i saw premlal at about 1.30 on monday afternoon in a busy OPD. he walked in, a tall burly man, whose blood pressure was recorded by the nurse outside as 150 / 110 mm Hg, which is high. i noticed his bloodshot eyes, and noted subconsciously that he did not smell of alcohol. he said he was a potter by profession and had come from neighbouring Madhya Pradesh. I asked why his eyes were red, and he said he had not slept the night before: he and his wife had travelled by bus from his village sekhwa to Pendra Road the previous night, waited at the station, then taken the train in the morning to Bilaspur and then another bus to reach Ganiyari. he complained of some non-specific low back pain, but i was more concerned with his high blood pressure.

i asked him to extend his arm so that i could measure his blood pressure again, and noticed that his hands were trembling. i asked about his alcohol consumption and he said he did drink occasionally, but not in the past month at least. i asked then why his hands were trembling and he said he had had it for the past five days. the reason? he had not been eating enough. since the previous day, all he had had to eat was one single roti: he could not afford any more.

as he said this, he turned away, frowning, and sat silently. i did not know what to say to him either.
i sent him for some investigations, and also gave him two free meal coupons to have lunch at the canteen we run at ganiyari. the free meals are courtesy some well wishers of jan swasthya sahyog.

he has been started on medication for his hypertension, and i still feel apologetic that his bloodshot eyes and trembling hands had made me wonder if he had been on a binge the night before, when the reality is so very different.

i think about this patient who travelled so far, saving on food in order to be able to afford the journey to ganiyari, after not having had enough to eat for some days before that. and i wonder when he will be able to afford two meals a day again. and whether he will be able to afford to return to continue his medication....chronic hunger is a reality for so many of our country's citizens

there are many premlals we see here.