Tag Archives: brain

The Illiterate Man with Brain Tumors, Fits and Common Sense.

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The Illiterate Man with Brain Tumors, Fits and Common Sense.
 
“I have brain tumors. Is it possible to treat? Will I survive?” asked the worried man as his wife tried to hide her fear of the answer.
 
10 years ago, as I sat in a peripheral small hospital outside Pune, a simple couple had walked in, carrying their poverty in obvious signs upon them. Mr. Sakharam Pawar worked as a mason, mainly repairing foundation and floors. He had recently had a convulsion, and his Brain MRI had shown multiple tumors with swelling around them.
 
One of his relatives staying with him had had tuberculosis in the past. His clinical examination revealed signs of increased pressure within the skull. After a few simple tests, I told him that the tumors looked like tuberculosis growth (called tuberculoma or Tb Granuloma), and there was a good chance that they would respond to medicines, if he took the medicines regularly without missing for a single day. He agreed. An anti-convulsant was also started.
 
The course was prolonged, over a year, and the drugs were known to be notorious. Mr. Sakharam did not ask me a single question. When I updated him about the serious side effects like liver failure or vision or hearing loss that could result because of some his medicines, he replied “Doctorsaheb, I am sure you know what is best for me. If a side effect develops, it is my fate. I know you will help me there too. I leave all the choices to you”. I was amazed at this compliance and trust. He was barely literate (can only sign his name), but his choices spoke of an excellent common sense. In an age where even the well-educated resort to all kinds of Babas, Gurus, Herbals, Net claims, ,self-treatment and even black magic, this illiterate couple was making scientific choices!
 
He did not even seek a second opinion! A doctor’s responsibility multiplies when his / her patient completely trusts them, no doctor abandons the best interest of such a patient.
 
A year later, his Brain MRI showed that all the tumors had vanished, only a small scar remained. His medicines were stopped, except for the anticonvulsant which he will have to take lifelong. He takes this single tablet regularly, and we try and make it available for him at lowest cost by requesting the pharmacy. He hasn’t had any convulsion since many years now. He visits me once a year, and brings me words that make my day. This poor, illiterate man has defeated a high-fatality disease by making the right moves in time!
 
Today I asked Mr. Sakharam if I could tell his story to the world. He agreed. Then he mused and replied “I want to tell everyone that when I was first diagnosed with this dangerous illness I thought it was the end of the world. Then I discussed with my wife and we decided to fight this with proper treatment rather than superstitious decision making. The most difficult part was that I had to keep working in spite of severe headaches and the nausea caused by medicines, as we have no other source of income. But I am happy that I have defeated such a dangerous form of tuberculosis. I would like to appeal to people to go to the doctor in time, take scientific medicines and do not fall in the hands of quacks”.
 
Indeed, we see many cases of tuberculosis, tumors and so many other diseases of the brain that reach us too late to be saved or treated. Many (even highly educated) patients resort to unscientific options and waste precious time. Many a paranoid literates would have questioned every single thing right from the necessity of an MRI to the medicines used, and threatened their doctors with legal action for adverse effects of medicines. What this uneducated, illiterate couple demonstrated really questions whether education brings common sense to all.
 
Our medical director Dr. Sanjay Pathare assured Mr. Sakharam of all the help for the future.
 
The happy couple left with blessings upon their lips. A doctor’s day was thus blessed!
© Dr. Rajas Deshpande
 
PS:
Due permissions obtained from the patient for publishing this educational post. There are thousands of great doctors all over India, even in the biggest private hospitals,, who diagnose and treat poor patients without charging fees. The purpose of the post is to spread awareness that all brain tumors do not need surgery, that most tuberculosis cases can be cured completely, and also that with proper compliance, convulsions can also be controlled completely.

Can Anyone Solve The Mystery of Atmaram’s Courtroom Death?

Can Anyone Solve The Mystery of Atmaram’s Courtroom Death?

©️Dr. Rajas Deshpande

A hungry poor man named Atmaram went to a big hotel, had a nice big meal, and told he had no money to pay. He was beaten up and handed over to the police. He was released after a warning and a slap.

Next day he filled up petrol in his bike, and said he couldn’t pay. He was again beaten up, handed over to the police. Then he went to the medical shop, bought medicines and mineral water, ate the medicine, drank water from the bottle, and again said he couldn’t pay. He was now jailed for a week.

Next week his house was damaged by heavy rains, so he went and requested to be allowed to sleep in the house of the chief minister. He was arrested again, thrashed up.

As angry Atmaram shouted at the police, he was beaten up by them, another crime was added to his offences. In the court, Atmaram insulted the lawyers and judges and accused them of accepting bribes and charging too much. The judge punished him extra for his behaviour. Atmaram was angry and threw his shoe at the judge. His punishment was extended.

