anonymous

TO LOVE IS TO HELP LIVE - 2

 TO LOVE IS TO HELP LIVE - 2

DR.S.N.BHAGWATI

Dr Ramdas had just come back from United Kingdom having completed his further training in General Surgery and obtaining a Fellowship of the Royal College of Surgeons in England (FRCS). He had a brilliant academic career. He had bagged several prizes during his school and college days and passed his Masters in Surgery Examination of the Nagpur University with flying colours before he went to U.K.

He was bubbling with enthusiasm to start his practice and had taken up his academic assignment at the Medical College as he loved teaching. Just before he left U.K. to return to India, Dr Ramdas had started experiencing tingling and numbness in his right upper limb. He had no other symptoms. He consulted a neurologist who examined him thoroughly and found no abnormality. Dr Ramdas was assured that his symptoms would clear up and that he did not have any serious problem to worry about.

However, a few weeks after his return, he started experiencing little difficulty in writing with his right hand and soon developed some impairment of sensations in the fingers. Plan X-rays of the cervical spine were normal. A lumbar myelogram was performed with myodil as he had definite neurological involvement suggesting a lesion at the level of the fifth cervical spine. To our horror, we found a total block at lower thoracic level with appearances suggestive of an intramedullary lesion that had expanded the cord from tenth thoracic level upwards. A cisternal myelogram from above was then performed. It showed a lesion from mid cervical level downwards with a total block at Cervical seven level (C1).

That meant that Dr Ramdas had a very long extensive intrame lesion of the spinal cord even though it had manifested with minimal neurological deficit.

Dr Ramdas was married to a lovely medico who had been student at the medical college. Her parents were quite wealthy and willing to pitch in and get the best available medical treatment for their son-in-law. Dr Ramdas knew the gravity of his illness. This was revealed to his wife and to his sister and brother-in-law who were young medicos. Excision of this tumour could lead to complete paralysis of both arms and legs with respiratory distress and sphincter impairment that is, loss of control of urination and defecation. Dr Ramdas' medical record and myelogram were sent to a world-renowned neurosurgeon in Switzerland. He was reluctant to take up Ramdas' case for surgery as it was associated with a high risk of paralysis of all the four limbs Moreover, the expenditure incurred for this treatment would have been enormous. Therefore Dr Ramdas and his family decided to have the surgery done in India.

It was decided to do this surgery in two or more stages. At first the cervical part was tackled. Laminectomy of cervical and upper dorsal vertebrae was carried out during which an extensive tumour was found within the spinal cord. The cord was split and the tumour was gradually excised from 4th cervical to 2nd thoracic segments. The operation lasted eight hours. We were happy to find that though he had developed some weakness of the limbs, he could still move them. This encouraged me to go ahead with the next stage of the operation a few weeks later when a total excision of the remaining tumour was carried out by splitting the dorsal cord. He developed further weakness of his lower limbs immediately post-operatively and then again started to show some improvement over the next few days. However, his wound broke down and needed to be re-sutured. He developed mild sepsis following which he developed almost total weakness of both his lower limbs. His control over urination and defecation was also lost. Intensive physiotherapy was started and a gradual rehabilitation was commenced.

It was quite apparent to Dr Ramdas that now his chances of a good recovery were remote. He also knew that he could not have a normal marital life. Even though his wife was against it, he persuaded her to divorce him so that she could have a normal life and have a family. Theirs was a love marriage and Dr Ramdas could not bear to see his young wife sacrifice her life totally for him. The decision to divorce her must have been a very painful one. He did not lose time to enforce this decision and saw to it that she subsequently got married.

 

After weeks of intensive physiotherapy, it became possible for Dr Ramdas to sit in a wheel chair. Though he could move his arms, it was not possible for him to use his fingers for any finer purpose. It was clear that

could not perform surgery any more. This was enough for anyone to go into a severe state of depression. With the indomitable will power that he had, Dr Ramdas decided to make the most of the life that God had given him. He loved students and loved teaching even more. Very soon he started taking clinics for the students and he became the most popular teacher whose teaching sessions would be attended by the maximum number of undergraduates as well as post-graduate students. The students loved their wheel-chair teacher who spared no efforts to impart as much knowledge as possible to them.

The Medical College and hospital authorities were very considerate. He was assigned the special side room of the surgical ward that became his new home and was looked after by the nurses and his students with great love. All his needs were provided for and the side room - his home - became an office also.

After some time, Dr Ramdas decided to specialise in Radiology as it was not possible for him to do surgery. He felt that he was not doing full justice to his job and that he should take up an activity wherein he could devote as much time as any of his co-staff members. He did not want any pity or sympathy. He was grateful for the facilities that were extended to him and wanted to give back to the institution as much as he could. He started attending the post-graduate course in Radiology and finally secured the degree of M.D. in Radiology. He was now transferred as Assistant Professor to the Department of Radiology. His reporting sessions and teaching clinics once again attracted a lot of students. The department started humming with academic activity.

During these years of trials and tribulations, his mother, his sister and brother-in-law stood solidly behind him. Dr Ramdas came from an average middle class family without much financial reserves. The entire family pooled together its resources ungrudgingly. They spent every minute they had with him, supporting him actively in his fight to lead as near a normal career as possible. Both his sister and brother-in-law refused promotions as these would have led them away from Nagpur. They would not dream of being away from Dr Ramdas and his mother who needed their support. They continued to shower their love and affection on these two generously and have been pillars of strength to them for near twenty years!

Whenever I have an occasion to be in Nagpur, I make it a point to visit Dr Ramdas. It was a matter of great joy to me when, during one of my visits, he took me down to the hospital canteen and offered me an aerated drink. He wheeled himself down to the cafeteria and refused help in doing so. One could see the sense of pride and satisfaction on his face when he sat in the canteen for about a quarter of an hour and had refreshments.

It was again a privilege for me to operate on Dr Ramdas' mother for a brain tumour. Fortunately the tumour was benign being a convexity meningioma. Normally I am averse to performing such cold procedures anywhere except in Bombay Hospital. I offered to perform the surgery at Nagpur with the help of Dr Deshpande since that would help Dr Ramdas to be with and visit his mother daily. This was the least I could do for a man whose courage, will power and determination to lead a meaningful life I admired. Fortunately, the mother did well and I meet her too, every time I am in Nagpur.

Dr Ramdas now lives with his sister in hospital quarters. He spends most of his time at home either in bed or in a wheel chair. The children hover around him all the time. The family makes sure that someone or other is always present in the house when Ramdas is in. From time to time accompanied by the little ones he goes out in his wheel chair for some fresh air. This is a saga of endless love and affection that has made Dr Ramdas sustain himself with courage and fortitude with the handicap that he has been laden with. It is a story of sheer grit and determination, of a desire to discharge one's duties in life, to lead a purposeful existence and brave all problems with a smiling face.

One cannot remain without admiration for this wonderful man and his devoted family.

Compilation of professional reminiscences of specialists - edited by M.V.Kamath and Dr.Rekha Karmarkar.