GOPAL - II

Today that old patient of mine I wrote about last month came walking to me.

You can read about him here

I am happy for this man as much as I can be. And I feel as proud of this man as much as I can allow myself to be. And this makes me promise to myself not to waste time on things and people who will never give you a chance in life, or understand your motives or intentions. 3 odd months back, we had an alcoholic who had seizures persistently who we took to be Rum Fits. Associated with an undeniable unconscious urge to let these patients be, we offered him the usual for delirium tremens. Somehow, somewhere, he did not recover and was transferred from bed 13 to bed 49 and given more than a cautionary glance than subconsciously reserved for these people. Somehow somewhere, it did not look like he had an ordinary problem most young alcoholics face. We did a CT Scan. Big Subarachnoid hemorrhage..and something something more... Something was missing. My SR Dr P suggested we start him on Low Molecular Heparin despite there being a hemorrhage. We got a MR Venography done. His CT Scan and MRI concurred. He had those bleeds with infarcts spread over 70 odd percent of his brain area dotting it like full cherries on a cake. He had loss of flow void in the sagittal veins and an empty delta sign. Diagnosis: Cortical Vein Thrombosis. To see it with alcohol was a rare condition. Only 3 patients have been reported so far the world over. Why he had it, what predisposing factors he had to have it, we havent managed to find any.

He was bed ridden, aspirated, fetid bed sores oozing serum from all over his body. I dare say he was being treated correctly but not being looked after correctly. His mother was a woman who would not listen to any advice. We have no nursing care in our hospital. Its not possible, to have them, with the number of admissions and the precarious work distribution we have. That was when I took over. I am not bragging about my achievement but I just want to say that proper instruction to attendants about basic hygiene and physiotherapy...these two are cornerstones of management of any neurosurgical patient. Life and Haryana have hardened me into an indomitable woman, unafraid of anything. I went after the parents, his pyorrhoea I ensured went with at least two Listerine scrubbings. I howled at the mother when she fed him water without lifting his head up increasing chances of aspiration, took care so he did not smell of pee that he did despite the catheter.Mostly i shouted at his parents, day in and day out. I could not do these things, looking after 20 odd patients lying any time. So I made sure my 'orders were obeyed'. In short, I did become what I hate being called the most...A Sister...the Staff Nurse. And a most angry one at that. Fortunately his parents got scared and did what I tole them to do. He would lie for days on one side of his body being able to move nothing but his mouth and eyes. His hands were clasped tight, and he almost always had his wrists clenched.

He recovered. His bed sores stopped oozing and started to dry. He stopped passing loose stools that continuously soiled his undersides. I remember the way I used to ask him everyday if he could move his hand. He used to sat Tch Tch in a way I cannot forget. There was a dogged way about him, a different light in his eyes. I never asked why he went binge drinking for three continuous days at a friend's marriage party. Earlier, he drank almost everyday. But he did not smoke. His father was a very docile man who was literally bent twice from the burden of his son's disease. He always had a sad smile on his face. His mother graduated, under my rather uncomfortable and voluble appraisals of her inefficiency as a mother to someone who started on his physiotherapy vigorously.

Last time I wrote that previous blog he continued to lie down in bed and was massaged by his entire family all the time. I asked him if he could sit. He said no. I ordered him to sit. Slowly he sat for the first time which you can see in that picture I took of him. That was the first time he sat in three months he said. I asked him why he did not do it earlier. To which he said he did not do it because no one had ordered him to sit so far.

What have I become.

Yesterday he came walking to the OPD. Meanwhile his father during the process of taking care of him suffered a left basal ganglia bleed. And barely recognizes his son he used to look after. But Gopal came walking in full glory today. He is a handsome man, with a beautiful daughter. And very very proud. Something about him doesn't look ordinary, commonplace. I don't know what it is. He doesn't drink anymore, and is about to start work as a photographer. His mother came upto me and ran her hands on my head blessing me yesterday.

I will take his snap next time to show what a remarkable man he has become. I am not talking about a case of Cortical venous Thrombosis we are trying to get published with minimal homework and preparation. I am talking about the human effort and kindness. About faith and hope, and how such lives get transformed after a tragedy if taken in the right way.

With Gopal, I learn few things. And one saying by Einstein rings loudest in my ears. I am clueless what sort of a person I will become tomorrow, especially with the iron fist I am developing sans any feminine streak, almost like a man. But I hope I will at least preserve the humanity in me. And that I become a good doctor. That is the most I will be happy with.

The secret to happiness lies in attaching oneself to something, not someone.