ICU Seventeen
© Dr. Rajas Deshpande
11 PM. Just as I finished my OPD I received a call from the ICU resident doctor: “Sir, you have a call from ICU seventeen”. I was tired and exhausted, feeling feverish that day. I was not on call, so could request them to send this call to another neurologist who was on call.
But it was ICU seventeen. I hated going to that cabin, my legs dragged heavy, my mind exploded, but I had to. © Dr. Rajas Deshpande
I went there, assessed the middle aged lady on the bed. She was already on a ventilator, had been unconscious since after a head injury. She had been knocked down by a speeding drunkard while crossing the road. This was day two. Examining her, I found feeble signs that indicated that her brain was not dead. . CT scan showed many injuries to the brain. I told her relatives –the husband and the son- about this, and also explained them the uncertainty and unpredictability of outcome.
“Shall we continue the treatment or let go? We are not rich, we can try only if there are good chances of her survival” said the husband and son. The husband was visibly fatigued with the situation, the son was talking to me without looking up from his iPad.
“Although the outcome is unpredictable, in my opinion, you must continue to try. This is not yet a hopeless case”. © Dr. Rajas Deshpande
As expected, they were unhappy.
They wanted quick answers that would either guarantee a good outcome or enable them to bank upon a doctor’s decision to withdraw life support which would make them guilt free. I did not want to hurry a decision for their convenience. My first duty was to protect the patient’s life, not to cater to anyone else’s expectations. A doctor who does not respect life in all its depth has no right to be a doctor. Especially in case of an unconscious patient, a doctor’s responsibility peaks, and sometimes he/she has to even struggle to convince the family to continue treatment. Notions like “dead patient kept on ventilator in ICU” created and catered by some stupids add to this situation. ICU expenses are indeed high. In such a scenario, any doctor who advises to continue treatment in a hope of saving life is indeed suspected to have “financial” motives.
But even that fear was below my duty to the patient. I told them that in my opinion they should not withdraw life support. I told them to continue to try.
“Doctor, what would you have done if your mother was in her place?” asked the son, looking up with a cunning expression from his iPad.
The explosions in my mind restarted. © Dr. Rajas Deshpande
In this same ICU seventeen, just a few weeks ago, I had witnessed my mother’s death. For three days and nights, my own colleagues had fought to tackle the umpteen complications that took away my dearest, and I stood at the door, telling them: do whatever you must, try your best, but save her. In her earlier life, mom had always wanted to live, live longer, and be with her family every moment at any cost. There was no reason for me to presume she did not want to survive. From Geeta to Bible, ever sacred book has advised “Do unto others as you would have them do unto you”. Medicine or law aren’t yet wiser than that.
I am a middle class doctor myself, not rich. I could not afford prolonged treatment. But I was willing to even sell myself if it was required to make my mother survive, even for a day more. She would have done the same for me, even more. There is no age and illness when a mother would want her child to die, and as her dearest son, it was upon me to become her mother when she grew old.
One cruel night took her away. I will never overcome that feeling of standing in the door of ICU seventeen, with the resident doctor and nurse, both crying too, tried to wrestle out my mom from the claws of death. That cabin, that door, that corridor brings back those moments. I cannot show that upon my face, I am a doctor. I work at the same hospital, see these places almost every day, and carry on what I must. © Dr. Rajas Deshpande
I paused to contain the agitations in my mind, then replied.
‘Yes, Sir” I told the son of the iPad: “I am suggesting you exactly what I would have done for my mother”. Still trustless, he continued fingering his iPad. His father sat clutching his head. They continued the treatment, but bitterly.
A week later, she opened eyes. In ten days, I received a call again “Sir, can we shift that lady out of ICU seventeen? She is fine now, conscious and oriented, accepting orally” the resident doctor asked.
“Yes please”, I replied, not without a tear. We couldn’t get my mother back, I will never recover from that memory, but we had defeated death in the same room! © Dr. Rajas Deshpande
Every doctor has had such experience: illness, death and extremely disturbing memories associated with it. They still have to keep their calm and continue to try for their patients what they could not achieve for their dearest ones. It is mostly taken for granted: that doctors have no feelings, that it is so routine for them to see pain and death that they are not affected by these anymore.
It takes a grand courage: that of a brave soldier, to be able to walk again in the corridors of death that have taken away one’s dearest people. The same diseases, illnesses, problems affect doctors and their families too, we fight them, we win or lose, but we come back to the battleground again, every day, to protect every single life we can.
Therein lies the pride of saying “ I am a doctor”.
© Dr. Rajas Deshpande
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