Today was the day of the geriatric clinic in my hometown.
The clinic was held at the Glory of Christ Church hall, following a kind invitation from the pastor. My intention was not simply to attend to each patient’s immediate complaint, but to conduct a comprehensive geriatric assessment—looking beyond disease to understand the person as a whole.
We assessed their medical conditions, psychological wellbeing, hearing, vision, mobility, continence and memory. These are aspects of health that can easily be overlooked during a busy consultation, yet each one has a profound effect on an older person’s independence and quality of life.
Among those who attended was a 74-year-old woman complaining of pain and swelling in her leg. On examination, the findings were consistent with cellulitis, and I prescribed antibiotics and explained the necessary precautions.
At the time, I did not realise that I had met her before.
As the clinic came to an end and I was preparing to leave, the president of the Wattala Elders Society and the pastor approached me.
“Thank you very much, Doctor,” they said. “The patients are very happy. Please continue this good work.”
Then the pastor added, “Doctor, there is a lady here who says she can hear properly now. She says it is because of your diagnosis and referral.”
I was surprised.
“Really? What did I do?”
“Last month, you examined her and referred her to the ENT clinic. The doctors treated her ears, and now she can hear again.”
I searched my memory but could not recall the encounter. During the previous clinic, I had seen nearly forty patients. It was difficult to remember every consultation.
Then the woman I had just treated for cellulitis stepped forward.
“Doctor, it was me,” she said.
Suddenly, the story began to return—not as a clear memory, but through her words.
“When you examined me last month, you said both my ears were completely blocked with wax. I could hardly hear anything. Even when someone spoke to me, I could not hear properly. When I walked along the road, I could not hear the horns of approaching vehicles. It had been like that for many months.”
She continued, “You gave me ear drops and referred me to the ENT clinic. The doctors there asked me to continue the drops for another five days and return. When I went back, they cleaned both my ears. There was so much wax!”
Then her face brightened.
“Now I can hear properly. In fact, it feels as though I can hear too much!”
We all laughed.
Standing there inside a place of worship, I felt an almost irresistible urge to say, “That is wonderful—it is a miracle.”
For a moment, I remembered the Gospel account of Jesus opening the ears of a man who could not hear. This woman’s experience was not a miracle in the supernatural sense. It was the result of a simple examination, the recognition of impacted earwax, appropriate treatment and a timely referral.
Yet, to her, it must have felt miraculous.
For months, she had lived in a gradually narrowing world. Conversations had become distant. The voices of those around her had faded. Even the warning sounds of vehicles on the road could no longer reach her. Then, through a relatively simple intervention, the world became audible again.
What had been a brief and almost forgettable consultation for me had made a profound difference to her daily life.
That encounter reminded me of one of the quiet strengths of general practice. Not every meaningful intervention is dramatic. Sometimes, it is simply taking the time to look inside an ear. Sometimes, it is recognising a problem that others may have accepted as an unavoidable part of ageing. Sometimes, it is making the right referral at the right time.
To the doctor, removing impacted earwax may seem routine. To an older person who has been living in silence, however, it can restore conversation, confidence, safety and connection with the world.
That day, I had gone to the clinic hoping to assess illness and preserve function among the older people in my community. I left with a reminder of my own: in medicine, the simplest acts of care can sometimes create the greatest change.
For her, the world had become loud again.
And what a wonderful sound that must have been.