in a Yedzi the gears on the left and the brakes on the right. This could cause confusion if you are used to one bike and by chance drove the other. You would be reflexively be pressing the gear thinking it’s the brakes and land up in a catastrophe.
After finishing my 12th examination and writing competitive examinations I had been called for the interview for Christian Medical College, Vellore. I had gone to celebrate in the evening at C.P. Club and there met my friend Bobby. He had borrowed a Bullet from one of his friends and driven it down to the Club. We both went down to the parking lot and admired the motorcycle and after which followed the most natural thing. I asked him whether I could drive it, to which he readily agreed. I drove it out of the Club Compound, the feeling was great with the wind raking through my body and the power of the motorcycle under me. A slight raise of acceleration and you could feel the motorcycle surge forwards. Sharp turns could be negotiated by shifting the body weight to one side and the motorcycle would bank to that side. By the time we were returning to the Club it had become dark. I had turned on the headlights only to discover that the headlights were not working and we were going on a lonely stretch at a fairly brisk speed. In the middle of the road there were sitting and ruminating a white cow and a black cow or maybe a buffalo, now I am not sure. Because of the fading lights the white Cow was visible but the black one was invisible. I shifted my weight to one side to avoid the white cow, then suddenly the handle bar along with the speedometer rose to become almost parallel to my nose and next equally suddenly it dropped to below my waist level. I was catapulted off my seat over the handle and face first to the ground, luckily self preservation instincts kicked in and my hands came forwards in front of my face preventing me from landing flat on it. I looked up and saw my friend sailing above me and landing unceremoniously on his bum just a little ahead of me. Then I looked behind and saw the cow casually get up and walk away. We had driven right over the cow which explained the suddenly rise and fall of the motorcycle. Both of us not seriously injured we examined the damage to the motorcycle. The front fork was bent so badly that the wheel of the motorcycle was perpetually turned to the left. We somehow managed to get it back to C.P. Club and left it in the parking lot. The next day we got a mechanic and managed to get it fixed. The fork had to be straightened by a hydraulic press and we had to pool our resources to pay for the damages. The motorcycle was returned to it’s rightful owner who I am not sure was the wiser and both of us laughed it off as another episode of our lives.
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Our 35 year class reunion was a refreshing affair, met many old friends from 35 years ago. The batch who were celebrating their 40th year reunion was also there. We have a special affiliation for this batch because these were our ‘Lords and Masters, Senior Doctor Sirs, Fagmasters’. It was great to see them still sprightly and spirited. I spotted My Lord and Master doing a Salsa on the stage with his beautiful wife. Then there was another Senior Doctor Sir doing an energetic belly dance. This took me 30 years back to Men’s Hostel, 17th of July 1978 to be precise when we took our first tentative steps into the ‘Mansion of the Gods’ and the resident ‘Gods’ took it upon themselves to convert us into Godlike material through acts of initiation which were anything but Godly.
Evening entertainment provided by the ‘Pseudo Priapistic Catmites’ was a well awaited affair and preparation and planning were of the essence. The planning went on in the Lords and Masters rooms with us sitting on the floor as mute spectators, listening to our seniors planning our fate. There were of course immediate seniors who would also join in the machinations and contribute their mite. I was along with another class mate of mine, our Lords and Masters were neighbours hence we were initiated together. No ideas for anything entertaining was forthcoming, one of the immediate seniors asked my classmate which school he studied? He proudly replied “St. Peters, Panchgani, Senior Doctor Sir!” What was your school song? Was the next question. He sang it out for them,
“Bells are ringing!
Bells are ringing!
We must hasten to their call….”
Somewhere in the song the word ‘penetrate’ came, and that was like a Eureka moment for the seniors. The song was then rewritten and now went like this,
“Balls are clanging!
Balls are clanging!
Right upto the bogs and shagging,
We must hasten to their call,
render arses when in need,
penetrate the art of laying……. “
The choreography was also planned, my classmate had to wear a tie and school blazer, hold two cricket balls tied with a string. And before beginning the song allow the balls to clang together accompanied by his own Tanndd! Tanndd!
Then it was my turn. The night before was the interclass music competition and a certain girl from the batch of 73 had sung the Hindi number “Aaj ki raat, yeh kaise raat, ki humko neend nahin aati….”. The girl was very attractive and had a characteristic way of swaying her hips while singing, I spotted her in the reunion this and she looks the same. This became the basis for my entertainment. I had to fashion a saree with two of my bed sheets pinned together length wise, for lipstick red marker pen was used! Yuck! Those were simpler times and who thought about toxicity. I was supposed to go on the stage sing the song while swaying my hips ‘___ madari’. Then at end of the song I am to announce, “I am ___ with a difference” and then dramatically lift the saree. Under the saree would be a bamboo and two cricket balls suspended from the waist.
So with the preparations completed we gathered outside the lower common room where a make shift stage had been made awaiting our turn. Our other class mates were also assembled there with varying attire varying from bra and panties, trophies from the raids of Women’s Hostel to a pink bow tied on the hair.
While awaiting our turn we could witness some of the other entertainment.
