Cancer Symptoms Pictures

00:14comm: for two years, this girl has bled from her head, hands and eyes - a condition thatdefies medical understanding. 00:22george buchanan: i am not aware of any medical condition that would explain this. 00:26comm: some say she’s possessed; but could she be blessed? 00:32now, a unique spiritual and scientific journey of discovery will try to solve the mystery. 00:38antia: if we can find out an organic cause

it will certainly be a landmark. 00:44comm: can modern science or religious ritual find a cure for the girl who cries blood? 00:56comm: this is twinkle dwivedi. 01:00in many ways she’s a typical indian teenager. 01:04when she’s not praying at her local hindu temple… 01:08…she hangs out with friends in the neighbourhood. 01:12twinkle: i come out to play at five… and

i come back at 7 to 7:30 when the tv programmesstart. 01:23comm: according to her sister goldie, she’s a real character. 01:29goldie: twinkle is not the kind of girl who will sit at home and study. she’s not likethat. she’s a tomboy - she wants to play and fight. 01:50twinkle: i study when i feel like it. if someone asks me to study, i don’t study. 01:56comm: in a male dominated society – twinkle

gives as good as she gets. 02:04goldie: she likes watching tv. she likes listening to songs. she likes playing games … she’sreally good at games… 02:12comm: at thirteen (13), twinkle is the youngest in the dwivedi household. 02:19her home is in the northern indian city of lucknow. 02:22it’s famed for its muslim architecture and is often called ‘the constantinople of india’.

02:38twinkle’s house is in a quite suburb a few miles from downtown. 02:47her dad works on the railways and is often away so running the home is left to nandani– twinkle’s forty-two (42) year old mom. 02:56nandani juggles the responsibility of running a beauty parlour and raising her kids… andwith twinkle… it’s not easy. 03:07nandani: i have four daughters, the youngest is twinkle. three are absolutely fine buttwinkle suffers from this problem… i don’t understand what i should do.

03:20comm: for the last two years twinkle divewdi has reported spontaneous bleeding from hereyes, hands, head and elsewhere on ther body. 03:32nandani: she can start bleeding when she’s watching tv or something. it can happen anytime. 03:39twinkle: mostly i bleed from my head, and the hands, the feet, the chest, the throat,the ears, the nose, the eyes, from everywhere! 03:59comm: twinkle’s shocking bleeding has meant that for nearly two years she’s been unableto go to school. 04:06comm: but remarkably, there’s little pain.

03:08there’s no visible source. 03:11there are no cuts on her skin. 04:20goldie: what i can’t understand is that she doesn’t get injured for her to startbleeding. if she got hurt and started to bleed i’d understand that. but she is not gettinghurt for the bleeding to start… 04:32comm: and when the blood’s washed-off it’s as if it never happened. 04:40these episodes terrified twinkle’s family. 04:44when they began two years ago they immediately

rushed her to their family physician – dr.siddiqui. 04:53dr siddiqui: a lot of the time the whole family starts to cry and scream ‘doctor save her!what do we do! my sister is going to die!’ so i told them to take her to a hospital. 05:09comm: crying tears of blood is not unknown to medical science. a rare condition calledhaemolacria can produce tears partially composed of blood. but twinkle’s bleeding isn’trestricted to her eyes. 05:27dr siddiqui: even after consulting two other doctors, an ent surgeon and a gastroenterologist…we still couldn’t make out where the blood

was from… 05:38comm: siddiqui referred twinkle’s case to the all india institute of medical sciences- aiims. 05:48goldie: the best hospital in india is considered to be aiims. mommy has taken her there butshe didn’t get any positive response. they said if she is bleeding, let her bleed. thereis no problem. she’s just looking for attention. 06:04comm: for the most part, twinkle’s bleeding has simply been dismissed. 06:13dr siddiqui: i feel very bad that nobody is

helping her. at all the places they have beento everyone has passed the buck from one person to the next. 06:30nandani: the doctors look at her and turn their backs. if it was their child do youthink they would turn their backs? no they wouldn’t! 06:39comm: now, after two years of trying to find an answer, twinkle and her family still haveno idea why she bleeds… 06:47…and are disillusioned about the ability of doctors in india to cure her…