“You must respect the authority “ the court said.

“But I am poor, I need free food and petrol and medicines. I need sympathy too” Atmaram argued.

“You should have begged and applied for favours and eaten in places that provide charity meals. Petrol, however essential, has the same price for everyone. You can sleep on the footpath, and above all, you are not allowed rudeness and violence because you are poor and needy” The court said.©️Dr. Rajas Deshpande

When released from the jail, Atmaram drank a lot of desi alcohol, had an accident and fractured many bones. He went to the best private hospital, got operated and refused to pay his bills that crossed one lac rupees. When the hospital insisted, the operating doctors were beaten up by Atmaran’s relatives, the hospital was vandalised, the police arrested the doctor who saved Atmaram’s life, the government closed down the hospital, while the media and the society kept villainising the entire medical profession.

The headlines next day reported the sympathy expressed uniformly by wag addicted tongues: some said the entire profession was tainted, some blamed the greed of the doctors, even some doctors desperate for attention shed crocodile tears about the ethics in this profession. ©️Dr. Rajas Deshpande

In the courtroom, during the trial, Atmaram sat facing the doctor, still heavily bandaged.

The hon’ble judge, kind but surrounded by security, told the doctor accused of negligence and malpractice in the court: “You as a doctor carry more responsibility for ethical behaviour upon your shoulders. You should never turn away the poor”.

The doctor, defending himself, asked “but Milord, doesn’t our constitution insist on equality? Why do you yourself or ministers get security but not the doctor? Why isn’t everyone supposed to stick to ethics in every profession including politics, police and judiciary? Why are others exempt? How do you explain beating up of doctors while also saying that the society treated them like gods?”.

There were no answers. The kind court asked if the doctor had to say anything else in his own defence.

The doctor said

“Yes Milord, but the real answers will hurt:

Jealousy against medical professionals across society and many other professions is a reality. Why else will anyone who couldn’t qualify to become a doctor try and teach the qualified doctors what they should do?”©️Dr. Rajas Deshpande

“A culture of exploitation of non-votebank groups

and a complete failure of government healthcare with no one accepting responsibility is well known to everyone, but even judges have no courage to suo motu question this and correct it, even when they see the poor dying”. ©️Dr. Rajas Deshpande

“In a country with never ending poverty, how much free can a healthcare facility provide? For how long? This is already forcing closure of hospitals and exodus of good doctors out of the country.”©️Dr. Rajas Deshpande

“Milord, can you assure that every doctor will get his/ her fees as per his service to every patient, and if the patient can’t pay, that much charge will be exempted from the income tax of that doctor? How else do you except a doctor to meet his needs and dreams? Just because there are millions of poor patients, is the doctor’s life and hard work taken for granted? If there has to be financial sacrifice, why not have everyone contribute to it by creating a national health tax fund for treatment of poor patients? Why healthcare is subsidised only at the cost of a doctor?”

Just at this point, Atmaram, who sat in front of the judge, collapsed unconscious, almost blue black.

The shocked judge requested the doctor to examine him.

“He is no more” said the doctor.

“What could have happened ?” asked the kind but sweating judge.

The doctor told the court about three possible reasons. Two of them were scientific and medical: a sudden cardiac event or a large blood clot in the lungs common after fractures and trauma.

The third non-medical, unscientific cause made the Judge seriously ponder.©️Dr. Rajas Deshpande

“Will this court be now closed down, Milord? Will your efficiency be questioned, will you allow the relatives to attack you and understand their sad situation at the cost of your murder?”

“I understand what you mean” said the kind judge.

Needless to say, the doctor was released without a blame.

Can anyone please solve the mystery of the third non medical, unscientific possible cause of Atmaram’s death?

(C) Dr. Rajas Deshpande

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The Changing Blood Group

The Changing Blood Group

(c) Dr. Rajas Deshpande

“He is sinking” shouted Dr. Siya.

The casualty registrar rushed to the bed, checked the vitals. Pulse very fast. Blood Pressure very low. Lips and nails white, hands and feet cold. The young man, unconscious, was on the verge of death.

“He must be bleeding inside. Get an urgent sonography of his abdomen”said the registrar to Dr. Siya, and call the blood bank. He will need at least two units of blood urgently”.

It was Dr. Siya’s first week into internship, she was thrilled with the idea of actually saving lives. At the young age of 22, she was witnessing death almost every other day. Along with that she was amazed to see the darkest sides of human nature: the potential of humans to hurt each other: via rapes, accidents, murders, fights. She had decided to not let this affect her attitude, and to continue to try and save every life she could.

