It was my first day at work as a house officer in a remote village in rural India. My supervising doctor had finished for the day and had gone home. I was about to leave when I was told that a “regular jaw dropper” had arrived. Curious to see who it was, I was greeted by an 80 year old man and his wife. The old man's mouth had refused to shut and was held wide open with some discomfort. Weird and wonderful differential diagnoses flashed through my mind, but, try as I might, I could not recall any major illness that had this sole symptom. In order to gain some time, I tried to discover more about the problem. The patient himself being unable to speak, his wife provided the …