06:54goldie: if you ask me whether i have faith in indian doctors i would say i have no faith.not even one percent. 07:01comm: they’ve been told that medically, twinkle’s bleeding can not be explained. 07:07but in the neighbourhood where twinkle lives, the rumour-mill is in overdrive. 07:13everyone has an opinion on what’s causing the tears of blood. 07:20man mohan sharma: you can call it a miracle.

i’ve have never seen or heard anything likeit before… 07:28rishi: friends say many things. some say that physically she is not so strong. some saybad omen has been cast, some say it’s a ghost… 07:40comm: superstition is so strong here that twinkle and her mother have visited a localmystic for guidance. 07:51prayer woman: it’s not a disease… it’s like this… there is a spirit. it’s likean insect that sucks blood. and where-ever it sucks the blood that’s where she bleeds.this is a spirit. it’s not going to go away

easily. 08 :10comm: according to the mystic, twinkle is possessed. 08:14prayer woman: we call restless souls external winds, souls who are not free, who are wandering.they need to take refuge somewhere – so they enter whosoever comes their way. it canbe an old person or a child. it can be anyone. and after that they start troubling the personin different ways … 08:36they are beings that drink blood, so they drink whatever they want and they rest theyboil and that’s why it comes out of the

body… 08:45comm: she’s told them to pray and make offerings in the temple as often as they can. 08:54nandani: the offerings at the temple have not helped. it’s not that i haven’t donewhat was asked of me. i haven’t neglected it. i’ve done it; but her condition hasn’timproved by going to the temple or by dispelling the spirits. they haven’t left… 09:14comm: but twinkle’s bleeding bares an uncanny resemblance to another supernatural phenomena.

09:22the mysterious appearance of the wounds jesus suffered at his crucifixion on the hands,head and feet of others is known as stigmata. 09:34though christianity is a minority religion in india less than two percent (2%) of thecountry’s population are catholic, there’s still more than seventeen (17) million followers. 09:47today, twinkle is on her way to ask gerald mathias – the bishop of lucknow if stigmatais the reason she cries tears of blood. 09:59twinkle: i have seen in your office this photo. is this what happens to me?bishop: have you seen a photo of jesus christ?

which photo?twinkle: where he is like this with his arms. i have seen it. 10:18comm: but the bishop doesn’t believe twinkle’s bleeding has anything to do with christ’ssuffering on the cross. 10:28bishop: we shouldn’t assume that the problem that’s worrying twinkle … is related tojesus christ. she doesn’t have a full knowledge of christ … and she doesn’t pray to him,…so she can not be involved in his sorrow and burden. my personal opinion is that inthis case, in twinkle’s case, it’s not stigmata.

10:04comm: he prays for her… 10:08bishop: our father, my god; i place my hand on twinkle. whatever her difficulty, whateverher illness, you can make everything better. we pray through lord jesus christ. amen. ok. 11:37comm: but miraculously, just moments after her blessing twinkle bleeds in front of the bishop. 11:48bishop: how did this happen? did it happen just now?twinkle: i was opening the bathroom door and when i came out, mom saw me bleeding. i didn’tsee it.

bishop: does it hurt?twinkle: no. 12:10comm: but twinkle’s spontaneous bleeding fails to impress the bishop. 12:18bishop: this is clearly not a case of mystical experience. a mystic will be in a trace asit were but this is not the case with twinkle. twinkle, no she behaves and is as a normalgirl…but how do we explain? i’m personally not an expert … so live in hope eh? ok twinkle…keep smiling. 12:43comm: their meeting has been unsuccessful. nandani’s daughter bleeds and the bishophasn’t been able to offer any explanation

why. 12:56nandani: that’s what i didn’t understand. we are all god’s children. blood doesn’tcome in different colours. if she was born a christian he’d have considered …thatthis was the soul of jesus christ. but because she is hindu it is not a case of stigmata. 13:17comm: catholicism can’t help them so twinkle and her mother decide to concentrate on theirown religion - hinduism. 13:27they’ve been to temples in lucknow but now they decide to go on a pilgrimage to one ofthe holiest places in india.

