Love and the knife

(First published in Earthenlampjournal, a reputed E-journal- vol1)

Can love be facilitated by a knife? This is the story of two couples who came to my OPD, seeking my help. And I wielded a knife – a scalpel to be exact.

Bobby and Anju arrived, both dressed in jeans and T-shirts. They were young and confident, and had accents to their English.

‘This is my girlfriend, Doctor,’ Bobby told me. ‘We have been together for two years.’

Both were newly minted software engineers working in the same office. The girl had an amiable smile.  They looked quite comfortable in each other’s company.

‘We have to separate, Doc. She has got a job abroad, and wants to migrate. I don’t want to leave India.’

‘You are still in love?’ I admit I had no business asking that, but I couldn’t help it.

‘Yes,’ the girl admitted. She flushed slightly.  ‘But we have to be practical, Doctor.’

Sure. One had to be. Realizing your destiny was probably more important than love, whatever that meant. But where did I fit in?

‘I want only the best for her,’ said Bobby. ‘There should not be any problems in her future due to our relationship. We … er … I would like to have her hymen restored.’

I remained silent for a few seconds. ‘You look like two progressive young people. It is a liberated world, isn’t it?’

Again, it was none of my business, but the words were already out.

‘India is the same as ever, Doc,’ the man replied resignedly.

And likely to remain so for quite some time, I thought. They were practical.

Hymenoplasty was done the next week. The patient was accompanied by her boyfriend. The entire fee was paid by him. They were very happy as they left.

Two weeks later, they came for a visit.

‘My marriage has been arranged for three months from now,’ Anju informed me. ‘The boy is a manager in a company in England.’

I nodded. She did not invite me to the wedding, of course. I didn’t expect her to. It would have been very difficult to explain my presence to anyone.

I noticed that Bobby did not look so happy about the wedding to be. Neither, for that matter, did Anju. I wondered whether he had received an invitation.


The next day in the OPD I saw Meenakshi. She was dark and beautiful. The bewitching eyes were lined with kajal. She had an ‘epicanthal fold’ in her eyelids that made her look faintly Chinese. Some Indians also had it. And she had a particularly attractive smile. She showed me a gynaecologist’s letter, and a scan report. I looked at her again, and thought she looked so feminine, so complete. A perfect woman.  Yet, she had no vagina.

I examined her. The external appearance of her vulva was perfectly normal. The clitoris rested in the normal place. But, between the urinary and anal openings, framed by normal looking labia, was nothing – just a blind wall. Beyond it there was no vagina, no cervix, and no uterus. According to the scan, the ovaries were normal.

It was a congenital condition. She had full knowledge of her problem. It had been detected at adolescence, of course, because she had had no periods.

It was possible to create an artificial opening through reconstructive surgery. But she would have to tell her future suitor that she couldn’t become pregnant. I told her that. She would also need to dilate the neovagina regularly with a stent, or have regular intercourse – that was, after marriage. That is what you tell them in India.

‘Where are your parents?’ I enquired.

‘I am an only child, Doctor. My father died very early, and my mother doesn’t keep well. She has renal failure.’ Though she said this, there was no self-pity in her voice. The smile didn’t waver much.

But this did complicate things a bit. Without proper family support, the surgery and proper follow-up would not be easy. And would she be able to find a good husband on her own? She seemed very ‘traditional’ and docile. I was thinking about how to respond, when she spoke up.

‘I am in love with someone, Doctor.’

‘I’m really sorry about this, but I need to acquaint you with the facts so that you can prepare yourself in case you face problems later on. You’ll have to tell him you can’t have your own children.’

‘He knows that part,’ she said. ‘Can you tell him more about the condition and the treatment? He is right here.’

That was unusual. My eyebrow went up involuntarily.

A young man appeared, erect and earnest-looking. I told him about the problem. Meenakshi had to have a complex surgery. Regular follow-up would be necessary for several months. It would take at least six months for the pain and discomfort to subside, and for the wounds to fully heal.

He listened politely, and nodded at everything I said. I expected him to back out from the relationship right away. Not having children is one thing. To know that your girlfriend is somehow incomplete sexually, in a fundamental way, is a different issue. Then there was the uncertainty about the surgery and its outcome. I looked at Meenakshi as she gazed at the young man who was listening to me intently.

Lakshman was silent for a while.  ‘Yes, Doctor,’ he said calmly. ‘When can we have the surgery? We are ready.’

I noted the ‘we’. So did Meenakshi. Her eyes misted over when she looked at him.

I sent a mental email to heaven, to strengthen the man’s resolve. I was not sure whether He was checking His inbox regularly. He seemed highly erratic.

There were reasons for my pessimism. I had seen many husbands who had left their wives with inconvenient illnesses. Women too left terminally-ill men, especially when money was a constraint. When they did not turn up for surgery at the scheduled time, I feared the worst. Frankly, I did not expect to see this couple again.

