Story of a Sesamoid

Story of a Sesamoid

Dr. Aditya Jindal

DM Pulmonary and Critical Care Medicine,

PGI Chandigarh

Consultant Pulmonologist

Jindal Clinics

The year was 2003.I had finished my internship and was trying to psych myself for the dreaded entrance exams to MD courses. Needless to say, I was failing miserably. Then a cousin suggested a skiing trip to the Garwhal Himalyas. It seemed just the thing, so I made my reservation and headed for the hills.

We went to Auli, a hamlet situated 12 km uphill of Joshimath, on the great pilgrim route to Badrinath. The snow clad hills and the fresh air were liberating. After being fitted out with the skiing gear we hit the slopes, all too literally. It was a beginners course and the first thing one was taught was how to fall. One of the instructors even boasted he knew fifty ways to fall!

Soon, one fact emerged – I was the only doctor for miles around. My nascent ability was soon put to the test when I received a message one fine morning – while I was out skiing  – requesting me to attend a young British  lady who had taken a tumble somewhere on the slopes.

The history was that of falling on her right hand. As I went to see her , morbid thoughts of Colles’ fractures and elbow dislocations were hammering inside my head, not to mention the butterflies fluttering in my stomach. Though I had done a lot of hard work during my internship, this was to be my first taste of independent decision making; never had I felt the need of a senior so badly.

Anyway, on examining her, all I found was an area of tenderness localized over the base of the right thumb. I had seen a small clinic in Joshimath when we had arrived, so I sent them there to get an X-ray done and prescribed some painkillers, of which they had an ample stock already!

We met an dinner that day and I was solemnly informed that the X-ray showed a fracture. I asked to see the X-ray; one point I noticed initially was that the doctor who had reported the X-ray was a BHMS. The moment I saw the X-ray I burst out laughing, for the ‘fracture’ was nothing more than a smooth round sesamoid bone lying lateral to the head of the first metacarpal bone! 

I explained this to the couple and told them nothing more needed to be done. I returned home soon after, after refusing payment from the grateful couple, feeling refreshed and with a renewed belief in the medical profession.