MY GIFTED SISTER
Prof. Gangadhar Sahoo, Dean
IMS & SUM Hospital & Pro. Vice Chancellor, SOADU,
Bhubaneswar
I had just settled in Bhubaneswar in 2013. After spending my life western Odisha since 1976, coming to the capital city of Odisha, adjusting to the city lifestyle was too difficult. I joined as Professor in the Department of Obstetrics and Gynaecology, IMS AND SUM HOSPITAL. Many faculties were known to me, barring a few. On the whole I was feeling like a fish out of water. My wife was totally against coming to Bhubaneswar. Anyway what's written in destiny, can't be altered. Here people are always busy. Even there are many relatives, but they hardly visit each other. Mobile phone and video chat solves the purpose. One day I got a personal invitation from Raseswari Madam, the renowned Gynecologist and MLA of Sambalpur to attend her nephew's son's marriage reception at Bhubaneswar. I was happy that it was an opportunity to meet many known people from Sambalpur. Anup, the nephew of Madam was the executive engineer PWD in Bhubaneswar.
My whole family went to attend the party, in a resort near Khandagiri Square. It was around 8.30 pm, not that much of a rush. People in Bhubaneswar have a habit of coming late, as a sign of aristocracy. I met Raseswari Madam who introduced us to a few guests. I met a number of friends from Sambalpur. While we were enjoying Gupchup, the item most of the ladies are fond of, irrespective of their age and status, I saw two beautiful ladies, smartly dressed with long golden necklaces hanging from their neck. They suddenly stopped before us and surprised us with their traditional way of wishing . I looked to their face which seemed known but I was unable to recognize. One of them tried to speak many things but not clearly audible because of background noise. Feeling our helpless condition, she ran and almost forcefully dragged her husband to me. “Sahoo Babu, Namaskar. I am Akhyaya, Executive Engineer, PWD, Jharsuguda. You were our family physician since 1985 when you were staying at Gosala and my father in law, was Assistant Engineer PWD at Attabira. You have done everything for my mother in law and my wife during her two deliveries. He went on narrating so many things, that I hardly recollect . Any way in that ocean of guests we talked so freely that I felt as if I am with my family. Akshyaya and his wife Namita touched our feet and we were about to depart when Namita whispered something into her husband's ear. Then with all humility Akshyaya took me to a lonely place to tell me something confidential.
Akshyaya told me that Namita, his wife about 50 years of age was having abnormal bleeding two to three times during the last 3 months for which she was treated by the local Gynecologist who had prescribed home medicine without examining her, thinking that this type of bleeding is usual around menopause. After asking some tricky and important questions I told him that she should be clinically examined. Our principle of treatment is, "Any bleeding after the age of 45 years is abnormal unless otherwise proved. All causes of abnormal bleeding should be excluded before confirming that it is physiological perimenopausal bleeding. The sooner it is done the better." Then I asked her to come to my OPD next morning for preliminary examination and evaluation.
Next day Mrs and Mr Pradhan came to my OPD with loads of burden on their head and shadow of apprehension and anxiety clouding their face. Their expression was telling what storm was blowing in their minds. Knowing this, I took both to my chamber, counseled and consoled them. We had a cup of tea. Over the cup of tea we discussed many topics other than the health issue. Then after following all the formalities she was thoroughly examined. On examination a suspicious lesion was found on the cervix with all the features pointing to the provisional diagnosis of CARCINOMA CERVIX STAGE 1 B.
A biopsy from the lesion was advised for confirmation of the diagnosis. The word "biopsy" created an adrenaline storm in Namita and on equal magnitude in Akshyaya also. Thousand and one queries were answered before biopsy like, “Why will you do a biopsy? You are such a famous doctor. Can't you treat with medicine? Is it a cancer? Is it treatable? Will the procedure be painful? How much time it will take?" So on and so forth. With much difficulty Namita was convinced. I felt, it is much easier to convince an ignorant, illiterate village lady than the advocate Namita. So at last biopsy was done. Same day evening she was discharged with advice of final treatment after the biopsy report is received.
