Destined to go…
Dr Vivek Hande
It was many years ago. I was young and recently armed with my MD degree. I felt powerful and I certainly believed I could save the world and get everyone on the road to healing ,if not completely on their feet.
Sushant was a handsome young sailor who was sailing on one of the Coast Guard ships on the high seas in the Andaman islands. He had everything looking up for him- a bright future, doting parents ,a lovely wife ,Smita , who was carrying their first child ,back home in Patiala. Fate ,it seemed ,had other ideas. He was carrying out some drills on the deck of the ship that bright Sunday morning. He had been feeling a bit unwell for the past two days with a bit of a headache and a slight fever. He suddenly fell on the deck and started convulsing repeatedly. His colleagues and the paramedics rushed to assist him but he had lapsed into a comatose state. He was evacuated by helicopter in very quick time from the high seas to the hospital in Port Blair.
I assessed him on arrival and found him deeply comatose and with evidence of Pneumonia affecting both the lungs ,probably on account of aspiration during the convulsions. I moved him to the ICU. I rushed through a battery of investigations . I did a lumbar puncture and drew out some cerebrospinal fluid and also took him for a CT scan. The verdict was clear –he had severe Bacterial Meningitis, an infection affecting the meninges,the covering layer of the brain. I put him on high doses of very potent antibiotics. He was on intravenous drips and being fed through a tube through his nose. He was being monitored vey closely and all his vital parameters were being frequently assessed. By late evening, he started dropping his oxygen saturation and the lungs were not functioning optimally and I had to place him on ventilator support to ensure there was adequate oxygenation . The young man was fighting for his life and was quite literally hanging by a thread.
I saw this strapping young lad, just about the same age as me, with his entire life ahead of him, reduced to a whole lot of tubes and drips and monitors and catheters invading every orifice of his body. I felt a strange kind of bonding with him. I had to save him, I told myself. His aged parents and very pregnant wife flew down to rally around him. I kept returning to the ICU a half dozen times a day and often late at night to check on him. I adjusted his fluids, his antibiotics, his ventilator settings and everything else that was in my hands. I would talk to Sushant and exhort him to fight and coax him to get back to the world. I told him we were going to win this war. He never gave any sign that he could perceive or appreciate any of my rumblings. Every time I stepped out of the ICU, his parents and wife would look at me expectantly. After a few weeks of this routine, they started averting my gaze and started preparing themselves for the inevitable.
Was this a doomed war? I was beginning to lose hope but somehow at some level, kept hoping he would come out of this state ,inspite of all medical and prognostic indicators pointing to the contrary. After nearly four and a half weeks, the tide started turning and Sushant started showing some signs of improvement. I intensified my efforts and the ICU was suddenly injected with a sense of hope .The ICU nursing matron smiled at me and told me , “Doctor, we are going to win!” .The next couple of days saw dramatic improvement in his condition. I was able to get him off the ventilator; he came out of his coma and started moving his limbs feebly. He soon started feeding himself and in a few days was walking around. Sushant had come back, from the dead. It was a tremendous feeling and I was elated . I somehow felt I had got a new lease of life. The gratitude of the family and the joy and relief of the elderly couple and Smita made me feel like a victorious General ; we had indeed won the war!
Sushant walked out of the hospital, a trifle weak and scarred but on his own feet. He returned to Patiala on leave . I got regular inputs from him over the next several months on telephone. He had become a proud father. My eyes turned misty and my spectacles fogged up when he told me that his son had been given my name. He told me his mother had distributed sweets on the happy occasion to most of Patiala! He gave me inputs about his son’s progress and his crawling and his climbing and so on. I was happy for them..
And then suddenly a call, almost a year to the day ,Sushant was admitted under my care. His father on the line, choking with emotion and barely talking coherently, “Sushant died yesterday. He was on his scooter and had a head on collision with a bus . He died on the spot” I felt devastated. The thought ringing in my head, “What a waste of a life! After such a heroic battle , dying so insensibly; such a meaningless death”. I felt it was such a sheer waste of an effort; all the struggle and anguish for nothing at all. I got on with my patients and OPDS and emergencies and carried on with my work but thoughts of a wasted life and a wasted effort kept coming back to me.
A few months down the road, another phone call from Sushant’s father. Quite controlled and much in command of his emotions,he told me, “Doctor, we had given up Sushant for dead a year back. You breathed life into him. You gave him an extra year- a very precious year. We have cherished his presence and thanked God and you for every day that he was with us. He was destined to go. You changed his destiny and gave him the opportunity to hold his child. You gave him the chance to enjoy his family for another year. You gave us the chance to love him and care for him for another year. We will remember you in our prayers every day”.
His words echo in my ears every time I have a Sushant. One can only try and one can do all that is in your hand as a physician, but the humbling truth is that when one is destined to go, one has to go……