Friday, October 30, 2015
India Medical Mercy clinic day 5
I examined her as she came towards me. Her clothes were of average quality, she stood barely 4 feet tall, and her smile paraded before her. Sitting across from me, she continued to smile until I asked her if it would be okay for me to look at her scalp. She mumbled and the warm smile turned to a frown, her eyes diverted to the ground and she became uncomfortable. I looked at her scalp and then scrolled through WebMD, skimming over the details of the type of balding it couldn't be. I shut down the tablet staring straight ahead pondering the consequences of what I was going to say. Smiling, hopefully in an attitude of assurance and without judgement, I had made a diagnosis. Not the one that would yield the best result and a smile from her, but one that was going to cement her fears. What mattered was that her situation was a worst-case scenario that could play itself out later in her life.
This all started when she was about 5 or 6 years old. She is now 12. Her hair fell out in clumps and had been that way for years with no effective therapy that she tried. This is alopecia areata which may be reversible with hydrocortisone, but no guarantee. I gave her a bunch of tubes of it. So why you ask, am I sharing this with you? Because you need to know that because of where you live and because of what you have, you'll never find yourself where she will find herself when she gets older.
I asked her if I could take her picture. This is a sensitive issue, balancing her dignity and telling her story so that others can learn. I struggled with the decision and eventually felt that she would understand. In just a few short minutes we had a covenant relationship, trusting me to do my best to help her.
You need to know that because of her baldness she may never marry, be stigmatized and marginalized, or worse yet, she may marry a much older man who cares nothing about her or for her. A forced marriage. The simple truth is that a dysfunctional society makes up rules as it goes along, blindly hurting many because no one is interested in making things right.
I am trying to be careful in keeping this non controversial. So you ask, what is the lesson here, the learning point, the reason for this blog post? It's this: we are lucky for who we are, for what we have and for where we live. What we have is better than good. For many here in India, what they have is worse than bad. For this young girl, I wonder what life will bring her. I hope that it will bring at least some good. Her smile will not allow anything less.
In all things, give thanks,
Posted by David H. Beyda, M.D. at 9:21 AM