THIS HAPPENS VOL XV & XVII
THIS HAPPENS VOL XV
Dr. Gangadhar Sahoo
My younger granddaughter, hardly 7years old and I were playing student and teacher. I am used to be the student, my wife plays the role of my parent and my granddaughter plays the role of the teacher. Anytime she finds me free she will start teaching seriously. She is expert both in online and offline teaching. She leaves no subject that is taught in her classes. Like a disciplined and serious teacher she examines my answer sheet. She is very miser in giving marks. I will fetch a big zero even when I commit a small mistake. When I disturb her she will immediately complain to my wife ( playing the role of my parent) and ask her to make me disciplined. Really it is a regular fun which I enjoy.
One day during my Hyderabad stay she was teaching me on a small black board fixed to the door of her cupboard . She was about to start writing something on the upper border of the black board, raising her hight with maximum limping on her toes. I just suggested her to wait till she grows to that hight and write comfortably while teaching. She immediately replied," Where will you be at that time? Will you be on this earth ?"
I was stunned to listen to her words. She was mentally so matured !
Her words reminded me a beautiful incidence.
It was an incidence in early 1990s. I was attending a 12th day ritual following the death of Mr.Bahidar, a reputed person of Sambalpur Town, around 15 km from our place. It was evening time around 8pm . People had started coming , slowly the gathering had started to swell . The venue was a Mandap(Pandal ) on the bank of the river Mahanadi , very close to the temple Maa Samaleswari, surrounded by scenic beauties. Cool breeze was blowing. The ambience was very much friendly for such a function to pray for the departed soul.
The venue was well decorated like an aristocratic marriage pandal. Hindi cinema music was being continuously played. An Odia music party had started their orchestra of spiritual songs and music with very few audience.
Different types of food items both veg and nonveg , drinks both soft and hard , starters, Chinese, North Indian, South Indian food were arranged systemically in different stalls. At the centerplace of the pandal a garlanded photo of Late Mr. Bahidar was seen mounted on a big decorated table with burning agarbatis and a basket of flower petals kept aside. It is customary for the guests to offer floral tributes to the departed soul . Some senior persons were seen in white dresses and offering towels as the local customary and as a mark of respect . But the younger generation with their kids were seen in their seasonal dresses with a gift envelope in their pockets . They were putting the gift envelope at the foot of the photo, offering the floral tributes and going for their dinner. They were enjoying the dinner as if that of a marriage party reception.
There, I marked a group of young kids of around 5 to 7 years old playing in one corner of the Mandap. They appeared to be friends of the granddaughter of late Mr.Bahidar. They were enjoying their game because they were meeting their friend after a long gap. Out of curiosity I came closer to them to know what is the topic of discussion. Two of them were seriously discussing something. One of her friends asked her , " How old was your grandfather? What had happened to him ?"
She replied, " My grandfather was around 80 years old He was bedridden with 5 tubes introduced through different routes and orifices of his body . My mother was telling that these 5 tubes were the lifelines of my grandfather. Doctors told that he had a stroke with severe intracranial hemorrhage. He was critical . He was unconscious for about a month. "
" Who was looking after your grandfather as both of your parents are working? "asked the friend.
The girl said, " Two servants, one medical attendant and my parents after their office work were taking all possible care . They were all exhausted for last one month. Taking care of an unconscious patient, doing the office work and looking after the house hold works simultaneously was really terrible . God forbids his illness was not prolonged. Not only he was suffering , whole family was suffering . I had also suffered in my studies . Now onwards paeace will prevail ."
Immediately her friend told , " My grandmother of around 75 years, suffering from a serious disease and is bedridden for more than one month. My father was telling that she had least chance of survival. Yes ! I have experienced the same unhappiness in my family as yours . I will tell my father to arrange the rituals preferably in an hotel and in a better and more aristocratic way. I will invite all my friends. We will enjoy the whole evening that day. I will inform you ."
This discussion created a volcanic eruption in my mind. The so called modern changes has destroyed the deep rooted culture of our society. Invalid , diseased and bedridden parents are a burden on their families. They are the chronic nonhealing ulcers on the face of their family members. The sooner they leave this mortal world, the better. The rituals have undergone metamorphosis to celebrations . The gift envelopes have replaced the condolence notes .
