FIRST STEP OF MY JOURNEY IN GYNECOLOGICAL ONCOLOGY
FIRST STEP OF MY JOURNEY
IN
GYNECOLOGICAL ONCOLOGY
Dr .Gangadhar Sahoo
Dean, IMS & SUM Hospital
Bhubaneswar
?I entered into the Post Graduate course Obstetrics and Gynecology in VSS Medical College Burla in July 1976. After approval by Odisha Public Service Commission I joined as clinical tutor (now re-dsignated as Senior Resident) in the same institution in 1985 and worked there till my retirement in 2012, a record breaking 27 years at a stretch in different capacities. I retired as Head of the Department. From the very beginning I had developed a feeling towards CANCER patients which later turned into my passion. I had heard that the Legendary surgeon Prof Sukumar Mitra was the first person in Odisha and one among a few in India who was operating on CANCER cases. I had not seen his surgery because he was transferred to SCB Medical College Cuttack long before I joined my PG course. I had heard that Prof Mitra had two teams of assistants. Since the surgery used to last for 8 to 12 hours, there was changeover of the team after 4 to 5 hours. At that time there was neither AC nor cooler. So big ice blocks were brought and table fans were switched on behind the ice cubes. That cool soothing air was keeping the OT cool and more so the brain of the tensed surgeon and his team . After transfer of Prof. Mitra, Prof. Nanda, Prof. Dey and later Prof. Raut continued operating cancer cases.
There was a cancer ward where advanced-stage cancer patients were kept. At that time RADIUM needles were used for intravaginal application in cancer of the cervix. Cancer of the cervix cases were plenty and that too in advanced inoperable stages. It was the duty of PG students to insert radium. I had done this risky procedure many a time, without understanding the hazards.
Even we the PG students were so careless that we used to carry those needles in our pant pockets. One day one needle was lost. Prof. Nanda, our HOD fixed the responsibility on the PG student and the staff sister in charge of the cancer ward. Prof Nanda was a hard task master. He suspended the staff and didn't allow the PG student to work, until the needle was recovered. Both of them searched every nook and corner of the ward, every surface of the bed, all the dustbins but to no avail. Then the three sweepers on duty that day were called. They showed us the places where they had dumped the solid garbage and litters. All of them cooperated in the mission of search for the lost radium needle. After around there hours of search the lost needle was found. Thank God, we were saved. This might appear a small issue of missing a radium needle, harsh punishment of Prof Nanda and negligence of the PG student, but it taught us a few lessons of life. From that day I understood the value of the life of a cancer patient, the importance of a radium needle in palliative treatment with prolongation of life of the dying old women and the smile on the face of their innocent relatives.
During PG days we had got no chance to assist a cancer case. Professor Nanda or Professor Dey will operate, an assistant professor will be the first assistant and a clinical tutor will be second assistant. PG student will be ready to number the retrieved samples in the suitable containers for sending to the Histopathology department after faultless filling of the requisition forms. The more the number of samples the better was the surgery, was the common notion at that time. If the dissected specimen was extensive, then that was kept in the Department museum for undergraduate and postgraduate examination purpose. The mounting and fixing of the specimen in a glass jar was the duty of the postgraduate students. We were satisfied doing our job as learners. When Professor was operating, others were watching the procedure surrounding the patient. If we got a little bit of space we were peeping through, as if we were watching a magic. It was just like a hide and seek game. We did not know what we gained, but our sole aim was to draw the attention of our Professor.
?When I joined as a clinical tutor in 1985 Prof. Nanda and Prof. Dey were already transferred to SCB Medical College, Cuttack, leaving Prof Raut as the only Doctor doing cancer surgery. For a long period I was posted in his unit. I used to assist his cancer cases because other faculty members were reluctant to do so because of lengthy procedures. I was also taking care in the postoperative period, dealing with post operative complications and keeping a record of post operative follow up as per the protocol. Through that I learned a lot and gained confidence that I can operate a cancer case. I read a number of books, attended a few workshops on Gynecological oncology where renowned surgeons were operating. At that time the team of Prof. Badal Mohanty and Prof. Dhira Pattanaik of Cuttack was doing radical surgery. I got two of my relatives operated by them where I got a chance to assist them. That was the best learning period for me to learn the tricks of selection, evaluation, preparation and counseling of cases. The tricks of avoiding complications during operation and handling complications if they occured was worth learning from them. Gradually I was maturing. I had developed my own methods, taking cream from my different Gurus. Prof. Raut was pleased with my dedication and commitment. Slowly he taught me radical surgery step by step.
After a year or two Prof Raut got transferred to SCB Medical College, Cuttack. At that point of time one patient Angurbala Behera was admitted. She was 42 years, a mother of three children, she had undergone sterilization operation and her husband was an employee of Hirakud dam project. Her final diagnosis was CARCINOMA CERVIX, in early operable stage. But to her bad luck Prof. Raut was transferred. She was in a dilemma what to do. After Prof. Raut there was none other than me who had the experience of operating cancer cervix . But the patient had no confidence on me because she was booked under Prof. Raut and she had seen me as his assistant. How could she trust me ? She had got no chance to judge my skill. She went to the residence of Prof. Raut, touched his feet and prayed, "Please save me. I am a poor lady, I can't go anywhere." Prof. Raut assured her, "Gangadhar can do my job, even better than me. Nothing to be worried. You are in safe hands". She returned consoled, convinced and confident. Next day in the ward round she volunteered to be perated by me. Now the burden of responsibility was on my shoulders. I felt How Abhimanyu might have felt when he was offered the responsibility of breaking the CHAKRABYUHA designed by Guru Dronacharya. I felt myself fortunate, jubilant and at the same time nervous. I accepted the challenge.
The operation date was fixed for Angurbala. All necessary investigations were done, two bottles of blood arranged after anesthesia fitness. I selected my team. I took one of my senior most, reliable, dependable and knowledgeable post graduate as my first assistant and one second year PG as my second assistant. It was my habit to tell all concerned to go through the chapter of cancer cervix from different operative books. In the evening round before the day of operation my team spent half an hour with the patient to discuss all her queries. It was a confidence building measure at the same time dispelling all the misconceptions, anxiety, fear and apprehensions from her mind . Then after giving some advice we all departed wishing her all the best. I patted her back and said, “Don’t worry. God will take care."
Next day as usual OT started exactly at 9 am. I was very nervous and tense I was reminded again and again by myself not to be adventurous. OT was full with staff and PG students to observe my steps of Surgery. I usually teach my students by way of live demonstration on the patient during my Surgery. That takes away my tension. I did that. When students ask to show them any organ or structure, I usually out of joke ask them to book tickets for the show. Operation was completed smoothly within four hours. I was satisfied. I was served a cup of tea by the OT sister in charge. That day the taste of the tea was different. I thanked everyone in the OT, sought blessings from my Gurus and prayed for my maiden cancer patient. My first case Angurbala was operated in 1995. She was under regular check up for 5 years. I retired in May 2012. On my last working day, 31st May 2012, I had operated two cancer cases. From 1995 to 2012, I must have operated around 1000 cancer cases with mixed results. I had gone through ecstasy and agony, excitement and depression, attachment and detachment. But I continued doing cancer surgery as my passion to help the downtrodden. That gave me mental strength and peace. In 2014 when I left Burla, ANGURBALA with her husband had come to bid me farewell. Tears were rolling from their eyes. The tears were telling me, “Thank you Doctor! You have given us a new life.”
Angurbala was my first inspiration. She was the first step of my journey of seventeen long years. From there I had not looked back.
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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