13:36there they’ll observe cleansing rituals on the banks of the sacred ganges. 13:44they’ll also visit a famous ayurverdic centre in the hope twinkle will get treatment. 13:56their journey starts with a thirteen (13) hour train ride. 14:05nandani: we will make offerings to god, i’ll make sure twinkle makes offerings to god…andwe’ll pray that my child gets better. 14:17comm: twinkle’s journey begins on a night

that has special significance for hindus’. 14:23it’s the first full moon of phalgun – the last month of the hindu calendar. 14:29it marks the beginning of spring and the start of holi – a religious festival popular innorthern india. 14:38twinkle and her mother are on their way to haridwar over three hundred miles north westof lucknow. 14:47it’s one of the seven holiest sites in hinduism and a place of pilgrimage.

14:55nandani: twinkle believes in god. she has a lot of faith. so we will pray and seek medicalhelp to cure her. sometimes you need to do both. 14:11twinkle: i believe in god a lot so i want to go there and ask him something… i’llpray that i get well soon … and also that i put on some weight. (laughs)… 15:31comm: it is eleven (11) o’clock in the morning and the express train is pulling-in at itsdestination. 15:40twinkle and her mother arrive in haridwar

as celebrations for holi - the annual ‘festivalof colours’ are well underway. 15:50the festival celebrates the start of spring and commemorate a hindu legend where goodtriumphs over evil. 16:00tradition has it that people throw brightly coloured powders over each other and generallygo a bit wild in the streets. 16:08today, haridwar is a riot of colour. 16:16but nandani and twinkle haven’t travelled here for the holiday - they’ve come fora spiritual cleansing in the ganges. 16:28in hindi, the name haridwar stands for gateway

to god. 16:35it’s believed that bathing in the ganges here washes away sins. 16:42the sacred waters free the soul from the cycle of birth and reincarnation and guarantee immortality. 16:50it’s believed that immersing yourself at haridwars’ ghat during a religious festivalis especially potent… 16:59…and tens of thousands travel to the city each year to do just that.

17:09twinkle and nandani begin the ritual by praying at a temple at the hari-ki-pari ghat - thesacred heart of city. 17:23next they give flowers and candles – called diyas – to the ganges, offerings that representthe soul and its blossoming purity. 17:38now, twinkle is ready to immerse herself in the sacred waters. 17:44it’s time for her cleansing. 17:56as she and her mother pray preparations for the aarti begin.

18:02it’s a hindu ritual which is often called ‘the ceremony of lights’. 18:10amid chanting, bell ringing and prayers, flaming torches are offered-up – it’s a symbolicgesture that asks for the ‘light’ that illuminates the lord to light-up the visionof the faithful. 18:31now that they’ve embraced all of these cleansing rituals… twinke and her mother wait fora sign that she is cured. 18:44nandani: her eyes started to go red, i kept looking at her. she asked me what i was lookingat … i know that when her eyes go red she

may start bleeding. then it started. 18:57twinkle: sometimes it hurts but today it doesn’t. 19:01twinkle: but hurts a little bit when i wash. 19:06comm: twinkle’s pain is often shared by her mother. not physically but emotionally. 19:17nandani: it worries me... i find it difficult. it hurts me to see her like this. 19:31nandani: is it hurting in your eyes? twinkle: no…

19:36comm: but when the blood’s washed off… there’s no redness or irritation. in fact,there’s no evidence at all that suggests that twinkle has just bled from her eyes. 19:49nandani: sometime i believe we’ll find a cure …but we are broken now. we’ve lostfaith. 20:00comm: it’s the next morning. 20:04as people in haridwar go about their daily business, twinkle has an appointment at patanjaliyogpeeth – one of the most advanced ayurverdic centres in the world.

