Thursday, March 3, 2011

The other side

My contribution to Chicken Soup for the Indian Doctor's soul -  (published by Westland.) Link to the  book

 I was a robust young man of thirty two years and doing well in life. My practice as a pediatrician was well established, I had just brought my first car and life was good. I had worked pretty hard to achieve my standing as one of the better doctors of my town. I worked on Sundays and holidays, never turned down an emergency and worked unearthly hours. I did not even slow down when fatigued or sick. I simply popped a painkiller and carried on.
I still remember that fateful morning very clearly. I woke up at 4.00 AM with severe pain in my neck. I was slightly disoriented with sleep and the pain was unbearable. I called up a fellow physician and asked for advice.
“If the pain is unbearable, take an analgesic. I’ll send over a nurse to give you the injection and we’ll get you investigated in the morning.” He advised.
The nurse came and gave me the jab. After a few minutes I felt a sudden weakness of my right hand. I was half asleep by then as the pain had subsided just a bit. I just decided to go back to sleep with the hope that I would be fine when I woke up.
When I woke up some two hours later, I realised that my right hand and leg were completelyparalysed and I could not move them. Now that triggered off a major alarm and a lot of doctor friends descended, examined me and tried to reach a diagnosis. On failing to reach a consensus, they decided that I would be better off in an institution. So I was bundled in a wheelchair and we caught the next train to New Delhi.

We reached in the evening and made our way to G B Pant Hospital. As we reached late, none of the consultants were available. However, the resident on duty admitted me and assigned me a bed in the general ward as there was a month long waiting list for private rooms. (Those were the days before the five star private healthcare establishments and health insurance had flooded the country)
I had virtually grown up in those surroundings as most of my life had been spent working in government hospitals; first as a student, then a trainee and later a consultant but for the first time in my life, I found myself on the other side of the divide. The ward was dirty, the toilets stinky, and all the beds were occupied by patients in even worse condition than me. That was the longest night of my life. I could not sleep as the pain in my neck had returned with a vengeance. I did not know whether I would ever be able to stand or walk again in my life. Frightening visions of dreadful diseases like cancer, nerve degeneration and other unknown entities kept playing in my minds eye. I realised that the uncertainty of the diagnosis was playing on my mind. 
The night of misery passed (they always do) and the morning brought hope in form of Dr. A. K. Singh, the professor of Neurosurgery. The whole day was taken up by extensive investigations he ordered, and evening found me in his office on a wheelchair.
“Vivek, I have studied your case in detail, and frankly, it is confusing. Your paralysis is due to a lesion in the neck. The MRI has revealed a fluid collection in the cervical spine which is pressing on the spinal cord. The radiologist suggests a possibility of tuberculosis but I am not convinced. We have two options; we either put you on anti-tubercular drugs empirically or open up your spine to see what the problem is.  If required, we may even take a biopsy during the surgery. If you wish, you may even go in for a second opinion.” Dr. Singh said.
“Sir! What would you suggest?” I asked.
“Given a free hand I would do a laminectomy and take a look. The fluid collection at that place is definitely odd and something tells me it is not TB. But opening the cervical spine is tricky business and there is always the possibility of complications. You are a doctor and that is making me hesitate. Why don’t you take a second opinion?”
It was then I made the most important decision of my life. “Sir! I have full faith in you. Go ahead with the Surgery.”
The good doctor was still hesitant, “Vivek, are you sure? Why don’t you discuss the matter with your family before reaching a decision?”
I simply reiterated my faith in him and God and asked him to go ahead.
Next afternoon I was wheeled into the operation theater. As the anesthetist started the pre-operative drugs, I had a sudden panic attack. “I am not getting out of here alive,” the thought which was at the back of my mind came to the fore with a blinding flash and frightening certainty. However, I managed to hold on my faith in God and the Surgeon. The drugs took hold and I slipped into oblivion. I woke up after a few hours. I realized two things. First, I was still in the realm of the living; second, I had not been shifted out of the operation theater. I saw an unknown face peering at me and asked him, “May I talk to Dr. Singh please?”
“He left around half an hour back after completing the surgery. I am the anesthetist and was waiting for you to come around.”
“Could you please tell me what was the per-operative diagnosis?”
“Nothing! There was no significant disease. We found just a small blood clot that was pressing on the spinal cord and causing the paralysis. I will be shifting you to the recovery room and you should be able to move in a couple of days.
Dr. Singh visited me in the evening and clarified that all the symptoms were caused by a simple clot of blood and there was no evidence of any other pathology. I walked out the hospital a week later and have been absolutely normal for last fifteen years.
Later, I realised that all the analgesics I had been taking off and on had precipitated the bleed. I have forgotten the sufferings, the mental and physical anguish and the feeling of helplessness and hopelessness of those days but not the lessons learnt from the episode.
The suffering has made me a better human being and a better doctor. Now I know how it feels to be on the other side. I realise that however bad things may seem at a particular point of time; tomorrow is always better. Now the motto of my life is, this too, shall pass. I understand that one must always keep faith in the treating doctor and in God. And instead of offering sympathy to my little patients and their parents, I give them empathy. Lastly, since that day I have never abused analgesics or overprescribed them to my patients.

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  1. This is truly mind blowing.

    Ankit Uttam

  2. Nice one ... Awesomely written!

  3. @Ankit and Nikesh. Thanks for your comments. The story is true and my contribution to Chicken soup for the soul- Indian doctors. I posted it on my blog to get some readers reactions.

  4. very well written.we ppl are witnesses of that episode.hats off to you for such a brave decision.

  5. What a heart warming story! Thanks for sharing.

  6. Proud of You Sir, mixture of emotions here

  7. Heart-touching! True, sometimes life throws us into a situation simply because it wants us to come of out it as a better human, or perhaps, a better untainted soul! :-)

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  8. A very interesting and engrossing anecdote,I immensely enjoyed reading.......Wish to read more from you.