anonymous

BEHIND THE CURTAIN 4

BEHIND THE CURTAIN 4

DR SATEESH R. GUPTE

 My uncle was a general practitioner in Bombay. His elder daughter was diagnosed as having a fibroid of the uterus which is a benign tumour. She was advised an operation. As there was no urgency, she opted for a date of operation after Diwali. She was admitted to a private hospital where an eminent gynaecologist practised. He was a close friend and a classmate of my uncle.

I had just passed M.B.B.S. and was in the operation theatre. After the spinal anaesthesia was given, the gynaecologist started the operation with the doctor and two attending physicians joking among themselves. When the abdomen was opened, however, the gynaecologist suddenly became serious and quiet. He told us in a hushed voice that the tumour looked malignant and stuck to the surroundings and that he would not be able to take it out. He took a biopsy of the tumour and closed the abdomen. A chill descended in the operation theatre.

Coming out of the OT, the gynaecologist told my uncle waiting outside what the facts were and promised to personally speak to Dr Borges, the eminent cancer surgeon of that period, to take over the case. Young and inexperienced as I was then, I did not feel the situation was totally hopeless and felt something could still be done for her.

The patient had a very excruciating headache the next day and would not respond to any analgesic. We did not suspect anything serious till the third day when she started showing signs of facial paralysis, squint etc. The gynaecologist who normally never saw a patient post-operatively, was informed by the physician who diagnosed her as having meningitis. They realised that the infection had gone through the spinal anaesthesia injection. Another spinal puncture was done and frank pus came out which, on examination showed a very resistant bacteria to be the causative agent. There was no medicine locally available, so we telephoned a relative in London and asked for the drug to be airlifted and it duly arrived in two days' time. This had to be given in the spinal fluid where the infection was but every time we gave the injection the patient would have severe convulsions and would turn blue. There were times when I felt that she would not survive one more injection.

But after six injections, the meningitis was brought under control; the fever left, but the patient became completely paralysed below the waist. She could not move her legs, she had a squint in her eyes and it was as if some one had practised black magic on her. The gynaecologist could not hold back the tears in his eyes when once she asked him: "Doctor, why has this happened to me?". All he could say was: "What can I say! It has to be your luck and my luck!" But not once did my uncle ask him how it all happened or what was the true cause of the tragedy. Those were the days of trust. The old man would have a tear in his eyes and his voice would choke when he discussed her future with me, but he never showed his agony to any of our relatives. Always he would assure them that she would get well.

After three weeks at home in a paralysed condition, we had to show her to Dr Borges for the malignant tumour that the gynaecologist had noticed. We took her in a chair to Tata Memorial Hospital. Dr Borges saw the patient, took note of all the reports and seeing my uncle's sad face joked with him to cheer him up a bit. He then got her admitted to the hospital for surgery.

My uncle had broken down by that time and could not come in to the operation theatre while Dr Borges did the operation. I was in attendance. Dr Borges told me in plain terms that the disease had gone too far and that taking out the tumour involved a grave risk.

I had just become qualified as a doctor and had no experience but my commonsense prompted me to say that it was worth taking the risk. The tumour was removed, the patient was given five units of blood transfusion, but she was young and made a fairly rapid recovery. She was then taken regularly to Tata Hospital in a chair for radiotherapy and check-ups. Dr Borges-a kind man--saw the suffering of a young life and the trauma of the people around her and told my uncle: "Listen, now onwards, she doesn't have to be brought to the hospital. I will come and see her at your place and the only thing you will have to do is to give me a cup of tea!" And this from a busy man who had hardly any time for himself or his family!

Thereafter he regularly visited her for check-ups and kept everybody laughing with his jokes and became a close family-friend. The patient not once asked her father, sisters, husband or me, whether she would ever get well. She did not even ask whether she had cancer or why she was being taken to the Tata Hospital to be given radiation. She would hug her four year old son but not once did we ever see her cry during the long illness, except, perhaps when she saw us struggling to carry her up three flight of stairs. I was really surprised at the stoic front she put up. She never showed what went on in her mind.

Six months after she was first operated for fibroid, in July 1960, I had to leave for England for further studies. A day before my departure, went to see her with a heavy heart, I vividly remember that day. In my small way I had done whatever I could to look after her and lighten the burden of her father and the rest of the family. Her husband had bought an ivory lamp as a gift for me, which she gave to me saying: "Sateesh, get through all your examinations quickly. I will be at the airport to receive you on your return!"

But I knew for certain that she won't ever be able to walk nor even live long enough to receive me on my return. I controlled my tears. I knew that she was merely trying to cheer me up and to stop me from breaking down.

I stayed in England for five years. During all that time I would make regular inquiries about her. I was told that she was taking physiotherapy, underwater exercises and so on. In two years time, she had started to walk, first with some support and then without! By the time I returned in 1965 she was driving a car! And she certainly was at the airport to receive me as promised. Her disease was so advanced at the time of the first surgery that we really didn't believe that she would live. How she survived the post-operative period and conquered her paralysis I have no way of knowing unless I can attribute it to her tremendous faith and positive thinking. She had not the slightest trace of self-pity. She was Mother Courage incarnate. She cried like a child when Dr Borges himself died of cancer. She is well today with God's grace and her husband celebrated her sixtieth birthday in a fitting manner. That is some story!

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