Biopsy report as anticipated came out to be carcinoma cervix. I advised them to undergo radical surgery as early as possible since it was in early operable stage. I counseled them everything in detail like different modes of therapy; surgery and radiotherapy, since they can afford and they can go to higher and better centers for treatment. Namita asked, “Can’t you operate on me. You are the best surgeon in Western Odisha and I have faith and confidence on you?" I replied, “I have operated around one thousand cancer cases. You will be one thousand and one. I operate them, who completely surrender before me. I never invite nor coax anybody. But my only advice is the sooner you get operated the better. Like time, cancer doesn't wait." Then Mr . Pradhan and his wife bid me farewell telling that they will be in touch with me.
One-day after a month and half, Engineer Pradhan and his wife entered into my chamber. I thought probably she had undergone surgery in some reputed institution by a renowned oncosurgeon and came to meet me. But contrary to my belief, expression of guilt was visible on their faces. I asked if there was anything wrong. Then with drooping head and slurring voice Mr Pradhan told, “Sir! The diagnosis of cancer was a terrible and stressful experience for both of us. We were confused in taking a decision where to be operated. Many people were advising many things, contradicting and misleading. Even my doctor relatives and doctor friends were advising to go to TMC, AIIMS, VELORE or even to foreign countries. Nobody had supported our view of getting operated by you. One of my friend’s wife who was also your student went to the extent of telling that she might not be
alive to see the marriage of her daughter and son if she gets operated by me. But we had direct information from the known cancer patients that your success rate is quite high and they are quite satisfied with you. After being confused and killing valuable time of about two months at last we have taken the final decision to be operated by you. This bold decision was possible only due to my wife. She took a pledge that whatever may be the outcome of the operation she will be operated by you, none other than you. No question of going anywhere. If she will die she will prefer to die in the hands of Dr. SAHOO. So we have come here to surrender before you.”
Once they surrendered, now the onus was on me. I got Namita admitted. Almost all risk factors were her friends. From head to toe if I enumerate, one page will fall short. She had hypertension, hypothyroid state, diabetes, respiratory problems, stress factors and what not. During counseling she was advised that all necessary investigations will be done and clearance from the anesthesiologist will be obtained before fixing the date for surgery. She was very reluctant to move from place to place for different check up like from laboratory to cardiology to pulmonary medicine to radio-diagnosis departments. At first an ultrasound and chest X ray was done. As a protocol an M.R.I is mandatory. When she entered into the room she got so horrified that she shouted at the lonely staff present there, " What for have you brought me to this ghost house ? I will prefer to die but never do this test." Saying this she jumped from the table and ran out of the room cursing everyone not even sparing me.
On 12th February she was referred to the anesthesiologist for check up. The anesthesiologist was the final authority to give a green signal for her surgery and to counsel regarding the method of anesthesia, preoperative preparation, risks of anesthesia and surgery. However the behavior of the anesthesiologist was not liked by Namita. Later she demanded that she will not be operated if that particular anesthesiologist administrates anesthesia. She refused to sign the consent form resulting in a deadlock situation. Her argument was that she had been hospitalized to be operated and get cured not to die of complications of anesthesia and surgery without anybody's responsibility. According to her the consent form was a death warrant. She was totally obstinate. None of her family members could convince her. Fortunately Namita had developed a close friendship with Dr. P. Sujata, my associate Gynecologist during her hospital stay. I entrusted Sujata Madam to convince her, which she successfully did by telling her that it was a hospital formality. At last the issue was solved and she signed the consent form with a smile, begging excuse for the inconvenience caused by her.
Operation was fixed for 15th February 2016. All preoperative preparations were meticulously made. We spent half an hour with her in the evening round. The essence of the round was mainly to alleviate her mental stress, fear of surgery and cancer and have a good sleep. While patting on her back before parting, she reminded me
"Can I see my son's marriage? "
"Have faith on God and on your doctor", was my reply.
On 15th morning sharp at 9am operation started. It took near about four hours. It was a clean surgery. To our bad luck wound dehiscence (wound gaping) occurred on the 8th post operative day for which secondary sutures were given and Namita was discharged with the advice that she should come for stitch removal and catheter removal on the 10th day.
On the 10th day of discharge the secondary stitches were removed. Fortunately the wound was healthy. The catheter was removed, after two hours an ultrasound was done to see for residual urine volume (amount of urine retained in the bladder after voluntary evacuation) which came out to be within normal range. Then total postoperative protocol was explained to her which was to be continued for five years. Listening to it she almost fainted.