I was happy when they called and re-scheduled the date. She was admitted the next week. Her beau accompanied her to the hospital. Instead of being worried about the surgery, she was radiant. I looked at the sindoor in the parting on her head in wonder.

‘We got married, Doctor,’ she said, and smiled shyly.

Once again, I was surprised.

‘Why wait, sir? This way I can take care of her during and after the surgery proudly. Why make the neighbours talk?’ Lakshman explained.

That was one way of looking at it.

The surgery went well. Essentially, it involved making a blind hole surgically between the urethra and the rectum, of adequate size and depth, without injuring either of them. I took a skin graft from the thigh. It would leave a flat large scar – faint but unmistakable. This was usually a concern, as most women liked to hide the fact that they had had a surgery. In this case, I did not have to worry about that. The skin graft was wrapped around a long mould with the raw area outside. The mould was inserted into the hole, and fixed with stitches.

It was removed seven days later. Regular irrigations and dilatations followed. They were painful and uncomfortable. The presence of a helpful husband was a totally novel experience for me. He made the whole thing a lot easier for Meenakshi. She was discharged after two more weeks, but was instructed to irrigate and dilate the artificial opening regularly. It was crucial though it would be painful. The natural healing process tried to make the opening narrower and shallower. The dilatations would make the sides stretch and bleed. Majority of the women who underwent this surgery never got it right. For them, it was a failure.

The couple returned every month for cleaning and dilating under supervision. After about six months the track looked fully healed. There was no discharge.

‘The treatment is over,’ I told the couple. ‘Now you can start … er … your normal life.’

They came for a visit some months later. Both of them looked happy. They had no complaints.

‘Should I take a look?’ I asked tentatively.

‘Yes, Doctor. It would be better to check if everything is alright,’ Lakshman concurred with me.

‘No need, Doctor. Everything is okay.’ Meenakshi looked shyly at her husband.

I smiled. But they did not rise to go.

‘Is there something you wish to talk about?’ I asked Lakshman.

‘Is there any way at all that we can have children, Doc? I mean, our own children?’ Lakshman said hesitantly.

That is one thing about human beings. Once they achieve something much sought after, they should be satisfied. But no. The next moment they want another. One cannot blame them though. I too am like that. Human desires are unlimited, but the means to achieve them are always limited.

‘I guess you could always adopt a child.’

‘That is not what we meant.’

I felt I had to disappoint them.

‘I don’t think it is possible.’


They came one more time. Hand in hand. They looked the perfect couple. Lakshman, dark and rather rugged, had a confident stride. Meenakshi, with her soft and feminine looks, complemented her husband well. A child would have completed the picture. But it was clear that Nature, or the scheme of things, or God – whatever you chose to call it – was not a perfectionist. I hoped they would not bring up the subject of pregnancy on this visit. But Lakshman did.

‘We are so happy together. Life is so good for both of us now. It is a pity that we can’t have … you know….’ He trailed off.

‘I really don’t know much about the possibilities,’ I said frankly. ‘Do you want me to send you to another gynaecologist?’

They clutched at that straw.

‘Yes, sir please.’

I sent them to a friend of mine, Neegio Inias, at KS Hospital, Chalakudy. He was somewhat of a maverick and an innovator.  But I had no hope as he was obviously no magician. I had lost touch with him over the years.


This was around six years ago. After that I did not see the couple any more for a long time. Two months back, I was surprised to see them in the OPD. Meenakshi had put on some weight, which made her curvier and more desirable than ever. Lakshman was courteous and gentlemanly as before. But what surprised me were the two toddlers, both about three – a boy and a girl. The couple stood there smiling from ear to ear, and offered no introductions.

I stared at the children for a long time. The boy’s resemblance to Lakshman was unmistakable. The girl had epicanthic folds in her eyelids – that oriental trait which made her look Chinese.

Meenakshi laughed softly.

‘Dr Neegio is good,’ said Lakshman

‘But how…’ I stammered.

‘The ovaries were normal, Doctor. They extracted the eggs by laparoscopic surgery. We got two as the medicine triggered ovulation. That is what the gynaecologist said. Then they took my sperms and … you know….’

‘But – ’

‘My sister has two children,’ she said. ‘She was very kind. She agreed to be the surrogate mother.’

I sat for sometime, dazed but pleased. I also felt a little guilty about not being aware of all the possibilities. About resenting them for desiring too much. I thought about the love Lakshman had for his wife. And the generosity of the sister-in-law. Miracles did happen from time to time.

And yes, I have to tell you that just the other day I bumped into Bobby at the children’s park. He waved to me, and I recognized him immediately, even after all these years. I was about to open my mouth, when Anju appeared with a small girl in tow.

‘You two are still together?’ I asked, surprised.

‘How could I leave a man like him, Doctor?’ said Anju, looking at him fondly. ‘It would have been the greatest mistake of my life. I decided not to marry that guy, you know, and go to England. India is better any day, don’t you think?’

Walking back home, I thought maybe – just maybe – God had started checking his inbox after all.