TWO AMBULANCES
Dr. Gangadhar Sahoo
Ex- Dean, IMS & SUM Hospital, Bhubaneswar
Ex- Pro VC S “O”A University, Bhubaneswar
President, ISOPARB
Dr Mishra a medicine specialist working as a consultant in VSS Medical College Hospital, Burla had chest pain and difficulty breathing one night. He was brought to the casualty and admitted to the department of cardiology for management. A known case of hypertension and diabetes for the last three years, he was under the treatment of Prof. Sahoo, HOD, Cardiology. That night he had typical symptoms of angina and on an investigation, it was found to be suspected IHD (ischemic heart disease) without any features of MI (Myocardial Infarction). He was treated conservatively that night. As desired, he was referred to Apollo hospital, Bhubaneswar (around three hundred kilometres from Burla) for evaluation and better treatment. The hospital ambulance with emergency facilities was arranged to carry him on the next day morning at 8 am to . The wife of Dr Mishra and a pharmacist were to accompany him.
By 8 am all official referral procedures were ready. Prof. Sahoo himself was present there to supervise everything. At that point of time , a group of medical students rushed into the cardiology department carrying their teacher Dr Panda, Assistant Professor of Medicine on a stretcher who collapsed in the lecture theatre while taking their class. Almost all the 150 students assembled outside the department. Some were crying, some were praying, some were rolling on the corridor and others were marching directionless. " Oh! God Save our teacher, " was their cry. Some students rushed to Dr Panda’s residence and virtually lifted Madam Panda to the cardiology department. Mrs Panda was a Gynaecologist working in the same hospital. She was my student. Burla is a small place. The news of the collapse of the most popular physician Dr Panda spread like a wildfire. Doctors and staff including the medical superintendent and principal reached the spot immediately. By that time Prof. Sahoo had already started all possible resuscitation measures. Dr Panda had regained consciousness but was not out of danger. He was pale, dyspnoec, tachycardiac and disoriented . It was urgent to shift him to a higher cardiac centre to save his life. The superintendent immediately ordered the 2nd ambulance. But it will take at least one hour for the vehicle with the required staff and equipment to get ready to move to Bhubaneswar. So the superintendent ordered the 1st ambulance to carry Dr Panda immediately to Bhubaneswar and the second ambulance to carry Dr Mishra. That was the best and most rational decision because Dr Mishra was stable.
Dr Mishra was a bit upset after getting this order. Even though both the doctors were good friends but in the race of life and death, both were competitors. Who will sacrifice for another life knowing fully well that one's own life was in danger? An ambulance was ready for him, but it was changed. Who can guarantee safety for him for the delay of a few hours in shifting? Those ideas were putting a series of questions to Mrs Mishra. Yes! Dr Panda and Dr Mishra were two friends but the situation was not sharing and caring. It was a situation of all or none law. How can Mrs Mishra give up? God forbids! Let this not happen. But how can a wife allow herself and her family to suffer for hours of waiting in apprehension when her husband was a cardiac patient with undiagnosed pain and unpredictable outcome? She ran to the medical superintendent and the cardiology professor and charged them with discrimination and deliberate negligence against her husband. She was not in a position to accept it. She threatened them with legal consequences if something goes wrong with her husband. But the practical situation was different. Dr Panda had a dissecting aneurysm of the aorta. It is a condition where there is an injury in the inner wall of the aorta and blood from the aorta sips through it and gets accumulated in between the two outer walls. A large volume of blood can be drained into that dissected space leading to a life-threatening condition. That had happened to Dr Panda. He was in critical condition. That was explained to Mrs Panda. Moreover, Prof. Sahoo assured her that her husband was stable. There was no detectable cardiac cause for the pain and nothing will happen in a few hours. He was properly monitored and taken care of. Then she became calm and came down from an emotional world to the real world. His husband also consoled her and the situation of turmoil was brought under control.
