Women's day, from celebrations to silent survival and a societal debt..

 2025-06-01 10:46:11    |     Dr. Sabarinath Mahadevan    |     Medical and Philosophical.

It wasn’t an unusual moment in the Rheumatology Intensive Care (RICU).

“No need, sir. It’s ok,” a stern yet frail voice cut through the silence. I turned to see an elderly woman, her eyes sunken with tears, refusing the Rs.500 note my colleague had just slipped into her hand.

“Keep it with you, Neelammal,” he insisted. She hesitated, then walked away, her sorrow unspoken yet palpable.

I glanced at my colleague. Having seen similar moments before, I understood. In our sponsored hospital, direct financial assistance isn’t encouraged often—not because of potential misuse or burden on doctors, but because it deepens our involvement beyond the disease. It draws us closer to the patient’s personal struggles—their battles with disease, poverty, and shattered dreams, often not amenable to control or cure by modern scientific medicine. Many of our patients travel long distances, mortgaging their meager savings, hoping for a cure for rare diseases. The money they bring barely covers their journey and a few days' worth of food for survival. The money Neelammal received was meant for a test that wasn’t available in-house and had to be paid for separately. It was her fifth day in this new place and hospital, and she was already drained financially.

Neelammal was here for her 26-year-old daughter-in-law, Veera—bedridden for six months. Veera had experienced episodes of muscle weakness over the last few years. Each time she was admitted—thanks to the free rural health center—she was diagnosed with low potassium, treated with IV fluids, and sent home walking.

“They told me to see a specialist,” she said, “but I couldn’t, doctor.”

Her husband, an alcoholic, had died in a road accident a year ago. She was left alone to care for two young children.

“We’re just trying to survive,” Neelammal lamented.

After evaluating Veera, we suspected her weakness was due to Sjogren’s syndrome—a rare autoimmune disease affecting mostly women. It causes severe fatigue and joint pain, but in some patients, the disease damages the kidneys, leading to potassium loss in urine, thereby causing profound muscle weakness. The autoimmune disease primarily affects the glands in the mouth and eyes, leading to dry mouth and dry eyes. Some patients may experience only a mild rash on sun exposure, while others battle with severe nerve and brain involvement. Like a rollercoaster ride, this disease has its ups and downs with stormy days followed by calm.

For Veera, the last six months had been unbearable. A hip fracture had left her struggling to crawl around the kitchen. Neelammal had to carry her for even the most basic needs. This time, she had brought Veera to a specialty hospital—determined to see her walk again. But the disease had progressed, leaving her bones too fragile.

“Are Veera’s parents nearby?” I asked my colleague, acknowledging that we were diving deep into the patient’s tangled non-medical struggles.

“No. Veera’s mother, a divorcee, took the children—three and two years old—back to her village. She’s raising them alone to ease Veera’s burden.”

We sat in silence, absorbing the weight of their struggle—three women, abandoned yet holding each other together, with no financial or social support.

“As a society, we’ve failed our women in more ways than one,” I murmured.

Rheumatological illnesses aren’t fair either. Most autoimmune diseases disproportionately affect women. Our RICU census tells the same story—women suffering silently, their bodies waging wars against themselves. A 28-year-old with multiple pregnancy losses and a lung clot due to antiphospholipid syndrome. An 18-year-old college student with kidney damage from lupus. A 45-year-old woman abandoned by her family after scleroderma disfigured her body and scarred her lungs. All in one room, each carrying a story of pain, perseverance, and survival.

Before we could dwell further, my colleague’s phone rang, cutting short our futile debate—just flogging a dead horse about society.

A saleswoman’s voice chirped from the other end:

“Sir, I’m calling from XYZ showroom with special offers on ABC as part of our Women’s Day celebration.”

He declined and hung up.

For a moment, we sat in silence, the irony sinking in. What does Women’s Day mean to a family of three women abandoned by circumstance—just like countless others, waging silent wars no celebration can ease?

“I’ll return the Rs.500 in two weeks, sir,” Neelammal’s voice returned, interrupting our thoughts. Her eyes were sharp now, her resolve unshaken. “I’ll stay here until she walks,” she declared. “I’ll find a way.”

My colleague nodded. Without another word, we moved to the next patient.