I apprehend it is just the beginning. The society is very fast moving towards a suicidal end game. Pray Lord Jagannath to rebuild the social fabrics where only peace will prevail irrespective of contrasting situations, both in pain and pleasure, in hope and despair and in life and death.
THIS CAN HAPPEN XVII
Dr. Gangadhar Sahoo
Before 1995 there was no Nursing home culture in Burla. Burla is a small town developed on the bed of River Mahanadi. When the Hirakud dam , the longest earthen dam was built across this river in 1949 the quarters were constructed for the accommodation of all categories of staff required for the construction of the dam . After the dam work was completed these Government quarters were sold on lease basis to private parties, mainly the business communities. The Burla market was built by those people. The big halls constructed during that period was converted to schools, a residential blind school , school for deaf and dumb , hospital , post office and community centers. Gradually the township developed . In due course three centers of excellence were developed an university (The Sambalpur University), an Engineering college(University College of Engineering) and a medical college (VSS Medical College) , the 2nd Medical College of Odisha , first being SCB Medical College Cuttack.
This medical college grew in stature and reputation because of the efficient faculties and excellent surgeons. Not only people of Odisha but from bordering states like MP and Bihar were getting quality service at an affordable cost. One small private pathology clinic, Gupta Diagnostic Center owned by a local doctor started functioning. Now it has grown in stature of any advanced center in the country . The owner of this diagnostic center came up with a private nursing home , The Gupta Nursing. This nursing home was started in a private rented house . I was one of those fortunate consultants who was a regular visitors. To start with it was very dull . Slowly it picked up .
Here just at the initial stage , I was doing one CS of a lady doctor, wife of a gynaecologist, for placenta previa( placenta situated in the lower segment of the uterus) with bleeding. All necessary investigations were done, the best anaesthesiologist available at that time and a senior paediatrician were in my team. She was Rh-negative . Since it was a rare group, one unit of cross matched blood was kept ready . Two donors of same ABO & Rh-negative group were kept as stand-by for emergency situations.
When everything was ready the operation was started under spinal anesthesia. When I opened the abdomen I saw large blood vessels across the anterior surface of the uterus. Not only these vessels challenged , but also frightened me . I took a deep breath, alerted the anaesthesiologist, the pediatrician and my assistant to be on the toes for any exigency because I have to cut through the placenta if required. When I cut the uterine wall there was placenta through and through, peeping through the incision. It was difficult to separate the placenta . I have to cut through. There was torrential bleeding. Without caring for it I delivered the baby , immediately clamped the cord , collected the cord blood for necessary investigations and handed over the baby to the paediatrician. There was severe bleeding. Anaesthesiologist administered uterotonics was preparing to convert to general anaesthesia . Placenta was delivered. Bleeding stopped. We started closing the uterus. About five minutes had passed. I couldn't hear the baby's cry.
I immediately went to see the baby, leaving my assistant to close the abdomen after proper washing the peritoneal cavity.
The baby was not crying , not breathing properly . Paediatrician was busy with throat suction, oxygen supplementation and all possible methods of manual stimulation , but of no avail. He had started sweating. I couldn't control myself. I lost my temper and shouted at the paediatrician, " Why making delay ? Intubate immediately." But to my bad luck neither he was aware of the procedure nor he was ready for that .The anaesthesiologist took charge of it . Baby laryngoscope was not available nor the neonatal intubation tube. I could read my fate . With adult laryngoscope and larger size tube the anaesthesiologist incubated with much difficulty . But to everybody's bad luck the baby developed pneumothorax.
This was my bad luck. I cursed myself. I had never faced such a situation earlier.
Both the patient and her husband were my students.
They had enough confidence on me. They had preferred me to other senior obstetricians. But I couldn't help them. I can't think of a neonatal complication in an operation theater , to happen in a Rh-negative mother. It is not a mistake but a blunder. I couldn't anticipate and prepare accordingly. I should not have left the patient party to choose their paediatrician.
As the team leader I shouldered the responsibility.
Till date I haven’t forgiven myself. After that fateful incidence I learned one of the greatest lessons of life. I have never faced such a situation in life.
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