Stage Two: The Diagnosis 

The next thing we knew, after three long months of hospital visits, was that the doctors finally decided to do a scan. We never saw the report—it was kept for the doctor’s reference, maybe for the ENT surgeon’s too. We weren’t told what they saw or suspected, just that surgery had to be scheduled. Within a week, a date was fixed, and my grandma was admitted around the 10th of March, 2023.

They tried to take her to the OT multiple times, but her blood pressure just wouldn’t cooperate. It kept spiking—160/110, sometimes even higher. Fear, anxiety, her long history of hypertension… everything added up. The doctors blamed salt, saying her years of diet might have caused the spikes. Maybe there was some truth in that, but deep down, we knew this wasn’t about salt. This was fear, pain, and uncertainty all wrapped into one body that was being poked and prodded without real answers.

They still didn’t know what the lump was. The FNAC might’ve shown some abnormal cells, maybe even hints of cancer, but no one confirmed it. They just said it couldn’t be properly identified until it was removed and sent for biopsy. So we waited again, this time inside hospital walls—one whole week of moving my grandma between a private semi-suite and the OT room, back and forth, every day.

We’d already spent over a lakh rupees by then, and nothing had really happened. Just pre-procedure costs, scans, and hospital charges—no surgery, no clarity, no progress. My grandma was exhausted, both physically and mentally. The lump had grown so much that it was impossible to hide now; it stretched her skin, large and obvious, as if demanding to be seen by the people who kept overlooking it.

After about a week of this, the surgeon finally said what should’ve been said months ago—that she should be transferred to an Employee State Insurance (ESI) hospital in Bangalore. It’s a government-funded facility, where, with the right documents, patients can receive proper treatment and medicines for free. So after all that time, money, and trauma, they referred her elsewhere. It felt like being handed off, like all those months of effort had led to the beginning of something new—but also, all over again.

After the referral, the real marathon began. Around April of 2023, after nearly twenty days of running around the ESI Corporation, we finally got her entitlement approved. That meant she could now access medical benefits, sickness and extended sickness benefits, and even super-specialty care as an inpatient. On paper, it looked like progress. But the process—it was anything but easy.

Getting anything done at ESI required patience that most people don’t have. My aunt, who handled most of it, had to take repeated leaves from her job. Every day off meant a salary cut, and she lost a lot of money trying to make sure her mother got the care she deserved. It was endless paperwork—go to this ward, then that ward, come tomorrow, bring more documents, stand in line again. By the end, we had submitted Xerox copies of almost every document that ever existed in my grandma’s life.

At that time, I was in my fourth year of dental school. I couldn’t be there for her when she needed me most, and that guilt sat heavy. My mom was there, though. Always. Along with my aunt and my other grandma. They were the ones who carried the whole process on their backs. The rest of the family? Especially the men? They didn’t care much about the paperwork or the waiting. They only showed up during the surgery or afterward, when things were already done. But the hardest part—the exhausting queues, the standing for hours beside other sick families, the constant running from one counter to another—that was done by the women in my family.

After nearly three weeks of this, of early mornings and late evenings spent under flickering tube lights in government hallways, of signatures and stamps and photocopies that blurred into one another, we finally got approved. My grandma was now officially “entitled to benefits.” It sounded so bureaucratic, so cold. But for us, it meant hope—a door finally creaked open after months of being shut.

Once my grandma got admitted under the ESI benefits, the tone changed. For the first time, the doctors started telling us what they were actually doing. They referred her for a PET scan, a CT scan—finally, some real steps. When the results came, even though nobody could yet say exactly what the lump was, we did know one thing: it wasn’t spreading. There was no metastasis. That single fact, that it hadn’t gone anywhere else, was our first breath of relief in months.

Still, every oncologist and ENT surgeon who saw her said the same thing in different words: the mass had to be removed. Only then, only with a full biopsy, could they tell us exactly what it was and how to treat it. That was the ultimate decision from all the scans: take it out first, ask questions after.

By now, though, life at home had become unbearable for her. The lump had grown so big that everyone stared. She could feel it pressing against her jawline. Speaking became hard. Even going to public functions became a torment because people always asked what was wrong, and she didn’t even know what to say. She would sit and whisper to us, “Why this, at my age? Why do I have to suffer like this? Why is it growing?” Over and over. It had started as something she thought was a small cold sore or cyst, and now no scarf or collar could hide the swollen glands bulging from her neck.

Along with the swelling, there were symptoms—hypertension, discomfort, difficulty speaking. Yet, after the ESI referrals, at least we had some answers. The doctors were cooperative, clear. I remember sitting in one of those sessions with the oncologist. He said the lesion on the left side of her thyroid cartilage measured about 4–6 cm. It had been swelling for at least six months. The only option was a total thyroidectomy. He couldn’t tell if it was benign or malignant yet, but he did say the word “cancerous.”

She had been on hypertension medication for 15 years, and even now her blood pressure swung wildly. But at least, for once, we weren’t lost in a maze of guesses. The oncologist noted there was no pallor, no icterus, no cyanosis, no clubbing, no lymphadenopathy, no edema. We held on to every one of those “no’s” like they were lifelines.