That late night, this young man of about her own age was brought in unconscious by someone, who had just dropped the patient in the casualty and left without leaving any identity of himself. “I found him lying unconscious on the road. I don’t know anything else about him. I am just doing my duty, I have a train to catch”said the stranger and left. The patient was reeking of alcohol. He had a visible head injury. A quick CT scan had revealed minimal bleeding due to a small skull fracture. He also had had bleeding from wounds from his hands and legs, they were sutured. The patient had no identity marks, wallet or cellphone. The policy of the hospital was to provide basic treatment and shift the patient to the government hospital. The police station was already informed. Treatment was started.

Dr. Siya requested two units of blood. The blood bank called. They had only one unit of the blood for his blood group. The registrar had the same blood group, and like many doctors working in the emergency departments, he went down to donate blood.

It was nearly midnight. The fate of the life of a young man depended upon what the junior doctor did just then. There was no one to sign any consents, the protocol was to inform the hospital’s medical director and obtain consent for emergency transfusion or procedure. Dr. Siya finished the formalities, obtained the permission, and started the transfusion. If the patient had reacted or something went wrong now, they all feared, there will be a havoc in the media: that they had let an unknown patient die because they wanted money!

Dr. Siya kept on managing the show. The angry and disturbed relatives of other critical patients kept on taunting her, speaking rude and reluctant to complete simple formalities and paperwork.

The sonography was thankfully normal.

Just as the first unit of blood was over, the patient became conscious, and revealed his name. He was quite shaken with the surrounding, but told in broken sentences about his friend’s number and address. He revealed that while returning from a party, his bike was interrupted by a bunch of goons, he had fallen down, they hit him upon the head and left with all this belongings.

The friend was called, and came in. He revealed that the patient was used to smoking weed and drinking alcohol in huge quantities. They were staying in the hostel of a famous college.

The second blood unit was started, and in a short while the patient threw a convulsion. He was immediately given injectables for controlling the convulsions, he slept off with the effect.

His parents arrived early next morning.. The shocked mother was consoled and explained about the situation by Dr. Siya. The elderly father, like all fathers, equally shocked but being a father unable to cry, kept mum, just holding hands of the boy.

When the patient woke up again, the father came to Dr. Siya, and touched her feet. Too embarrased, she told him that the registrar had donated blood for the patient. The father went and thanked the registrar, again trying to touch his feet.

As Dr. Siya had finished her night duty, she prepared to leave. “Beta, Will you come soon please?”asked the tearful mother to her. “Yes Auntie, I will be back soon. Don’t worry, he is ok now”she reassured and left.

On her way back her genius young mind tried to look at the situation sitting upon her shoulder, the little third person that resides within each one who has a conscience. That booze and weed was easily available to youngsters in almost all Indian hostels, that even educated people rode bikes without helmet, that crimes were happening almost everywhere that injured and killed people, that law and order was a laughable term in many parts ofthe country, that there was no government mechanism in place to provide emergency medical / paramedic support ambulances to raod / traffic accident victims: which one is the most responsible cause, when patients like these died? Who is responsible?

She reached home, told her proud parents what had happened, that she had helped save a life. Her mother folded her hands towards the sky, said “God, let my daughter save many lives everday”.

While having the breakfast, her father turned on the TV. A famous but ill educated political leader, in his mind-and-other- organs blowing speech in Karnataka, was explaining the illiterate public how all Indian doctors charged in excess, how they were only after money, how everyone except himself was the enemy of the millions of patients surviving from critical heart attacks, accidents, strokes and other diseases. All patients getting better all over te country was only thanks to himself and his government!

Dr. Siya’s father laughed bitterly. “Next time you need blood for any poor or unknown patient, call him” he said.

Dr. Siya replied, laughing “That kind of ëver changing blood group doesn’t match anyone, it is useless for any patient, Papa”.

(c) Dr. Rajas Deshpande

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The Colour Of Blessings

The Colour Of Blessings

© Dr Rajas Deshpande

Carefully calculating the dose and mixing it with the intravenous fluid with precision, I told the kind old lady: “I am starting the medicine drip now. If you feel anything unpleasant, please tell me.”

Through her pain, she smiled in reply. Her son, my lecturer Dr. SK, stood beside us and reassured her too. He had to leave for the OPD, there already was a rush today. “Please take care of her and call me if you feel anything is wrong” he said and left.

Dr. SK’s mom was advised chemotherapy of a cancer. It was quite difficult to calculate its doses and prepare the right concentration for the intravenous drip. Just a month ago, my guide Dr. Pradeep (PY) Muley had taught me how to accurately prepare and administer it, so when Dr. SK’s mom was admitted, he requested me to do it for her too.