20:16if religion can’t cure her, perhaps a more holistic approach is needed. 20:21she’s already seen ayurverdic physicians in lucknow with no success. 20:28but here in haridwar twinkle has an appointment with a famous practitioner who claims to havediscovered cures for incurable diseases. 20:39she’s extremely fortunate. acharya balkrisha rarely gives personal consultations. 20:47acharya: how long have you had this problem

of bleeding from everywhere?twinkle: two years. 20:57acharya: how many doctor have you been to see?nandani: four 20:03comm: ayurveda is an ancient indian holistic medical practice that combines diet, yoga,massage and herbal remedies to maintain health. 21:14according to ancient hindu texts the health of the human body is governed by three elementsor ‘doshas’ – these are the vata (spirit), pitta (bile) and kapha (phlegm). 21:30acharya: the body functions because of these

three elements… and when we balance themwe can cure any disease… beit cancer, aids, heart disease or arthritis. 21:45comm: to make a diagnosis acharya checks each of twinkle’s ‘doshas’. 21:51he’s looking for an irregularity in her pulse at three points on her wrist - thatwill tell him where she has the imbalance. 21:58acharya: and for someone with acidity problems or blood related problems you will feel ithere… 22:04acharya: her problem is related to pitta so

if you check you will feel the pulse here…it’snot here or here, it’s here. 22:12comm: acharya‘s identified a problem with twinkle’s pitta – her bile. he thinksit’s the source of her bleeding and is ready to admit her as a patient. 22:24acharya: i want to do this as a challenge… because you said there’s bleeding but idon’t know what type. i’m not worried because it’s not that serious. it’s notan emergency case. she should stay here. it will be for the best. 22:40comm: but his offer to treat her doesn’t

get the reaction he expected. 22:48acharya: will you stay? twinkle; no, not here..acharya: you want to get better don’t you? lots of people stay here… we have tv. thisis not a hospital. she will stay! 23:18comm: twinkle and her mother refuse the offer. 23:22nandani: we have shown her to so many people. so many people. and with the doctor here itfelt as if he took it very lightly. 23:34comm: but the heart of their decision lies in the fact that a top american blood specialistis flying to india to meet twinkle.

23:46twinkle: i want to meet the american doctor. i have greater faith in foreign doctors. notthe doctors here. i have already met ayurvedic doctors and they’ve given me medicines butit hasn’t changed a thing… 24:00comm: twinkle is putting her faith in dr. george buchanan, a world renowned pediatrichematologist who’s flown over nine thousand (9000) miles to investigate her unique condition. 24:13dr. buchanan: the news reports i heard about twinkle were just so intriguing because ofthe unusual nature of her bleeding. crying tears of blood, having bleeding appearingspontaneously on her scalp, on her palms,

under her eyes … it’s not recorded inmedical history to my knowledge and doesn’t fit with any known bleeding disorder so forthat reason i was just very, very intrigued by it. 24:37comm: dr. buchanan will base his investigation at one of mumbai’s top hospitals - jaslok.there, he’ll be working with consultant haematologist dr. antia. 24:50together, they’ll try to solve the extraordinary puzzle of twinkle’s bleeding. 24:56antia: the sites that i have mentioned are

totally unusual. scalp, eyes, unheard of,undocumented. 25:03comm: about seven percent (7%) of human body weight is made up of blood. in adults, thisamounts to four (4) or five (5) quarts. 25:11blood has four main components… 25:15red blood cells carry oxygen… 25:18white blood cells defend the body against infection… 25:23…and platelets help the blood to clot. 25:26these three are carried within the fourth

- a protein rich fluid called plasma. 25:33the heart pumps this blood through an intricate network of tubes called blood vessels whichkeep it contained within our bodies. 25:43dr. buchanan: so there are only 3 ways one can have bleeding. something wrong with theblood vessels, something wrong with the platelets, or something wrong with the proteins or factorsin the blood that make the blood clot. 25:53dr. buchanan: it just doesn’t seem medically possible for bleeding to come through intactskin where there’s no evidence of any skin abnormality or damage to the skin… and soin trying to get an understanding of the cause

here is extremely important. 26:11comm: that afternoon, nandani and twinkle arrive in mumbai. 26:16their appointment to meet the doctors is scheduled for tomorrow. 26:22dr. buchanan: seeing the actual bleeding given its very unusual location and nature i thinkwill be extremely important for us. 26:28comm: as a precaution, dr. buchanan has asked that twinkle and her mother stay at his hotel.