In those days there used to be a popular animated ad for red ‘lal’ eveready battery. It featured an animated radio walking and singing “kabhi kabhi mere dil aata…” then suddenly his voice would stop. Another radio would come and advice him to use ‘lal eveready’. Inspired on that theme one of my classmates enters the stage singing the same song and he stops. Then enters another classmate and says “Sir your voice is a eff up!” to which the first one replies, “yes I think I got the wrong thing stuck up.” To which the second one reaches to his back orifice and produces a ‘lal eveready’ and says “use lal eveready.” The first one takes it from him and pretends to use it as a suppository also giving a satisfied aaah exclamation. Then both of them leave the stage singing with arms around each other.
Next came three, one stood tall and thin covered by a sheet and wearing a helmet. The other two crouched on either side also covered by sheets. “I am ___ ‘s dick and this is my right ball and this is my left ball” declared the tall and thin one. “And we are going to show you how it’s done” declared the dick. Then all three of them began jumping in unison. “How is the weather up there?” asked the right ball. “Hot and humid replied the dick.”
As you can imagine there was a riot of laughter making our acts insipid in comparison.
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The rectum as a repository
I read in the newspapers a few days ago about a man caught smuggling gold into the country by placing it in his rectum. The Police were at a quandary on how to retrieve it. Their only option was to given him a megadose of laxatives and make sure he defecates in their presence and in a bedpan! This method of smuggling is far from ingenious I have read the South American drug cartels used this method for smuggling cocaine into the USA. The processed cocaine was packed in cylindrical plastic bags and after adequate lubrication pushed up retrograde into the rectum of the couriers. These couriers had the uncomplimentary sobriquet of ‘mule’. Though it did accurately described their job of physically transporting goods from one point to the other.
In the 1970s book ‘Papillon’, by Henri Charriere, an autobiography. He describes how he was wrongly accused of murder in France and sentenced to life imprisonment in the French Penal Colony of French Guiana. He further goes on to describe that the only way they could keep their money safe from the other prisoners and the guards was to roll it up tightly into a metal cylinder, called charger. This cylinder was inserted into the rectum and the author confesses he got so used to this method that even after he escaped he continued using a charger to keep his money safe. He never elaborated how he removed the charger!
Though now this method would not be of much use as a digital examination of the rectum is included in the protocol of frisking of prisoners.
A glance into Bailey & Love’s ‘Short Practice of Surgery’, has a section on the foreign bodies in the rectum. I quote “The variety of foreign bodies which have found their way into the rectum is hardly less remarkable than the ingenuity displayed in their removal. A turnip has been delivered per anum by the use of an obstetric forceps. A stick firmly impacted has been withdrawn by inserting a gimlet into its lower end. A tumbler, mouth looking downwards, has been extracted by filling the interior with wet plaster of Paris bandage, leaving the end of the bandage protruding, and allowing the plaster to set. A pepper pot which when removed had the inscription, ‘a gift from Marsgate’. A screwdriver and a live shell which had to be handled carefully.“
In my surgical practice I have encountered my fair share of ‘foreign objects’ in the rectum. More ingenious than the objects themselves is the explanation of how they came to reside there albeit temporarily. When I was doing my MS, I was called to the casualty to attend on a patient. The patient was an elderly man in his 60s. He told me that he suffers from piles and was using an Ayurvedic medicine which had to be applied locally. The Ayurvedic medicine was dispensed in an old Benedryl bottle (cough syrup). He apparently was sitting on his haunches on the floor, applying the medicine with his finger to the area. The bottle was also placed next to him and then he shifted a bit and accidentally sat on the bottle! And up went the bottle! This explanation caused sniggers amongst the junior staff and incredulous look on the face of the seniors. For retrieving this bottle we used the obstetrics forceps which is used to deliver the head of babies in prolonged labour.
Then there was the case of the middle aged man who was brought with severe abdominal pain. He admitted to being gay, though he was the AC/DC type. He had a wife and two children. He was accustomed to inserting a stick into his anus for the purportedly pleasure it gave him. That day he pushed it up a little too much and it perforated the intestine. This caused a serious condition called ‘fecal peritonitis’, stool contaminating the abdomen. The patient had to be operated and the perforation closed. A temporarily colostomy or an ‘artificial anus’ also had to be constructed.
I was working in a Mission Hospital in rural Madhya Pradesh. A young male patient had been admitted a day earlier with abdominal pain. Since he did not give any other significant history the medicine people admitted him. The next day he passed large quantity of blood in his stools. I was given a call and I ordered an X-ray abdomen standing. To my surprise there was massive air in the peritoneal cavity, which indicates perforation of an intestine. I took him for surgery and was amazed to find not just a simple perforation but complete transection of the intestine! Not only a foreign object was pushed up but it was done with a considerable amount of force. When the patient recovered from anaesthesia I asked him how did it happen? He told me a different story every time. One of the stories was that he was sitting on a tree and fell off. An upright twig went up the wrong end. This was possible but not plausible, the main hole in this story was how did the twig reach the opening so accurately without causing any collateral damages?
The patient never told me the truth!
The most recent incident is just 4 days ago, an 18 year old male was brought to the hospital with a history of having fallen on a construction rod from a height. Again they appeared to be no collateral damages, the rod had accurately entered the anal opening. He also had perforation of the intestine. I have not even bothered to ask the patient for any further details and taken his story at face value.