The drip started. After a few hours, I noticed that her urine bag needed emptying. The ‘mausi’ supposed to do it was already out for some work. Any resident doctor in India naturally replaces whoever is absent. So I wore gloves, requested a bucket from the nurse, and emptied the urobag into it. Just as I carried the bucket with urine towards the ward bathrooms, Dr. SK returned, and offered to carry it himself, but I told him it was okay and went on to keep the bucket near the bathroom where the ‘mausi’ would later clean it. © Dr Rajas Deshpande

Once the drip was over, Dr. SK invited me for a tea at a small stall outside the campus. He appeared disturbed. He said awkwardly: “Listen, please don’t misunderstand, but when I saw you carrying my mother’s urine in the bucket, I was amazed. You are a Brahmin, right? When you were away, my mom even scolded me why I allowed you to do it, she felt it was embarrassing, as we hail from the Bahujan community. I am myself a leader of our association, as you already know”.

I knew it, to be honest. His was a feared name in most circles.He was a kindly but aggressive leader of their community, but always ready to help anyone from any caste or religion, to stand by anyone oppressed, especially from the poor and discriminated backgrounds.

“I didn’t think of it Sir! She is a patient, besides that she’s your mother, and I am your student, it is my duty to do whatever is necessary. Otherwise too, my parents have always insisted that I never entertain any such differences”. I replied. © Dr Rajas Deshpande

“That’s okay, but I admit my prejudice about you has changed,” he said. “If you ever face any trouble, consider me your elder brother and let me know if I can do anything for you”. What an honest, courageous admission! Unless every Indian who thinks he / she is superior or different than any other Indian actually faces the hateful racist in the West who ill-treats them both as “browns or blacks”, they will never understand the pain of discrimination!

As fate would have it, in a few months, I had an argument with a professor about some posting. The professor then called me and said “So long as I am an examiner, don’t expect to pass your MD exams.”

I was quite worried. My parents were waiting for me to finish PG and finally start life near them, I already had a few months old son, and our financial status wasn’t robust. I could not afford to waste six months. © Dr Rajas Deshpande

I went to Dr. SK. He asked all details. Then he came with me to the threatening professor. He first asked me to apologise to the professor for having argued, which I did. Then he told the professor: “Rajas is my younger brother. Please don’t threaten him ever. Pass him if he deserves, fail him if he performs poor. But don’t fail him if he performs well. I will ask other examiners”.

The professor then told me that he had threatened me “in a fit of rage”, and it was all over.

With the grace of God, good teachers and hard work, I did pass my MD in first attempt. When I went to touch his feet, Dr. SK took me to his mom, who showered her loving blessings upon me once again, and gifted me a Hundred rupee note from her secret pouch. © Dr Rajas Deshpande

Like most other students, I’ve had friends from all social folds at all times in school and colleges. I had excellent relations with the leaders of Dr. Babasaheb Ambedkar Association, and twice in my life they have jumped in to help me in my fight against injustice when everyone else had refused. I love the most fierce weapon of all that Dr. Babasaheb Ambedkar himself carried: the fountain pen!

No amount of fights will ever resolve any problems between any two communities, the only way forward is to respectfully walk together and find solutions. Fortunately, no doctor, even in India, thinks about any patient in the terms of their religion or caste. (© Dr Rajas Deshpande). Just like the Judge in the court premises, humanity is the single supreme authority in any medical premises. Blood or heart, brain or breathing are not exclusive to any religion or community. Just like the bigger brain, a bigger heart is also the sign of evolution.

I so much wish that the black clouds of disharmony between different communities are forever gone. The only hope is that our students can open any doors and break any walls, so long as they do not grow up into egoistic stiffs. © Dr Rajas Deshpande

I am proud to belong to the medical cult of those who never entertain any discrimination. A patient’s blessing has no coloured flags attached! Even outside my profession, I deeply believe that the very God I pray exists in every single human being I meet. If at all anyone asks me, I am happy to say that:

My religion, my caste and my duty as a doctor are all one: Humanity first!

© Dr Rajas Deshpande

Neurologist

Pune

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The Proof Is In The Pudding

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© Dr. Rajas Deshpande

Seven years ago, Srinirmala Kanduri and her doting husband Vamsi Krishna came over frustrated by what appeared to be an unending punishment: Srinirmala suffered from a common type of epilepsy called CPS (Complex Partial Seizures), and was already taking three to four different anti epileptic medicines for the same. Her fits were still uncontrolled, and she would become unconscious without warning. She also had severe panic attacks, in which sudden fear grips the person, and a feeling of doom with actual physical symptoms like sweating, breathlessness, palpitations and blackouts keep reappearing. This not only made her own life miserable, but her husband had to rush home many times as she used to be alone. Their whole existence revolved around the fear and uncertainty of her illness, even at this young age, they could not plan any future.

Her physical examination was normal, and in spite of so many issues and side effects of the medicines, Srinirmala always kept a positive attitude. “I want to overcome this. I want to defeat this illness” she said every time. Sometimes, the medicines used for the treatment of epilepsy / seizures may themselves cause / worsen seizures. That’s what was happening with her. We gradually reduced her medicines, and were able to bring her to a single medicine, although she required frequent SOS medicine for her panic attacks.

