As I welcomed this friendly and creative photographer yesterday to the work place, I got to see the steps he went through the steps to take a short interview in connection with creating a video of the hospital in c connection with its 50th anniversary. It was not his obvious charm or skill that appealed to me, but his evident pleasure in what he was doing. He having completed 42 interviews and visits to the different departments, I would have expected him to be casual and in a hurry to complete his assignment. Instead he seemed to have kept the focus on the final 20 minutes video he hoped to produce out of it. He worked about six hours with his camera each day and about three Horus on editing and dubbing sound tract and interviews.
The tow things a camera man uses is his eyes and hands. This photographer had an unusual skill and flair for both to design and create. It was a pleasant meeting and something to learn from!
I paused to reflect on this meeting after he left. As a clinician I too depend on the skills of observing with my eyes and examining children with my hands.
Yesterday, a child of 21 years sat crying in his mother's alp. Every time I approached towards him, he intensified his resistance to be examined. As his symptoms related to behaviours language delay, and social aloofness, I was keen to look for any neuro-cutaneous markers in him. He was referred to me by an adult neurologist with a question about his behaviour. I could not make any headway in my clinical examination except check on his hearing and vision. Usually I am inclined to search the body for any neuro-cutaneous markers. He did not allow to expose his body. In about ten minutes, I finally got to search his body. To my surprise there was a large hypo-melanotic patch and two large cafe-u-let spots.
I had geed up at least on three occasions to examine his skin, due to his intense resistance. But something within me prompted to be patent and continue the search. They added to the diagnostic suspicion I had carried with me. Now I wait for the results of post-mydriatic examination of the eyes to be for decisive of the diagnosis.
I was glad to have met the photographer in the morning to observe his patience and diligence. He did not let his work be less than to be of high standard that he had set for himself.
One's quest to do whatever one does is to do it better each time. This is a good aspiration to live with. That is how one protects oneself from falling into the trap of taking short cuts.
It is now forty-five years since I have been in clinical practice with children. I continue to be amazed by the enormous critical information that one can gather by a careful examination of every child.
How often I felt inclined to give up on clinical examination, as a child was resistant for examination!
In fact, children have been my teachers and they have helped me to stay refreshed clinically!
M.C.Mathew (text and photo)
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