Dr Rajesh Gupta
I still remember that crisp, sunny day in 2009. Dr Sircar (Head Intensivist, Fortis Hospital, Noida) and I had just finished our usual morning ICU rounds. It was around 11.15 am and we were about to walk out of the ICU, when a young patient was wheeled in.
He had met with a severe road accident in Uttrakhand and was referred to our hospital.
He was in coma, his body wrapped in bandages, and a jumble of tubes attached to his nose, mouth, neck, both the lungs and stomach. His pulse was feeble and the oxygen saturation in his blood was way too low despite mechanical ventilation.
The doctor from the emergency department, who brought him to the ICU, said that he was an IITian and had his final exam a day before the accident. He went out with his friends to celebrate and met with an accident while returning home. His chest X-ray showed his left lung had collapsed.
I saw an old couple, his parents, standing in the far corner with folded hands, their eyes filled with tears.
In those few seconds, so many thoughts flashed through my mind. "What a terrible fate," I thought. He was hardly 24 and an IITian. His parents must be so proud of him, must have dreamt of a bright future for him, and here he was battling for life right in front of their eyes.
Suddenly, another thought came to my mind and I asked Dr Sircar if I could try to open up his lung through bronchoscopy. I knew that his chances of survival were grim and I was in for a futile exercise, but I desperately wanted to give it a try.
As I inserted the bronchoscope and travelled from the trachea into his left lung, I saw that some thick blood clots restricting his passage. The moment I removed the clots with gentle suction, his oxygen saturation went up from 65 to 85.
I could feel my heart beat faster. I thought there was still some hope for him. I cleaned up the rest of the secretions from his lungs. His vital parameters became better. Now we had to take care of the infection in his lung and put him on antibiotics.
Outside the ICU, I met his old parents who were pale with grief. I explained his condition to them and they listened with folded hands.
They didn't utter a word, didn't ask any questions.
As an intensivist, I am used to counselling families of patients who have grim chances of survival. But this was different. Their silence was daunting, it lingered in my mind and enveloped my thoughts. Every day, I would go to the ICU for my rounds and saw them standing still, they would fold their hands each time they would see me.
The unshakeable faith of parents’ is the heaviest pressure a doctor feels.
After 20 days, Santosh's condition improved and we shifted him to a room. But there were no sign of him coming out of coma.
Their silence was daunting, it lingered in my mind and enveloped my thoughts. Every day, I would go to the ICU for my rounds and saw them standing still, they would fold their hands each time they would see me
I used to go to his room twice a day and talked to him like we talk to any patient to check his response. But he remained vegetative. His eyes were open but had a blank look. He could not move a finger.
I felt that had I not performed that bronchoscopy, he would not have survived. "Did I do the right thing? Had I prolonged his and his parents' suffering? " I often asked myself. "It would have been extremely difficult for his poor, aged parents to bear his death, but would it be less miserable for them to take care of their bedridden son?"
I had no answer.
I could see that the funds they had collected for Santosh's treatment were depleting fast.
As not much was in my hands now, I continued the treatment and praying for him as usual.
Around 40-45 days later, one day as I entered Santosh's room, I saw him gazing at the television screen showing a cricket match. "So, you are watching cricket? I pretended to ask him. To my surprise, he replied, "Yes."
I was shocked. I could not believe that I heard his voice. To confirm I asked another question, "Who is playing?" He took his time but slowly named the teams.
I was overjoyed, my happiness knew no bounds.
It was a miracle.
Santosh was not only awake, he was alert. I was trembling with joy as I called Dr Sircar to give him the news.
--The writer is principal consultant, pulmonology, Max Hospital, Vaishali