In the middle of a busy outpatient clinic a couple of months back, I saw two young men, one after the other, for the same complaint. Both had suffered limb injuries a few months prior, and had developed scar hypertrophy with itching. But that’s where the similarity ended.
The first young man, let’s call him Sudhir, had a viral cold, for which I prescribed lots of fluids, and some medicines for symptomatic relief. He then mentioned conversationally, “Three months back I got leopard bite.”
I couldn’t register at first what kind of bite he got. After a few questions back and forth, it finally dawned on me that he was talking about a big spotted wild cat!
I wanted to hear more, of course, but I was of two minds – on one hand there were patients waiting outside, on the other hand how many times in life does one meet a ‘leopard bite’ survivor? Sudhir actually didn’t need any encouragement. Assuming I would want to hear more, he started recounting what happened that day when he wrestled a leopard and lived to tell the tale.
There had been leopard sightings in the hills near his village, but the big cats generally stayed away from the villages. This one leopard ventured close to his village, possibly out of hunger, but got scared when dogs started barking, and went and hid in a thicket of bushes. The whole village gathered near the thicket out of curiosity. Someone called the forest department.
The leopard got scared even more with all the commotion, and ran out of his temporary hiding place into the village lanes, and entered a house with an open door. A few brave souls, including our protagonist, ran after it, following the screams. They found it attacking a labourer in that house, and started beating it with whatever they could find in the house. The leopard left the labourer, attacked Sudhir in the commotion, and bit off a chunk of flesh from his right leg.
The leopard would have continued to maul Sudhir, but his cousin came to the rescue, and attacked the leopard with a bamboo stick. The leopard ran out again into the village lanes. Fortunately by that time the forest department officials arrived, shot it with a tranquilizer, and hauled it away. No lives were lost that day, and Sudhir became a hero!
Since then, he tells the story to whoever he meets, rolling up his pants to show off his scar as the grand finale! And he did, and revealed the thick, red, knotty, irregular scar in all its ugly glory! I quietly admired the scar, politely complemented his bravery, and suggested coconut oil to try and soothe the itching. He left with the satisfaction of a magician having thoroughly impressed the audience with the prestige!
The other young man, let’s call him Gajendra, was a study in style. He was wearing perfectly fitting trousers, with a full-sleeved shirt in complementary colours, suggesting a good eye for fashion. The moustaches were trimmed to a point. His haircut framed his face well, and there was just a hint of hair gel. His confidence, however, didn’t match his carefully groomed persona – he barely met my eyes.
When I asked how I could help, he said he had scars which itched a lot and left him sleepless at night. Mostly out of the curiosity to listen to another thrilling story, and partly out of the need to ascertain mechanism of injury, I enquired how he got the scars. He just said, “I feel off my bike.” I had a strong feeling there was more to the story. I asked the most open-ended question I could think of at that moment, “How did that happen?”
And the story started unfolding. He was going from his village to the city for some work. To save time, he drove the bike onto the wrong lane of the highway, just like he had done hundreds of times before. This time, though, there was a car coming in the lane he just turned onto, and would have collided with him. The other lanes were full of traffic, so the car driver braked hard, lost control, veered onto the shoulder and turned over.
Gajendra wasn’t hit, but the surprise was enough for him to lose control of the bike. He fell on the road with outstretched arms, getting road rash over a large area of the arms. Not a happy day for anyone, but fortunately no lives were lost. Gajendra’s wounds healed, but then started growing excessively, and causing intense itching. Gajendra consulted a lot of doctors, tried a lot of lotions and creams, but got no relief.
I followed up with a few more questions, and then asked to see the scars. The patient reluctantly rolled up his sleeves. There they were – large, thickened, irregular, ugly scars, almost the same as Sudhir.
Hypertrophic scars often form at sites of injury or surgery, and cause a lot of discomfort to the patient, in addition to the cosmetic problem they create. There are a lot of treatments available, none of them wholly satisfactory, and surgical removal of the scars often leads to recurrence at the same site.
I discussed all this with Gajendra, and he decided to explore the surgical option. I gave him a couple of names of plastic surgeons, and he left, somewhat hopeful. I’m guessing he would continue to try everything possible to get rid of this constant reminder of the day he almost killed a car-ful of people!
Sudhir, of course, needed no such discussion, and would most likely continue wearing his itchy ugly scars with pride all throughout his life, showing them off to his grandchildren, and telling them, as often as they would listen, the story of the day he got a “leopard bite” and saved a life!