26:37if twinkle has a bleeding episode, dr. buchanan wants to be on the scene as quickly as possible. 26:48that night, at one am dr. buchanan gets an emergency call to room five zero three (503). 26:59eight (8) hours ahead of schedule, he meets twinkle for the very first time. 27:11dr. buchanan: are you feeling ok? are you feeling ok?man: translates twinkle: i’m in a bit of pain.dr. buchanan: where is the pain now? where

does it hurt?man: on the back of her head. dr. buchanan: yeah. wow. i’m just gonnalook ok. i’m not going to hurt you. 27:36dr. buchanan: there’s what looks like blood here. i’m just looking for a wound of somekind but i don’t really see any. you know an opening of the skin. usually when somebodyhas bleeding like this one can see a cut or a scratch or something that started it…it’s not clear to me. i’ve not seen this before. 28:04dr. buchanan: do we have one of those glass slides? err…it’s just a little piece ofglass... i’m not going to cut you or hurt

you or anything with this but i just wantto touch this to the top of your head. 28:17comm: testing the substance on twinkle’s scalp will help dr. buchanan’s investigation.next he collects another sample using a different technique. 28:31dr. buchanan: this is saline and what i wanna do is get a little dab of the blood and, andsave it so we can look at the blood cells and measure them. 28:40comm: storing the sample in saline prevents the blood from drying-out.

28:46dr. buchanan: so this is basically giving us a suspension of red blood cells – andso the laboratory ought to be able to some testing err determining the type of blood. 29:00comm: with the evidence in hand, dr. buchanan gives his initial reaction to what he’sjust witnessed… 29:06dr. buchanan: it’s very unusual yeah, err with the lack of any, err, clearly it lookslike blood to me, it’s partially clotted err i think it’s gonna turn out to be blood…err …i am not aware of any medical condition that i can explain scientifically as a haematologistknowing about blood clotting that would explain

this. 29:38comm: dr buchanan thinks the analysis of two samples he collected from twinkle’s scalpmight help solve the mystery of her bleeding… 29:47comm: …and for nandani, the tests he’s commissioning represent a real breakthrough… 29:51dr. buchanan: …give you some specimines of blood… 29:55nandani: twinkle bled in front of dr. george. he was prepared for it. this has never happenedbefore. such a test has never been done by

anyone else. 30:07comm: after last night’s bleeding, dr. buchanan is eager to begin his official evaluationinto twinkle’s unique problem. 30:15he begins by reviewing her records. 30:19dr. buchanan: the medical history that is the most important part of working up andevaluating a patient with a bleeding disorder. the tests are helpful, the tests can sometimesbe diagnostic but it’s the history, the location of the bleeding the severity, thefrequency, when it began, what brings it on, what’s done about it. that kind of leadsus in the right direction.

30:39comm: next he talks twinkle and nandani about the bleeding. 30:43dr. buchanan: …ask twinkle some questions about her health, her overall heath, her generalhealth over her entire life. (woman translates) dr. buchanan: when she was a young girl growingup was her… 30:59comm: he’s looking for details that will help him uncover the cause of the condition… 31:05dr. buchanan: were there other problems with her health prior to july 2007?nandani: she had some nose bleeding.

dr. buchanan: any problem with her visionor her hearing when she was growing up? nandani: no.dr. buchanan: oh, ok. how about her stomach? 31:20comm: it’s a lengthy process... 31:22…and it’s repeated by doctor antia. 31:26antia: during her menses she has to use about eight pads. that is very heavy. 31:34comm: twinkle’s history of nose bleeds and heavy periods is significant. 31:37they’re both common symptoms of a problem

with platelets - one of the four main componentsthat make-up blood. 31:45platelets are cells that form the primary plug when there’s an injury to a blood vessel. 31:51they ‘stick’ together or ‘aggregate’ at the site of the injury - forming a clotto prevent blood from escaping. 31:59if there are too few of these cells or they don’t function properly it means that theblood ‘clots’ less effectively. 32:08if twinkle has a platelet problem it might explain her unusual bleeding.

