I was woken up by the screaming of my phone in the middle of the night. A child was critical and needed urgent surgical advice. As the junior most in the surgery department, I was expected to attend to such calls and inform the seniors. As per protocol, if the situation warranted emergency surgery, seniors rushed to the hospital. If senior residents found it complicated, consultants would join the team. Life of junior resident is pretty hectic but devoid of any big responsibility. I was called to attend to Gyani, a 2 year old child, who was admitted for treatment of blood cancer and undergoing chemotherapy. Since the last one hour he was incessantly crying of pain and holding his stomach. He was tossing on the bed and was not allowing anyone to even touch him. His mother was equally distressed and trying her best to console the little boy. The nurses and doctors had tried everything to relieve his problem but it only became worse. I was called to look for any cause that may warrant surgical intervention. The child started to vomit with streaks of blood. With teary eyes, he was begging his helpless mother for relief. As I stood there overwhelmed by the grief around me, the mother held my hand and pleaded for relieving the excruciating agony. Little did she know that I was the junior most doctor with no experience in pediatric surgery. To be honest, I was as nervous as the mother due to my own inherent weakness. It is very difficult for me to maintain my composure and confidence while treating kids. I get too involved and become emotional seeing their plight. Fortunately, in this case, my role was limited to attending to him and informing my seniors to take the final decision. After careful examination and looking at the X-ray, I concluded that the child had perforation in his bowel through which intestinal contents had leaked into the stomach. It is a rare complication of chemotherapy and invariably fatal if not treated expeditiously. The child needed emergency surgery as soon as possible to save him from the infective shock. His cries had grown shriller and mother’s tears flowed incessantly.
I rushed to the nearest telephone in the nurse’s cabin to connect to my seniors. The telephone operator tried several times but could not connect to any of the seniors. Twenty minutes had already passed. Drenched in sweat, I could hear the cries of Gyani while helplessly trying to connect to my seniors. Gyani’s mother suddenly appeared in the cabin with folded hands and expectant eyes. The nurse rushed in just behind her to inform me that the pulse of Gyani was becoming feeble and he was becoming listless. I was shivering and my hands started to tremble. I had no option but to call my consultant who picked up the call but his response pushed me into greater distress. He was 6 hours away from the hospital! I stood there frozen and devastated. The mere thought of being all alone to handle this complicated surgery was quite unnerving. I had never operated on a 2 year old that too with such a serious problem.
A nurse came running to inform me that the child had slipped into shock and his abdomen had ballooned up. This drained out whatever little confidence and strength that was left in me. My exhausted brain started mulling over various escape routes. One of the option was to explain everyone that child could not be saved and walk out of the situation. Alternatively, I could continue the supportive medicine in the ICU till the morning when all the seniors would be around. Nobody would have suspected me if I had exercised any of these two choices. Both these options would have saved me but not the child. Left in that condition, we could have lost Gyani in couple of hours. Struggling to regain my composure and overcome my fears, I told them to shift Gyani to the operation theatre. The mother was almost hysterical and the news of emergency surgery aggravated it further. Gyani was the only child who was born after a decade of treatment of infertility, 4 miscarriages and hundreds of trips to temples.
As I explained Gyani’s problem and details of the surgical procedure, her mother held my arm with her cold and clammy hands. Behind her, I could see Gyani being rushed into the elevator leading to the operating room. The boy laid motionless with oxygen mask on his face and several plastic tubes running all over him pushing fluids and antibiotics. The mother, looking straight into my eyes, enquired if my seniors or consultants were coming for the surgery. This created a moral crisis for me. If I had replied in affirmative, I would have lied and cheated her. If I had told her the truth, I could have demoralized a distraught mother who could have refused surgery. I did not want to lose Gyani at any cost! Moreover, you are not supposed to speak the truth, especially in a hierarchical medical setting.
Gripped with uncertainty, I walked into the theatre and asked the nurse to prepare for surgery. She was perplexed when she realized that she was the only assistant that I had. Even the anesthetist stared at me with a bewildered expression. The child’s pulse volume and blood pressure were dropping fast and his heart rate was increasing menacingly. We could lose the child any moment from the dreaded septic shock. I could gauge that everyone was suspecting my ability to handle such a complex case. I walked near the kid who was lying on the operation table and being prepared for surgery. As I stood next to him looking into his drowsy eyes, he grabbed my left index finger. His grip was weak but it transmitted limitless feelings. I suddenly realized the magnitude of expectations from me. I had the responsibility of not only saving a life but also an opportunity to prove my skills. The boy’s touch invigorated me and infused me with confidence and boundless energy. I performed the entire surgery guided by my previous experience and knowledge. After a careful exploration, I realized that the boy had multiple perforations in his gall bladder causing leakage of bile filling into his entire abdomen. I could feel the panic among the anesthetists due to progressive deterioration of the condition of the child. The nurse’s frightened eyes kept looking at the monitor that was beeping loudly due to the alarming drop in the blood pressure. I had never done surgery for gall bladder in such a small baby. But my hands were being guided by invisible forces and mind was full of positivity. As I was nearing completion, the alarms silenced and staff in the OT heaved a sigh of relief. The boy was showing signs of improvement. I could feel the mixed expression of awe and admiration on the faces of those in the operation theatre. I did not realize how long the surgery went on but I do remember the gentle tap on my hand by the nurse to congratulate me. As the surgery neared completion, the vital parameters of the boy had returned to normal. He was now out of the danger zone.
At this point, my consultant walked into the OT almost breathless and panicked. I briefed him about the entire episode including the intra-operative findings. He shook my hands, patted my shoulder and expressed his appreciation before leaving the OT. I helped the nurse shift the boy from operation table to the stretcher. Few minutes later we started to wheel him towards the ICU. As we passed the corridor leading to the ICU, I could see boy’s mother holding the feet of my consultant and blessings him for the miracle that he had done. As she saw the stretcher with her child on it, she ran towards us. She kissed the forehead of her son and started sobbing uncontrollably. At this point something magical happened. The child opened his sleepy eyes and gripped my finger again. The mother’s joy knew no bounds. She rushed back and embraced my consultant once again and showered him with good wishes. After all, he had saved the life of her only son following a grueling night long surgery! I had merely assisted him.
With my fingers still in Gyani’s grip, I could hardly control my own tears. I thanked Gyani for the invaluable lesson he taught me that night. Ordinary people can also do extra ordinary things if they believe in themselves. Success is not about leading a comfortable life but enduring pain for comfort of others. The rising sun seen through the ICU window marked the beginning of a new life – Gyani’ s and mine.
Credits – Thank You Gyani where ever you are. Stay blessed.