Her husband Vamsi Krishna, working with Infosys then, relentlessly cared for her like a parent. He adjusted everything in his own life to suit her requirements: job, duty hours and undeclared leaves. He was not only completely supportive and understanding, but never even showed that he was doing anything extra for her. “We married in love” he says even today with his shy smile!

Then came the great trial of a woman with epilepsy. She badly wanted to become a mother. They were quite anxious and apprehensive, like all patients of epilepsy who face this situation. Vamsi was comfortable always with her choices, and said he would even support her if she wanted to avoid having a child. This is a nightmarish situation, given the emotional attachment that the mother and father have with the child they imagine. Now a days some safe medicines are available, although there’s none with a “completely safe” profile. Epilepsy medicines taken during pregnancy, almost all, have some risk for causing adverse effects upon the baby. Adding a simple medicine like folic acid and some supplements reduces this risk significantly.

Srinirmala and Vamsi decided to bite the bullet. These are the decisions that actually make the lives of the successful. We reduced her medicine doses to minimum, folic acid was added, and Srinirmala came with the good news soon. All through her pregnancy, her husband never left her alone except for his duty. Fortunately no fits came during her pregnancy, and she warded off her mild panic attacks with courage.

Then one day, THE call.

Shanmukhapriya was born in Hyderabad, under the care of Dr. Bhagyalakshmi at the Yashoda hospital, and both mother and the baby were smiling fit!

Another battle against epilepsy was won!

“There are ups and downs. There is uncertainty, no one can escape these. Keeping patience in difficult times helped me most, and that’s what I will advise everyone who plans to go ahead with extending the family while battling epilepsy. When I explained my situation rather than hiding it (stigma associated with epilepsy among the ill educated is a curse in India), my colleagues and bosses at Infosys and later Cognizant were very supportive.” says Vamsi Krishna.

Now Srinirmala has completely recovered, and rarely needs to hit the panic button. “I think it is very important to decide once and for all : that I will live normal, I will be fearless, whatever happens. That is what helped me win my battle” she says.

Then, as she asked the cute, sweet, and beautiful Shanmukhapriya (she is my child too, I feel, and the parents kindly allow me that) to blow a flying kiss at me, she commented “The proof is in this pudding”.

© Dr. Rajas Deshpande

PS: Thank you, Mr. Vamsi Krishna and Mrs. Srinirmala for allowing me this write-up for patient education, and Thank you Ms. Shanmukhapriya, for your heart throbbing smiles!

Beyond Fear: The Lady Who Defeated Brain Cancer

 

Beyond Fear: The Lady Who Defeated Brain Cancer

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© Dr. Rajas Deshpande

About a year ago, a young man came with the MRI reports of his 64 year old mother, 
Mrs. Vijayalakshmi, who was then in Bijapur. She had developed paralysis on the right side of her body, could not speak, and was losing her consciousness fast.

The MRI looked bad, a big tumour was compressing much of the left side of her brain. It looked cancerous, and needed immediate surgery as a life saving option. Otherwise the tumor could damage the heart / blood pressure and respiratory control centres in the lower part of her brain, that risked life. The situation could turn into an emergency anytime now.

The family was devastated. They brought her to Pune. She was sinking fast. Required investigations were done, and we explained the facts to the family. The surgery could risk life or also cause permanent disability, including permanent loss of speech.

Her husband, Mr. Venkat Babladi was always by her side, with his hands folded, and had only one thing always to say every time any doctor visited her: “Please save her doctor, do everything possible”.

She was operated. Her husband, son Mr. Anand Babladi, and his wife all stayed in the hospital, taking turns to attend her. The tumor was sent for analysis.

On the third day, the report brought the bad news: it was a type of cancer called primary central nervous system lymphoma. These tumors have a high death risk, with or without treatment, especially after the age of 60.

“Tell us doctor, where can we do the best treatment for her? We want to do everything” her husband and family kept on telling us. She was still in critical care, but had started now to speak a few words.

Our oncologist Dr. Minish Jain and his assistant Dr. Yuvraj Rangam took over, and started high dose chemotherapy. She developed many complications, some related to the medicines, but her family always stood firm. Every day, her husband sat by her, holding her hand, and telling her that she was going to recover, that he will ensure all was well. Her son and daughter in law arranged for all expenses and logistics, not by staying away and sending money, but by attending her every day after their respective jobs. After few days she was discharged with advice to continue chemotherapy.