32:14to find out if her platelets are functioning properly a small incision is made on her skinand the time it takes for blood to clot is monitored. 32:28antia: the normal person should stop bleeding in about five minutes or seven minutes. ifshe continues to bleed prolonged that itself will prove in itself that she has a functionalplatelet disorder… 32:37comm:it’s a simple but effective test. 32:42antia: the clot is forming. dr. buchanan: it really has, i think so. yessir it’s err…

antia: there you are…antia: seven minutes exactly. normal. 32:52comm: the result suggests that there’s nothing wrong with twinkle’s platelets. 32:58but to double check, the specialists will perform a full range of sophisticated testson twinkle’s blood. 33:05jaslok’s technicians will look for any evidence of abnormalities. 33:12but dr. buchanan isn’t sure that these tests will answer the key question.

33:20dr. buchanan: where does the blood come from? it seems like it would have to come seepingthrough the skin of the scalp or through the tissues in the eyes and i’m just not awareor any medical condition that would lead to 33:35comm: medically speaking it shouldn’t be possible for twinkle to bleed from her scalpwithout there being any sort of opening. 33:45dr. buchanan: what i’m looking for in the middle of her scalp is to see if there’sany cuts that would explain these events of bleeding from her scalp. 33:54dr. buchanan is searching for any sign that

will tell him where the blood came from. 34:04dr. buchanan: almost always people with low platelet or platelet problems bruise easily,they also have little pin-point red spots on their skin so called petechiae they’represent really on the skin all over the body that’s seen with low platelet counts. 34:15comm: he thoroughly scrutinizes her skin, limbs and joints. 34:18dr. buchanan: does this hurt when i just touch your knee…twinkle: no.

34:22dr. buchanan: basic impressions of the physical exam. really, it’s quite normal. i reallydidn’t find anything that suggests some kind of underlying deep seated generalisedproblem that might be associated with bleeding. 34:233dr. buchanan: …listen to your heart a little bit… 34:36comm: dr. buchanan’s investigation is about to take an unexpected turn. 34:45dr. buchanan: twinkle’s really very unusual bleeding is really is a mystery and makesme suspect that this could be something that’s

been called factitious bleeding. the bleedingoccurs as a result of the patient or a family member putting the blood there or err causinga lesion or scratch or cut to bring on the bleeding - yet the physical examination doesn’treally support that because there’s no evidence despite the bleeding from her scalp. 35:18comm: now, the doctor begins to question everything about twinkle’s case. 35:22dr. buchanan: is it twinkle’s blood? err, we’re not sure of that right now. we didn’treally see the bleeding start and so we really don’t know how it began – how the bloodgot there.

35:34comm: to find out, dr. buchanan has to confirm that the substance he took from twinkle’sscalp is actually blood. 35:42dr. buchanan: by looking at this under the microscope i can say for sure there are redblood cells and white blood cells there so its blood. the question is, is it twinklesblood? 35:53comm: to answer that, he needs the results of the other sample he collected – twinkle’stest tube. 36:01its contents is being analysed to identify what ‘type’ or ‘group’ the blood is…but the results won’t be in for another

hour. 36:12in the meantime, drs. buchanan and antia are about to get the results of the other teststhey commissioned yesterday. 36:22these will tell them if twinkle has any defects or deficiencies in her red blood cells, proteinsor platelets. 36:31dr. buchanan: the 1st page really is a series of basic screening tests…antia: yes dr. buchanan: …including some one that arefairly … looking for some unusual conditions…and, they’re all normal…antia: they’re all normal.

36:42comm: but page two tells a different story. 36:45antia: so here we are finding some abnormalities in the platelet aggregation study… 36: 51comm: twinkle’s test results have shown that she does have a problem with her blood.but it’s a minor one. her platelets aren’t sticking together properly. 36:59dr.antia: from the basis if these tests i can certainly say she has a bleeding problem…what i can not understand is, on the basis of these tests i still can not explain hersymptoms.