In the meantime, Prof Panda had been shifted to the Apollo hospital Bhubaneswar under cardiac support. His wife and one PG student accompanied him. It took nearly six hours to reach the Apollo hospital. The cardiologist in charge who was informed well in advance was ready to receive Dr Panda. As soon as he reached he was taken to the Cardiac ICU. In the meantime, an air ambulance was booked to shift Dr Panda to AIIMS New Delhi. That Air ambulance had to fly from Chennai. But to everybody's bad luck, it sent a message of regret because of technical difficulty. What to do? Mrs Panda was clueless. Her only power was prayer. The only option left was to fly on a regular flight. The doctors of Apollo tried their best to book tickets for an Air India flight scheduled to depart at 6 pm. Air India demanded a certificate of safety to travel , along with an accompanying cardiologist with the necessary support machines. That was arranged by the Apollo hospital.
At around 10 am the second ambulance got ready at Burla . Prof. Sahoo compiled all the reports and the treatment given to Dr Mishra and handed over the discharge ticket to him. The examination findings at the time of discharge were written. It was almost normal. Prof Sahoo wished Dr Mishra all the best and a safe journey and begged apology to his wife for that inadvertently made delay which was not with any conflict of interest but as per humanity as well as part of duty. Dr Mishra reached Apollo hospital at about 4 pm. It was the time of departure of Dr. Panda. Mrs Mishra ran to the cardiology ICU to meet Mrs Panda, who was busy shifting her husband to the airport. Both the madams looked at each other. Both could not control their emotions and unknowingly tears started rolling. The tears were telling everything about the goodwill and prayers for the well-being of their husbands. In the mean time Dr Mishra got admitted into the cardiology ward. All necessary investigations including echocardiography and TMT were done. Fortunately, everything was normal.
With the help of the cardiologists of Apollo hospital, Dr Panda could board the Air India flight safely at 6 pm with the necessary arrangements. The two and half-hour journey to New Delhi appeared as if it was the most difficult never-ending journey for Mrs Panda. All the passengers on the flight were her moral boosters . In one voice all the passengers and the crew wished Mrs Panda a safe journey and assured her every help during the journey. All had a mass prayer for Dr Panda. The power of the prayer acted like the third engine for the flight. That Divine power generated by the mass prayer , strong willpower of Dr Panda and the devotion of Mrs Panda helped the Air India Flight to land safely at Delhi Airport at around 8.30 pm. The AIIMS ambulance with the team was ready at the airport. Immediately Dr Panda was shifted to the ambulance. Mrs Panda thanked all the passengers and crew for their moral support and proceeded to AIIMS. Dr Panda was directly taken to the Cardio-Thoracic surgery ICU where all evaluation was done by a team of doctors comprising of a Cardio-Vascular surgeon, a cardiac anaesthesiologist, and a critical care specialist. The decision for the emergency operation was taken. Mrs . Panda was just a mute spectator . She had left everything to God.
This is a very rare and risky procedure. Very few people in India were experts in this procedure. The operation started around 12 midnight and continued for eight hours with much turbulence. Almost it was presumed as a lost case. But the operating team were ready to fight against all odds to save the life of Dr. Panda. Anyway, by the grace of Lord Jagannath Dr Panda came out of the OT with a ray of hope at around 8.30 am. The aftermath of this critical surgery is a different story altogether. If possible, I will write it in another episode. But the conclusion was that both the doctors(Dr. Panda and Dr.Mishra ) reached their hospital safe, right treatment by the right persons at the right time was given to both of them. It couldn't have been humanly possible. That was the belief of the people. The bone of contention was , "Who was to travel in the 2nd ambulance? " That was solved right at the nick of time. Ultimately both were safe. People believed that those two ambulances were not mere mechanical vehicles. They were the two horses of Lord Balabhadra and Lord Jagannath sent on time to carry their devotees to their destination. WHEN LORD JAGANNATH IS WITH YOU NOBODY CAN CHANGE YOUR ROUTE NOR YOUR DESTINY.
JAI JAGANNATH.
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