© Dr. Rajas Deshpande
“He is probably brain dead” said the daughter, holding back tears.
“Now we have to make a decision whether to continue treatment or not. We are not that rich. Can you help us decide?”.
Not very pleasant, nonetheless the inevitable duty of a doctor: to decide when to pull the switch off. We suffer these decisions too. I went with them.
The patient had developed a heart attack just after a supra major heart surgery, the risk was already predicted by doctors and accepted by the relatives. Now he had no visible signs of any brain function, and the doctors had updated the family so. What with film stars alleging that “some hospitals keep dead patients on ventilators”, most hospitals and doctors now are on the overprotective / overcautious drive, especially with a society that has more blind faith in cinema than in medical profession. © Dr. Rajas Deshpande
As I examined the patient, the handsome junior cardiac resident doctor, Dr. Paramjeet, standing by my side kept on informing me details. An uncorrupted mind of a resident doctor, who wants to do good to all patients, save every patient with heroic efforts was too evident in his demeanour. As in most cardiac care units, the smartest and fastest nurses were hovering around, silent angels who do such enormous complicated brilliant work without any hoopla about it!
I found some doubtful signs of life in the patient’s brain. I told the relatives “His brain is alive, we do not even have a right to think of stopping treatment at present”.
“Don’t worry, Sir, we want to continue. Make all efforts for him please, we will make arrangements too” said the daughter, with something that most doctors see every day: tears, smile and a heavy throat all at once. © Dr. Rajas Deshpande
As I instructed about the changes in prescription, I noticed that Dr. Paramjeet was tearful too.
Outside the CCU, I asked him what was wrong with him. He told me he had had an argument with his boss that morning, when the boss had told him to inform the relatives about this patient being probably brain dead. He had assisted his boss for this surgery, and was reluctant to let the patient die under any circumstance. However, the boss had seen many more seasons, and knew what was legally required, even if it was against common sense sometimes. The boss cared for the patient as much, but was aware of how things go wrong when the relatives are suspicious and faithless.
I received a call from that unit after two days again. The patient had started moving one leg. Dr. Paramjeet and the nursing staff were very excited when they told the details of his improvement. There definitely were more signs of life. The family was completely cooperative, and repeatedly assured the doctors of their trust in the on-going treatment and the staff’s efforts.
In another week, the patient opened eyes. In a month, he started speaking a few words, and standing without support. He was discharged. © Dr. Rajas Deshpande
Yesterday, the whole family came for a follow up. Dr. Paramjeet accompanied them too, happily carrying his gift bag. The patient had regained almost all his faculties, the cardiac surgery had given him a new life. The family told him once again in front of me, what all had happened. Then the wife, who was always there by the patient’s side but had never spoken a word, folded her hands and handed over to me a box of sweets and a shirt and started to speak, but choked upon her emotions. “You returned me my husband” she said. © Dr. Rajas Deshpande
Well, my mental OCD acts up sometimes too, and I told her that it was the cardiac surgeon, Dr. Paramjeet and the nursing staff who saved her husband, not me.
“Yes, but it was you who told us we must try. You doctors have powers like God” she said.
That was simple to answer.
“Tai (Sister)”, I replied to her, “Whenever a patient completely trusts the doctor, it becomes an automatic responsibility of that doctor to cross all barriers and make every effort to save that patient. That power is in your faith. We have just done our duty”.
When they left, Dr. Paramjeet showed me his gift: a wrist watch and a gold chain. “I am gifting these to my Mom and Dad, Sir, when I go home this diwali!” he told me.
I knew how his parents would feel. Every doctor knows it.
© Dr. Rajas Deshpande
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