37:15dr. buchanan: taking an aspirin two days earlier would cause the abnormalities we’re seeingon this test. it’s not going to cause twinkle’s unusual bleeding manifestations. 37:26dr. buchanan: so it does make me very suspicious that this is bleeding that’s been broughton purposefully in some way by twinkle and or her mother. 37:38comm: now the doctors wonder if the result of the test tube sample will tell them theanswer. 37:45they know twinkle has a rare blood type – ab

positive. 37:58dr.antia: this is ab positive. and the reason why we … 37:00dr. buchanan: this would be consistent with the blood from her scalp being actually herblood - not absolute proof - but would be consistent. 37:08comm: dr. buchanan can’t rule out the possibility that the blood isn’t twinkle’s. 38:14dr. buchanan: i mean right now, it’s very

unclear. i think the mother’s blood groupis still going to be important and i agree that’s she’s unlikely to be ab positivebut if she were from the same blood group then i think that would still raise the questionthat the blood could come from the mother. 38:30comm: but before the doctors can test nandani’s blood – that night, back at the hotel twinklebleeds again. 38:45dr. buchanan: ohh… i’m sorry what’s happening here?twinkle: i was watching tv and then i started to bleed from this eye and then this one.dr. buchanan: how about your eyes? do they hurt at all? or burn?twinkle: it’s burning a bit because of the

blood… 39:08comm: dr. buchanan takes a closer look. 39:11dr. buchanan: do you mind if i kinda put my finger round you eye just to kinda check if…wouldthat be ok? twinkle: okdr. buchanan: … ok... i’m just going to look here. 39:20comm: it’s the first time he’s witnessed twinkle’s tears of blood. 39:25dr. buchanan: i’m sorry. can you look way

up here, the ceiling look way up there? that’sgood. thank you. ok. ok. sorry. 39:39comm: he’s looking to see if the blood has come from her tear ducts – a rare conditioncalled haemolacria. 39:47dr. buchanan: so it looks like the bleeding sort of comes from outside the actual eyerather than from the eyes. there is no real pattern, it’s just blotted… 39:57comm: for the first time, dr. buchanan openly questions twinkle about where the blood iscoming from. 40:04dr. buchanan: do you have any bleeding anywhere

else right now?twinkle: no dr. buchanan: nowhere else on your body, onyour skin, chest. on your back… dr. buchanan: so how do you think this happened?twinkle: i don’t know… dr. buchanan: so you didn’t make it happen?dr. buchanan: did you put the blood there on your hands and on your face?twinkle: no. 40:44comm: nandani doesn’t like the questions. 40:49nandani: do you think someone is putting it there? 40:54george i don’t know. i think that’s it’s

a possibility yes. 41:04comm: dr. buchanan is suspicious that twinkle’s tears of blood are being faked. the next morninghe confronts nandani. 41:14dr. buchanan: i have to ask you one very important, difficult question. are you causing twinkle’sbleeding, are you causing the bleeding, putting blood on her, are you responsible for this?nandani: no, i do not make my child bleed nor do i put blood on her. 41:35comm: then, for the first time, dr. buchanan meets twinkle away from her mother.

41:41dr. buchanan: um, i wanna ask you a couple of questions would that be ok? have you broughton or caused the bleeding yourself.? do you make yourself bleed?twinkle: no. dr. buchanan: you’re sure?twinkle: yes. dr. buchanan: you’ve never done anythingto bring on or cause bleeding? twinkle: no.dr. buchanan: ok, i had to ask that question. you understand that, why i’m asking thequestion? twinkle: no.twinkle: do you think i put blood on myself? if you think that i don’t want to be treatedby you.

twinkle: i don’t want to be treated by you. 42:40twinkle: i don’t want help from someone who asks me these questions.twinkle: mom may not get angry by these questions, but they make me angry. 42:nandani: twinkle listen to me… twinkle: i don’t want to listen to anyone.nandani: first listen to me… twinkle: no i don’t want to!twinkle: you brought me here so they could ask me those questions.nandani: don’t you want to get better? twinkle: no!nandani: tell these people that we’re telling

the truth! 43:26nandani: the doctors are asking because they’ve seen you bleeding from the head… and yesterdayyou were bleeding from your eyes… but the world will ask; ‘have you seen it start?’then what answer can they give? you have to give them the answer! 43:52say to them ‘fine!’ put cameras on me… like the ones they have in shops! put thosecameras on and the whole world will see…if i’m putting the blood there or it’s comingout on its own. 43:11comm: after a few minutes – twinkle is calm

enough to see dr. buchanan … 44:18dr. buchanan: i’m sorry twinkle…i want you to know first of all that as your doctori wanna help you. i really do. dr. buchanan: i’ve never seen anyone whohas bleeding like you have. dr. buchanan: i’m not accusing you or sayingthat you’re doing it but i have to ask as your doctor to try to help make this better.i had to ask that question whether you were doing it to yourself.twinkle: it’s ok… 44:57comm: it’s 7am the following morning. nandani has agreed to have her blood tested to confirmthat the blood on twinkle isn’t hers. dr.