Unfortunately, Mrs. Vijayalakshmi had a fall while walking at home, and fractured her hip, she had to be operated. Her chemotherapy had to be stopped. It was resumed after she recovered from the fracture. Then in few weeks, radiation therapy was started. As a rare complication, she developed life threatening brain swelling, and had to be shifted to critical care unit. She lost her speech again. Her husband, who was now on the verge of an emotional collapse, met us outside her room and with tearful eyes, asked only one question daily: “She will be ok na, doctor?”

Medical treatment is mostly standard all over the world, but the affection and care of one’s family is not. Hundreds of doctors treat thousands of such patients, many patients get cured of cancers and other dreadful diseases, a simple statistic that is never made public by those who perpetually talk against medical professionals. Equally unrecognised is the fact that a caring family makes a huge difference in the patient’s recovery, this has become very rare now.

After a year, we repeated her scans recently, and told her the ultimate medical good news: she had defeated brain cancer! Her scans did not show any tumor activity at all. She comes smiling to the OPD now, her husband holds her hand on one side, and son on another.

The most beautiful gift she gave me this time is that she learned two new Hindi words specially for me, because everytime I saw her I asked her how she was, and could not understand her answer.
This time, her husband poked her, then she smiled and said “Achcha hai”.

Those two words were the winning roar of a simple, middleclass woman against a dreadful killer disease!

© Dr. Rajas Deshpande

PS: Thank you, Babladi family for the kind permission to share facts.

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Worse than Death

Worse than Death
(C) Dr. Rajas Deshpande

“Doctor, I have started to die. Can you help me somehow?” he asked, calmly.
In his late twenties, a handsome young man, well dressed, but with a certain painful gloom upon his face that was a mismatch to an overall nice and clean appearance. What could this be? I started thinking, hoping he was wrong.

Then his shoulder twitched, and arm had a slight jerk. A pang of suspicion bit my heart immediately. He confirmed it in few seconds. Those who take life for granted are often so full of anxiety, and here he was, who had initiated a countdown to his own death, talking to me in a low but clear voice.
“Doctor, I have been diagnosed with Huntington’s disease over 7 years ago” he said, “Till now I had only these jerky movements. Now I have started having some mood problems and also memory issues. My parents died in an accident when I was three. My uncle’s family cared for me till I could go to a boarding school. I stay alone in a rental apartment, I work in an IT company”.

Examination and review of reports established that his diagnosis was correct. There is no treatment.
This illness of brain degeneration starts with abnormal movements, then causes loss of memory and other cognitive functions, mood swings, depression, finally causing complete immobility and usually death ensues due to blockage of windpipe because of food while swallowing. A patient usually survives less than 13-18 years after the diagnosis. Some commit suicide.

What do I tell someone aged 28 who knows he will definitely die soon?
Yes there are research options and support groups. Yes I can send him to a professional counsellor. Yes I can use some mood stabilising medicines and antidepressants.
But can I emotionally detach from this event as a doctor? (C) Dr. Rajas Deshpande

Diagnose and treat with empathy, educate and move on. Don’t take home the burden of your patient’s illness. Don’t get emotionally involved in your patient’s lives and problems. Never. But is that possible?

Shall I ask him if he has any bucket list of things he wants to once experience, before he forgets who he is? Is there something there that I can help him with? Has he planned anything about his life when he is mentally or physically disabled?

I told him that some medicines can help him, and wrote a prescription. Also referred him to an expert counsellor.

What would I do in such a situation? What is it that I would like to hear from the doctor, knowing the obvious too? What is so important in life when one knows that there are only a few years remaining?

Those who have the luxury of ignorance can laugh and superficially answer. Those who answer immediately have seldom used thinking. Those who are assured of their health have changing answers.
But those who know it?

I decided to ask him. (C) Dr. Rajas Deshpande

Next time he visited, he told me that he has resigned from his job, as he had problems dealing with the responsibility. He could not ride his two wheeler too, he had sold it off.

“I am going to my ancestral village, doctor. A dharamshala (religious sanctuary) has agreed to allow me stay and food, and help me as much as they can. I am also willing to donate my body for research, so at least others don’t suffer this. But I have to finalise yet”.

In India, just as there is no scope for genuine research, there also is complete lack of any infrastructure for the care of such patients.

I decided to ask him what troubled me.
“Is there something you wanted to do?” I could not bring myself to say “before you go”.

He tried to smile. His eyes welled up as he thought about the question.
“Yes, Doctor. I wanted to feel someone loving me madly at least once. In fact I had a girl in my office whom I liked. I think she liked me too. But then my diagnosis was confirmed and I didn’t want her to suffer, so I never told her. I met her before resigning, and told her the truth”.