She was a complete changed lady after the operation. Now she was stress free, jubilant as usual regained her special character for which she was famous i.e. short tempered, argumentative and talkative. But seeing the rigid and regimental protocol of follow up she frowned on me and roared, "Have you operated or not? If operated why this punishment again? I will never undergo any follow-up. If I am destined to be cured I will be cured. If not I will die. Why to be tortured? Let me live a peaceful life as long as I am alive." I thought that it's impossible to convince her at this high voltage atmosphere. I applied my patent formula. I once again entrusted the responsibility to Sujata. She took the charge of follow up. I lost my credibility as her physician and became a family member and elder brother of her. I felt honored with this new responsibility. Since then I had never seen her as my patient. Whatever medical issues, I got the right information from Sujata.
Is it a coincidence or Divine plan? A marriage ceremony of a third party, meeting of two very well known families without communication for a long span of time almost on the verge of forgetting each other, an accidental meeting revealing a serious gynaecological problem resulting in early diagnosis seems to be reading the story of Alladin's magic lamp. The interesting part was the last scene of the movie where in spite of tough resistance by others, Namita's stubborn attitude/ strong faith on me created the stage where I had to play the most vital role of discharging my duty as a savior. In spite of her whimsical behavior, careless attitude towards follow up and treatment she had successfully completed five years and led a disease free and symptom free life. It's not a joke. For me it was a miracle. Namita was a patient I operated and after that I found she was not my patient, she was my gifted sister, the most loving sister God had blessed. I am no doubt fortunate and hope everyone to be blessed with a sister like her. The best Divine gift received by me in my more than forty years of clinical experience is unique. Pray Lord Jagannath to bless my Namita with good health and happiness with her family and friends.
She was very erratic on her follow up. Many a time she was reminded upon repeatedly. Sujata was taking care of that part, I had very little to bother. But I was very much apprehensive because we were succumbing to her whimsical attitude. May God forbid, we might not miss something? Fortunately nothing happened. On the Rakshya Bandhan day of 2016 she came with her husband to my chamber with sweets, gifts and tied Rakshi, which created a new relationship. She touched my feet. Unconsciously my voice choked and a few drops of tear rolled down my cheeks. It was such an emotional moment, I experienced for the first time in my clinical life. Namita and Akshyaya left my chamber. I was just praying for her complete recovery. Then I attended her daughter’s marriage with the responsibility of an uncle. In between we had not met on Rakshi Purnima because of my mother’s demise and covid pandemic. On the same auspicious day in 2021 she came to my chamber to tie Rakshi after a gap of long 5 years. I was the happiest man on that day seeing my sister leading a disease free and symptom free life for more than 5 years. After a few moments she left my chamber, touching my feet and saying something which I couldn't understand. Just before leaving the chamber Akshyaya told me that her son's marriage was fixed. I prayed God to bless her. During these 5 years many changes had occurred. Her daughter got married.
Akshyaya got promoted to Superintendent Engineer and then to Chief Engineer. I am waiting for the auspicious day when her son will get married and I will be performing the role of maternal uncle. She had celebrated her 6th postoperative anniversary on 15th February 2022. Pray Lord Jagannath to bless her with a symptom free healthy life and continue celebrating the unique anniversary.
Prof Gangadhar Sahoo is a well-known Gynaecologist. He is a columnist and an astute Academician. He was the Professor and HOD of O&G Department of VSS MEDICAL COLLEGE, Burla.He is at present occupying the prestigious post of DEAN, IMS & SUM HOSPITAL, BHUBANESWAR and the National Vice President of ISOPARB (INDIAN SOCIETY OF PERINATOLOGY AND REPRODUCTIVE BIOLOGY). He has been awarded the BEST TEACHER AWARD of VSS MEDICAL COLLEGE,BURLA in 2013. He has contributed CHAPTERS in 13 books and more than 100 Scientific Articles in State, National and International Journals of high repute. He is a National Faculty in National Level and delivered more than 200 Lectures in Scientific Conventions.He was adjudged the BEST NATIONAL SPEAKER in ISOPARB NATIONAL CONVENTION in 2016.
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