antia is overseeing the process. 45:15she’s a negative. 45:17the ab positive blood dr. buchanan found on twinkle can’t be from nandani. 45:25but does this mean dr. antia can explain where twinkle’s tears of blood come from? 45:32dr.antia: that’s the only answer i can not give you, the explanation of her symptomson the basis of these lab tests that is something which i have to say sorry… i can’t answerthat question…

45:43comm: but dr. buchanan thinks his investigation has uncovered enough information for a diagnosisto be made. 45:51dr. buchanan: …done an awful lot so i’m ready now to kind of explain to you my opinions… 45:54comm: back at the hotel he tells them what he thinks… 45:57dr. buchanan: … who really wants to understand twinkle’s problem and help her… 46:00dr. buchanan: now, there’s two possibilities

as to what’s causing this. one possibilityis that you have ‘twinkle syndrome,’ totally unique medical problem that no one else hashad before and we’ll name it after you if we can prove that …. that’s one possibility,but in order to determine that we are going to have to see the bleeding start… 46:27comm: this simple fact means no one can rule out the possibility that twinkle’s conditionis the result of something else… 46:35dr. buchanan: …now as you know other doctors have raised suspicion or question about thebleeding and there’s a term called munchausen’s syndrome by proxy…

46:46comm: munchausen’s syndrome by proxy is a rare disorder where a child’s illnesshas been fabricated or induced by a parent. 46:56in most documented cases that parent is the mother. 47:00dr. buchanan:… and that’s why i asked each of you whether this was bleeding thateither of you caused and you told me it wasn’t. i trust you, i believe you. but many otherdoctors haven’t believed you and aren’t going to, until we can actually see the bleedingourselves start without anybody causing it. that would convince people that you don’thave that problem.

47:26comm: but dr. buchanan is offering nandani and twinkle a ray of hope. 47:31dr. buchanan: so i think the best thing ideally, would be for us, to observe twinkle for aperiod of time, twenty four hours a day, so we can see the bleeding start. might be difficultto arrange, and to do, but i will try very hard to see if we can do that … 47:48comm: it’s an offer that nandani is happy to accept… 47:53nandani – how will i know when they have

arranged for everything?george: well, you and i are going to stay in contact and we will have to work out ameans to do that. well, we will be in contact and will try to make those arrangements.nandani: ok. 48:12comm: it’s the news they’ve both been waiting for. 48:16nandani: no one has ever said i believe you or your mother. no one has ever said that.george is saying that. 48:24comm: even twinkle is seeing the bright side… 48:28twinkle: like dr. george said, i am absolutely

fine and i should go back to school, so ishould go back to school. if i go back to school i will be teased (laugh)nandani: ok, so when the children tease you saying that you’re still not better andstill bleeding’ what will you say then? twinkle: i’ll say that i need to concentrateon my studies and not listen to your rubbish!’ 49:01comm: unless twinkle’s bleeding can be observed as it begins there’ll always be the suspicionthat her tears of blood are somehow faked. 49:10until then, dr. buchanan can only speculate as to the cause. 49:18dr. buchanan: it’s heart versus head because

i really very much admire this young ladyand her mother and trust them see a very healthy relationship between the two. my heart tellsme that this really is truly something that i’ve never seen before… my head tellsme as a physician scientist that in fact munchausen’s syndrome by proxy is the most likely diagnosisbut i’m going to keep an open mind at this point. 49:46until dr. buchanan can arrange for the 24/7 monitoring of twinkle in a ‘sleep lab’back home – her case will remain a mystery.