“Everyone will only degenerate,” he continued, “I am ready to see myself degenerate early. But the one purpose, the one good memory of life that one can wrap himself with when facing the decline, is love. Everything else only reminds of loss”.Dr. Rajas Deshpande

Then, wiping his tears and sobbing, for once, openly, without the restriction of pride, he held my hand, and said, “Thank you doctor for all your help. I came to know just now, that not having loved is what I regret most. It feels worse than death. Even if I had felt true love once, I won’t have regretted this early death”.

He had only echoed what every particle, every corner and every breath of life always reminds us of, while we keep on searching for everything else.
Dr. Rajas Deshpande

The Living Phoenix

The Living Phoenix
© Dr. Rajas Deshpande
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“Stop treating me as if I am only a woman!” she told the bank manager, who probably did not grasp the meaning of that sentence. Little did he know who he was dealing with.
Sharon Harmon Muir is a lady to beat most men. Right from Religion to Depression, she has fought her battles with the determination to win. She indeed won them, including her last battle with suicidal-level depression.
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4 years ago I met her with her husband Harry Muir, for some mild memory issues which turned out to be the symptoms of severe stress and depression. As she revealed the details of her life, I realized what an extraordinary life she had been living. When analyzing her own thinking and her art (painting), she said things that made me realize her genius.
I gave her a compliment I had rarely used: “You are one of the most brilliant minds I ever met”.She laughed aloud, looked at her husband, and winked “I told ya!”. Mr Harry was only too happy and proud.
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Sharon was born in South USA to parents who were mill workers. She started her theatre performances at the age of 13. She sold her first painting at the age of 15. She was actively involved in civil rights movement. Once while service in the church, a black couple was denied entry in the church. Sharon quit organized religion that day, protesting against racial prejudice.
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She went to an all-male institute of design and technology, University of North Carolina and later started teaching men at the same center to use power tools and build theater sets (That was in the 1960s!). She studied various art forms, ballet, composing music, painting and much more, also working as an electrician.

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She says: my job profile was easy: whatever anyone could not do, I offered to do it for them. Working at such odd jobs, she met Harry Muir, who was a political protester within the US army. As Harry was jailed, Sharon’s family opposed the marriage. She was even labeled “carni-trash” then. Together Sharon and Harry worked as college professors, musicians, fine artists, magicians, and stood for each other. Sharon got an excellent corporate job, so Harry decided to complement it by choosing to be a house-husband, cooking and serving and looking after their daughter, and when the daughter went to school, he spent his time as a street singer.
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At the age of 50, during menopause, the first attack of depression struck Sharon. In her own words, “It wasn’t me who was sad and suicidal, it was like someone else within me. I fought those thoughts, I knew I had to overcome this”. She developed severe panic attacks that prevented her from going out of their home. So she trained a Scottish terrier who would stop the traffic for her, take her to a safe place and then find Harry!They reached India in search of spirituality, finding it at Meherabad, and settled there. She continued to work as a painter and musician. “I was lucky that I could be the head of the family” she comments, although every time she speaks of Harry now, her voice becomes tender.
Once on a flight from Atlanta to Paris, Harry collapsed and was resuscitated. He was shifted to an ICU in Paris from the airport, and was diagnosed with pulmonary fibrosis (shrinking and progressive failure of lungs) of unknown origin. A few weeks later, they returned to India. In January 2016, Harry suddenly collapsed and passed away while in a hospital. Sharon kept on resuscitating her life partner of 50 years, till the hospital staff arrived after 8-10 minutes. She cannot forget that trauma.
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With this loss, her depression resurfaced again, stronger than ever.
The worst loss in life is not death, it is the loss of love. Once more, suicidal thoughts and severe depression engulfed Sharon. To be left alone in a foreign country at the age of 67 is not easy.
“My belief system is very strong. I know my intelligence is above average, so there was no reason I couldn’t do everything I wanted, if I just put my mind to it” she tells how she decided to overcome her depression. “I read about it all I could, tried to get help, and got it”. She is thankful for getting good medical help in India, although she adds with a wink “I didn’t want a doctor who pats my back and laughs aloud telling me not to worry. I wanted a doctor who understands me, my illness and my worries as well”.
After Harry’s death, she had to clear a lot of legal hassles and banking formalities. Her daughter helped her there. When one bank manager tried to behave high-handed thinking that she’s just a woman unable to cope up, she told him : “Stop treating me as if I am only a woman!”.
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When she visited me recently, she laughed a lot and told me: “This time again, I have chosen to defeat my depression. I will never give up. Back to life now”.
I usually keep busy, but when some patients talk, I want to listen to the beauty they create in my life. They expand my mindscape. When I asked Sharon what was her favorite subject for painting, she answered with a mysterious smile: “I paint the colors of the spirits of places”.
As I drank in the beauty of that sentence, I realized that the soul of this extraordinary woman can only have one title: “Phoenix”. The legendary bird is not imaginary, so long as we meet people like Sharon. This great magician called nature has given us the magical ability to be everything we want to be, to be happy, to win over any challenges we might face, just with a small trick: wanting to do it.
Sharon is an extraordinary example of that magic.
© Dr. Rajas Deshpande
Thank you, Sharon Harmon Muir, for the permission to share the story of your extraordinary life.

