Chapter 2: A Puzzling Case Unfolds

She had already bought mouthwash at the chemist, tried boroline and other remedies, but nothing worked. The ulcer had lasted nearly two weeks and still wasn’t better.

Her roommate piped in, 'She’s tried everything—mumma sent boroline by courier, we bought mouthwash from the medical shop outside college, even tried honey and ghee.' The patient nodded, 'It’s been almost two weeks, sir. Not improving at all.' Her hands trembled as she fidgeted with her college ID card, the worry etched deep in her posture.

That struck me as odd.

I sat up a little straighter, my doctor’s instinct kicking in. Mouth ulcers usually heal faster, especially with all those home remedies. Two weeks was definitely unusual. For a moment, the noise of the ward faded, replaced by the growing sense of something not quite right.

“Could it be body heat?” the intern beside me muttered—referring to the common Indian idea of ‘body heat’ causing mouth sores.

The intern, a fresh-faced MBBS lad from Jhansi, leaned in and whispered, 'Sir, body heat hoga shayad?' He said it like a seasoned auntie would at a family gathering, as if mouth ulcers and 'body heat' were written in the stars. His tone carried a mixture of confidence and innocent curiosity, almost inviting agreement.

She then enthusiastically shared her own experience with mouth ulcers, recommending a certain shop’s nimbu-paani, assuring that drinking it for two days would cure everything.

He couldn’t resist adding, 'Arrey, mujhe bhi hua tha last year—ek number ka ulcer! Phir I drank that Gopal Juice Corner’s nimbu-paani for two days, sab theek ho gaya! You also try, madam, it works, I swear.' He mimed squeezing a lemon, as if the taste was still fresh on his tongue. He looked almost proud, as if sharing a secret family recipe. The patient smiled weakly, but her friend rolled her eyes so hard she nearly dropped her phone, clearly unconvinced.

The patient said she’d already tried drinking lots of nimbu-paani and coconut water, but it hadn’t helped.

She replied, 'Nimbu-paani toh roz hi pee rahi hoon, bhaiya. Even coconut water, but nothing happened. My mummy made me drink haldi-doodh also…' Her friend made a face at the mention of haldi-doodh, as if she’d rather eat karela than have another glass of it.

The intern wanted to keep sharing, but I quickly stopped her.

Before he could launch into the next story about home cures, I raised my hand. 'Okay, okay, let’s focus. We’ll see, haan?' I shot the intern a warning look. Time was ticking, and this was becoming a small mela in itself.

This wasn’t body heat. How could a mouth ulcer caused by body heat not be painful? When I get those, even my tongue aches terribly.

I thought to myself, 'Arrey, when I get mouth ulcers from too much mirchi, it’s so painful I can’t even eat dal-chawal. This one is not even paining?' Something wasn’t adding up, and my unease grew with each answer.

Besides, our textbooks don’t even have a diagnosis called ‘body heat.’

‘Body heat’—I couldn’t help but mentally scoff. Not even a single line about it in Harrison’s. Only in our country will you find people blaming everything from pimples to ulcers on “garmi.” Like Dadi always said, “Sab kuch body heat ka khel hai, beta.” But here, you have to nod along, otherwise patients get offended. I kept this thought strictly to myself, though.

Of course, I whispered that last part so only the intern could hear; the patient probably didn’t catch it.

I leaned over, murmuring under my breath to the intern, 'Yeh sab textbook mein nahi likha hai, yaar.' The patient and her friend were too busy discussing amongst themselves to notice my aside. The intern grinned sheepishly, suddenly aware of his overenthusiasm.

I examined the patient’s mouth and found several oval-shaped, red erosions inside her lower lip and on her palate. Some had turned into ulcers. The largest was almost 1 cm—quite alarming to look at.

I put on my gloves, asked her to open her mouth, and carefully examined under the harsh fluorescent lights. There were several oval, angry-looking red patches—some already ulcerated—inside her lower lip and on the roof of her mouth. The biggest one was nearly a centimeter. For a moment, even I felt a little unnerved, as if I’d stumbled onto something much more serious than a college girl’s singing anxiety. The friend peered anxiously over my shoulder, whispering, 'Kitna bada hai, yaar…'

No wonder she was worried about her singing.

I thought, 'Ab itna bada ulcer hai, toh obviously she’s anxious. Who wouldn’t be, especially before a big competition?' I remembered my own college days, how the smallest trouble could feel like the end of the world when you had something important coming up.

Such large ulcers, and not painful? I found it hard to believe.

I tried pressing gently with a swab, expecting her to flinch, but she barely reacted. 'You really don’t feel much pain?' I asked, a bit incredulously. She just shrugged, looking more helpless than before.

The patient said that at first there was some pain, but soon there was no sensation. Mostly, she just felt the ulcer itself—a foreign body sensation—which made speaking and singing uncomfortable.

'Pehle toh thoda dard tha, sir,' she said quietly, 'but now it’s mostly numb… bas, it feels like there’s something stuck there. When I talk or sing, it bothers me.' Her friend squeezed her shoulder gently, the two sharing a silent moment of worry.