If you have seen the ventriloquist’s performance in magic shows or the Double Take on NDTV and enjoyed it, then you’ll certainly rue what you have also missed by not becoming a Doctor. I see at least three ventriloquists in a day and am sure my other colleagues too are seeing the same numbers if not more. Only they must have missed the diagnosis, because, it is not the patient, but those who accompany him/her that have this affliction.

Being a rapid learner, I diagnosed my first case early in my career. When two women entered my office, the younger one seating herself before me and the older one standing by my table, I naturally looked at the former and started my questioning.

“Hello! What’s your name?”

“Ganagavva,” she had replied, her lips and tongue not moving a millimeter!

“How old are you?” I wanted to re-view the magic.

“Um...twenty three..maybe.” Fantastic! I could write a research paper on –“True Ventriloquism-Personal Experience.”

“Where is your husband?”

“Oh! My husband is at home but her husband is right outside!” I suddenly realized that the statue before me was not speaking, but it was the women standing who was doing all that talking. I made a mental note to consult my ENT doctor for any pathology in my ears! I thus began my study of the ventriloquists.

Here is a broad classification:

1. The Professional Ventriloquist (PV):

 These can be of any sex or age; related or unrelated to the patient. Often they are self-styled saviors/ agony-aunts of the neighborhood. Before consulting the doctor, the patient equips the PV with her complete CV and medical history. On entering the doctor’s office, the patient’s job is simplified to only glancing at the PV whenever asked a question. The understanding and innuendos between the two is a lesson in circumspection to poker players and cricket match fixing bookies! A cough-“She has severe pain at night doctor.” Throat cleared once-“She has headache also,” Throat cleared twice, -“The headache increases in the afternoon,” and so it goes on. I have tried to interpret the signal communication but must confess I have failed because of a lack of uniform code. A nod may be ‘Anxious to conceive,’ in one Patient-PV duo but might signify a want of abortion in another!

2. The Obligatory Ventriloquists (OV):

They are often relatives of the patient-the husband, mother-in-law or an aunt.

“When did you have your last menstrual period?” Just glance at the husband. HE has it entered in his pocket diary.

“What is your problem?” The MIL starts off without any innuendo. “She is always sleeping doctor...Says she is unable to do any household work even in the mornings....” and continues her timetable till she goes to bed at night!

Or the mother who wails, “She doesn’t eat ANYTHING doctor,” as I look incredulously at the 72 kgs of protoplasm-statue sitting without even a shameful squirm!

3. The memory jogging Ventriloquist:

Unlike in the previous cases, the patient is not vocally challenged. She gives a complete account of her problems herself and as I finish jotting the last of her symptoms, the memory jogger comes to play. “Did you tell her of the loose motions you had three weeks back?”....” Did you recount how you threw up in the bus?”...”Did you tell about your backache that recurs once a year?” And sure enough, the patient goes back to start from the beginning. I have no alternative but to follow while the Ventriloquists gloats at her achievement.

4. In absentia Ventriloquist: 

When a single person barges into my office, out of turn, oblivious to the reprimand by the receptionist or protests by other patients, I brace myself for this genre of ventriloquists.

“My wife, she is at home...very busy.  But she wants to postpone her periods....Or ...Has pain in lower abdomen....or has a knee pain....” This man wants to save consultation fees, avoid transportation costs of bringing the patient AND wants to be considered a good husband.

“Doctor, my sister has had a fall in the bathroom. Is her bones broken?” It is a caring younger sister enquiring about her sibling who has fallen down in her home in the suburbs of Ahmedabad! She expects me to have not just X-ray eyes but long-distant vision too!

5. The second opinion Ventriloquist:

 Just as I am settling into sanity after instructing the patient, these insensitive beings barge right back.

 “Doctor, she did not understand your instruction (after even repeating twice!), can you tell me once again?” And just as they are at the door, they do a 180 degree and come back again. They are of course oblivious to my sigh of relief which has stopped in its tracks, transforming into a helpless wince! “Well, uh... I had a very painful right knee all of yesterday...can you prescribe some tablets for me too”  free consultation) Or..”Er.Doctor, could you just check my BP once?” And most disheartening of all, “My friend has similar problem, but she is shy to consult a doctor...can I bring her to you and myself explain every thing?” They are blind to tears of pain and self-pity that well in my eyes.

            One unfortunate day, listening to one ventriloquist after another, I lost my cool. The next duo that came into my room had it. Much to their surprise and bafflement, I sent the patient out and decided to examine the ventriloquist.

            ‘Put out you tongue,” I ordered, brandishing the tongue depressor. Caught unawares, she had to oblige. I had to do something to the voice boxes of this lot. And sure enough, two huge vocal cords stared back defiantly at me. So hypertrophic were they that Shah Rukh’s six pack abs seemed dismal in comparison. I tottered back in surprise noting that they were indeed large enough to gain an easy entry into the Guinness Book of World Records!

            I was depressed as I could do nothing to curtail this menace. Listening to THEM and treating the OTHER human being was confusing my psyche. Another day, I had tried another trick too. “If you are reporting her symptoms, why don’t you take the treatment instead of her?” I had said gleefully to a very vocal ventriloquist. I was having revengeful visions of using all uncomfortable instruments on her on the pretext of a FULL check up.

            But the lady was shrewd. “Sorry, doctor. Please carry on. I shall wait outside.” She had backed out. I was triumphant! I had succeeded in ousting the first ventriloquist!

            I now settled to seeing the patient in great detail and began giving instructions.

‘Lady, could you come down a little?....Don’t be scared...I’ll not hurt you...A little more...a little...” and suddenly a loud shout filled the room.

            “Rashmi, do as the good doctor says! Don’t get scared. I’m here itself, waiting outside the door!” The Ventriloquist was now across the door service provider, and in all possibility peeping through the keyhole or a split in the door!

            My moods were back in the dumps, until I hit upon a novel idea. Set a thief to catch a thief- set a ventriloquist to answer a ventriloquist! We are taught in Medical School that History taking is an art which helps to establish that important rapport with the patients. But probably the artists who wrote those dictums had never suffered at the hands or rather the vocal cords of these ventriloquists. Hence I had to device my own method for survival and sanity.....

            In entered the unsuspecting sufferer-teller duo the next day.

“Hello, please sit.” I said not moving my tongue or lips. They were startled at first, but regained their comfiture as they were used to vicarious cross-talk.

‘What’s your problem?” I had installed Dolby stereo for better effects.

“She has this nagging back ache......” the patient’s ventriloquist started describing her friend’s ailments. The dialogue flowed smoothly. I only had to use my fingers for forward, replay and rewind on the record player.

            As the history taking ordeal was over, I settled back, satisfied. Only examining the patient remained. As I got up to do so, the two look startled. “Yes?”

            “Uh..Doctor, you are so hi-tech. You are using a tape recorder to talk to patients. But, don’t you have a ..a machine for examining patients too?”  It was time for a make-over in Medical practice!