Please share unedited for spreading awareness about fighting depression.

The Sacred Duty of A Man

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The Sacred Duty of A Man

© Dr. Rajas Deshpande

One night after the ward rounds, just as I left the hospital, I received an urgent call. The patient, a lady in her late 50s, had become comatose. She was admitted three days ago under a colleague for bleeding in the left side of her brain, that had caused right sided paralysis. She was drowsy since admission, but that day she had some vomitings and then became deeply unconscious.

She was already in the ICU. The most common reasons for drowsiness in admitted population above 50 years of age is either medicines or low sodium levels. Her sodium was very low, we started the treatment.

Her elderly husband walked up to me as I came out of the ICU. Extremely worried, but still maintaining his calm, he asked me “Will my wife be okay?”

I explained him the situation, and reassured him that though there was no threat to her life then, the recovery from paralysis was unpredictable.

“That is okay doctor, but she must survive. We don’t have any children, she has looked after me all her life. I will do anything for her” he said with a heavy voice.

They came from a village 5 hours away from Pune. Mr. Arvind Gandhi was a retired pharmacist, surviving on his savings, with his wife Mrs. Aparna, till this calamity hit them.

That was four years ago.

Since then, he became her complete attendant and caretaker. He took care of her in that bedridden state for over a year, cleaning her and feeding her many times every day. He took her regularly every day for physiotherapy, and brought her for consultation to Pune as frequently as required. He learnt taking care of home, cooking, housekeeping etc., and never shied from the medical expenses although his sources were limited. Thanks to his extreme dedication to her care and extraordinary will power, Mrs Aparna Gandhi has now recovered enough to independently carry out her daily routine, and also helps her husband in cooking and other tasks.

“When I saw my wife in that condition, I was heartbroken. Then I thought, it is my duty as a man to fight for and take care of the woman I married. I changed overnight and decided to win this situation rather than giving up or asking for help”. Mr. Arvind said today when they followed up.

“Looking at his dedication and love for me, and his effort to make me recover, I developed a willpower too, and decided to recover and take care of him again” his wife replied with a smile.

As doctors we commonly see that many men treat their wife and her health problems as ‘not so important” issues. Many in fact drop their wife to her parents’, to be treated and sent back after the ‘repair’. Many take it for granted that the lady’s parents should pay for all her medical expenses even after years of marriage. In fact, many even compel their sick wives to continue with cooking, housekeeping etc. shamelessly claiming that there is no option. There are no laws about any of these.

We also come across such rare ones like Mr. Arvind Gandhi, who fight with the fate with all they have with the simple yet golden mentality of caring for the woman who cares for them. All men are thankfully not the same, and there indeed are simple and humble men like Mr. Arvind Gandhi who set examples of what a man should be. In the growing market of meaty and arty men flaunting everything except culture and kindness, these examples are easily drowned. Hence this article.

While many pundits fight for the correct definitions of life and love, let us congratulate Mr. Arvind and Mrs. Aparna Gandhi for their extraordinary struggle, willpower and the victory.

©. Dr. Rajas Deshpande

PS:

Thank you Mr. & Mrs. Gandhi for permission to share this story.

Please share unedited.

The Epic Struggle Against Epilepsy

The Epic Struggle Against Epilepsy

(C) Dr. Rajas Deshpande

In a war-torn city, she kept on having fits almost every other day: convulsions and seizures of different types. 21 years old and home-bound, she had suffered with epilepsy since childhood. Dreams of a beautiful life that must adorn the life of a young woman were shattered due to a devastating and humiliating illness.

Her elder brother could not bear to see her suffer. He decided to take risks and enquired. Someone told him to take his sister to India for treatment. The airports in his country were destroyed or closed. All doors to India appeared locked.

Without any clues about future, he took her by sea to a nearby country Djibouti, a small African country. From there they traveled to Ethiopia. Then to Kenya. Finally they reached Mumbai and searched for the lone contact they hoped to meet: Mr. Abdul Aleem Alakeli, who works free to help patients. That was two months ago.

She reacted badly to two of the best medicines used for treating epilepsy, but their faith and determination were extraordinary. The brother and the sister had made a final decision: come whatever may, they wanted to defeat epilepsy.

Today as they left with complete control of seizures, I told the sister what she already knew: that she had an extraordinary brother. I congratulated her for her strong will power too.
Her brother was smiling after a long time, and her pride was obvious.

We wish her and her brother the most beautiful and healthiest life ahead. May God bless them and ensure their safety on the way and back home.

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