The Full Stop and The Comma

The Full Stop and The Comma
(c) Dr. Rajas Deshpande

A panic struck voice shouted on the other end of the phone: “Doc, This is Neerja. My husband suddenly cannot remember anything. Not my name, not even the kids. I am rushing him to the hospital. Can you please see him now?”.

Mrs. Neerja Dev was my old patient, under treatment for migraine. Actually it was late and I was done for the day, but when faith and trust calls, a doctor cannot say no. I drove back to the hospital.

Her husband Mr. Alok, a young and handsome software engineer in his early thirties, was placed in a big multinational. He was his company’s blue-eyed beloved, groomed for a long-term high flying career. His salary much exceeded that of the President of India. I had met him earlier, when he accompanied his wife. Quite brilliant, he had an arrogant attitude to go with his achievements. Neerja had often complained in privacy that she had a lot of stress as her husband worked excessively, had too much responsibility upon his shoulders, and growing up two daughters was left to her. “He loves me and the kids, but he has no time to spend with us” she had often complained.
“There’s cut-throat competition in the software industry, I need to work hard to be where I am” Alok had replied curtly whenever the topic came up. (c) Dr. Rajas Deshpande

I reached the hospital and examined him. Indeed, Alok was blank. He could just answer his name, and yes/ no to some questions, but he could not even complete a sentence. As he struggled to find words. Neerja was devastated, and could not stop crying. Their sweet daughters, aged fourteen and seven, boldly waited outside the casualty.

“Did he have fever? Did he take any new medicines? Did he fall down? Was he fasting?” I went on with a long list of questions. Nothing should be left to chance, every bit of information must be collected for an accurate diagnosis. There were no clues from the history. His pulse, heart, and blood pressure were normal. He was able to move well, and had normal sensation all over the body.

We rushed him into the MRI. Alok had many large white spots all over his brain in the MRI, a condition that is called “demyelination”. This usually happens in young patients after viral infections. Some other abnormalities in the immune system can also cause this. I explained the situation and its uncertain outcome to Neerja.

“There is no threat to his life right now, but we cannot comment anything about the recovery”. I concluded.

“What now? Will he recover at least enough to remember me and our kids? What will we do?” She broke down again.

“High dose Steroids may help some patients, but this treatment may increase his blood pressure, sugar levels, and also his chances of developing an infection. Are you ok with this risk?”

“I will leave it all to you. I cannot understand anything now.” She replied.

We started the injections of high dose steroids. His heart rate, blood pressure and sugars were continuously monitored, fluctuations treated promptly. The ward doctors, nurses stayed upon their toes, informing me every hour about him.

Friends from his company and even his boss visited. The boss just asked how long it will take for him to recover. “You know, we have deadlines and our clients need to be informed” he said.

After three days, Alok started to gradually recognise family and friends. In about ten days, he spoke well, and even started understanding what had happened. He was shocked.

“What about my job? Can I work from the hospital? They are dependent upon me. My boss has immense faith in me. Many high end projects need my supervision” he asked impatiently. (c) Dr. Rajas Deshpande

As controlled mental activity is good for recovery of brain functions, I allowed him to work from his hospital bed for an hour or two.

The next day he was all depressed: “Doc, I cannot remember many things necessary for my work. I cannot afford this. Please don’t tell anyone from my company. How long is this going to take? Will I ever completely recover?”

I wished I could reply, but I had no answer. Every doctor is frustrated when explaining uncertainty about outcomes.

“This is going to be a long process. I cannot say how much recovery is possible or how long it will take” I explained to him. His wife and friends requested my permission and sent his reports to various specialists in the developed world, and were reassured that the ongoing treatment was correct. Finally, they accepted the situation.

Alok followed up every month. After first three months his company fired him. His boss who he treated like God, refused to even meet him, and did not reply to his emails. For him Alok was dead. Word spreads. Although recovering fast, Alok did not get any new job. Neerja took up a job, and they divided the housekeeping chores and babysitting among themselves.

The family is now far less stressed, the kids are far more happier now because their father spends more time with them. At a lower income, they have reached a higher happiness bracket. The kids took every effort to jog their father through the past memories,and that has helped him recover faster. There is no higher medical stimulus for recovery than love. (c) Dr. Rajas Deshpande

Yesterday, all of a sudden, Alok came over with a box of sweets, and a greeting.

“I have decided to start my own business. I feel confident now. I may have lost some bits of my brain, but my heart is still strong enough to dream big. I have decided to turn this full-stop into a comma. But this time I have decided that I will first reserve time for my family and then work hard. It is because of them that I am back. I just came to thank you for standing by. My daughter has made this greeting for you “.

The sweets were of course delicious, but the greeting hand-made by his daughter moved me.

It said: “Thank you, doctor, for giving back our papa his dearest family”.

(c) Dr. Rajas Deshpande

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