I met Mr P
at a function organized by a society of my community, to honor me in my home
district. They claimed, I was one of the few from my community, who returned to
work in India after working in Melbourne. Also my uncle was standing for
elections in the society that year, so he actively went about organizing the
function to subtly convey to the voting members, that he supports young
achievers in the community.
A certain Mr
P was invited to be the MC (master of ceremony) in that function, he later told
me he was felicitated by the same group earlier. Mr P has great command over
English and his mastery has to be heard to be believed. He is an expert in languages.
His PhD thesis was about a dialect in Naga language. Government of India
approaches him for work related to North eastern languages. To top it all; he
was a student of Prof U R AnanthaMoorthy. Yes, the same alleged rationalist who had
claimed that he urinated on (his) village deity at night when no one was
looking. I was in my early thirties at
that time and he was in late forties. When we spoke to each other we came to
know that we stay in the same neighbourhood in the city. So we decided to keep
in touch.
Our meetings
were feared by Mrs P, let me call her Babhi. We used to be loud and
argumentative. I never believed a word he said and used to make fun of Nehru,
Gandhi and Socialism. He a true follower of AnanthaMoorthy used to give me back
in kind. We still fondly remember the day Babhi came with a chapatti roller in
hand and threatened us to stop fighting in such loud voice. She said: she was scared that
the kids will think we were actually fighting (although I believe she was scared
herself). We turned out to be great friends and still are, to my credit Mr P
today has turned capitalist and agrees that “woke” phase of life should not
last beyond adolescence.
This weekend article,
is about his younger daughter S and her husband. S was
a 16 yr old when I first met her. She was a bright student and went on to
become an engineer in computer science. Like all CS engineers of early 2000,
she moved to Amrika and started working in the Silicon Valley. It was
here she met her John Doe. Mr P the liberal that he was did not oppose to their
marriage. I used to occasionally rake up about S to tease him; by repeating
his old dialogues about communism being a product of capitalist oppression blah
blah...
Newly wed
S and her husband Mr John Doe visited India and stayed in Mr P’s home. Me
and my wife invited them home and had lunch together, discussing about life in
US, harping about non availability of domestic help in the US, which is taken for granted
here. Mr P and a friend of his had arranged for their visit to Madikeri and
surrounding areas so they were off to Madikeri next day.
By 3 PM next
day, my wife called me (I pick only her calls on my cell inside hospital) and
told me to talk to Mr P, that he was calling me continuously and I had not
replied his calls. I knew something was wrong, so I called Mr P immediately. He
was almost crying and it took me awhile to understand that John had been bit by
a snake and was not responding after first aid in Madikeri Govt Hospital. I
knew Dr Ravi, an old student now a colleague who was working in Madikeri Govt hospital and
called him immediately, he appraised me of the situation and told me snakebite
was on right elbow and John was responding to painful stimulus. Dr Ravi had
done all the necessary first aid. I requested Dr Ravi to accompany John and
S to the hospital where I was working at that time.
It was 11 PM
when they reached our casualty. I was waiting there after hand-holding Dr Ravi
in managing the patient through the transit. John was awake but intubated and
Dr Ravi was giving him artificial breaths using an ambu bag. He was able to
manage a weak thumbs up sign when he saw me otherwise his muscle power was very
poor. He was shifted immediately to the ICU, snakebite protocol started and put
on artificial respiration through a machine called ventilator. He appeared to
have stabilised for the night. I explained to Mr P and S that their
presence will not help John and made them leave to their home.
Next day it
appeared as if John had gone into a coma. His heart rate seemed to be fixed in
a window of 50 to 60. He was not responding. His GCS was 3/15 with absolutely
no response for even deep painful stimuli. His pupils were not reacting to
light and not a muscle moved in his body. I was deeply worried, had no idea how
to face S or Mr P but I had to do it. When I met them in the counseling
room; S was crying hard and Mr P had tears in his eyes. I explained everything to them dispassionately (years of ICU practice has converted my heart into
stone: says my wife) and gave them no guarantee about John’s recovery. Hope
and prayer was the last resort, so I told them to pray.
John’s
condition did not improve the next day; my staff and junior doctors had
already started susurrating behind me, I could perceive them make eye signs to each
other. Sir “patient’s pupils are not reacting to light”; they informed me three
times in the day as if I had not heard it the first time. I had my doubts too;
I rummaged through all available data on snakebites and found one similar
report by a doctor called Rallis. I emailed him and asked for his phone number.
Dr Rallis a nice man, he called me back. I explained to him John’s condition.
He asked me to stay put and continue the supports as long as John’s heart holds
and if necessary support aggressively and last but not least: don’t worry about
non reacting pupils.
After 3 agonizing days I got a call from ICU at around 2 AM. I thought John may have
kicked the bucket; but to my merry, I was informed that John’s pupils had
started reacting to light. I got ready and drove to hospital to check and was wonder-struck to see him, showing signs of life. It was pure ecstasy nay
jouissance. Very few understand how a doctor feels when his almost dead patient
comes back to life. I thanked Mahadeva Mallikarjuna Swamy for it.
Next day I allowed
my next in-charge to explain the good news to S and Mr P while I observed
his performance carefully. It had become my habit by then, to allow juniors give
the good news while I personally discuss bad news with the patient relatives.
In the next
2 days John improved very fast and was off artificial respiration. S and
John send me a card now every year for my birthday.
Doctors like
myself carry the burden of a graveyard in our minds of all the patients we
lost. Amidst the graveyard, we do remember these beautiful memories like a lost
person in desert who comes across an oasis.
Dr
Jagadish J Hiremut is a superspecialist medical doctor based out of Bangalore,
a medical author, blogger, medical technology expert and is a proponent of
Value Based Ethical Medical practice. He is Director for clinical services and
Advanced Medical Technology in the home grown multinational medical equipment
company Skanray Technologies Pvt Ltd. He is also CEO of ACE Embedded Intensive
Care Units Pvt Ltd a company which runs outsourced Intensive Care Units for
hospitals. You can follow him on twitter @Kaalateetham or mail to drjagadish10@gmail.com
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