THE DAY I CARRIED AN ANGEL

In the wonderful days of my innocent childhood, one day, my father walked into our study room and quietly pinned a poster on the wall. After he went away, curious as I always am, I walked upto it and it read as follows:

‘Footprints In The Sand’

One night I dreamed I was walking along the beach with the Lord. Many scenes from my life flashed across the sky.
In each scene I noticed footprints in the sand. Sometimes there were two sets of footprints, other times there was one only. This bothered me because I noticed that during the lowest periods of my life, when I was suffering from anguish, sorrow or defeat, I could see only one set of footprints, so I said to the Lord, “You promised me Lord, that if I followed you, you would walk with me always. But I have noticed that during the most difficult periods of my life there has only been one set of footprints in the sand. Why, when I needed you most, have you not been there for me?”
The Lord replied, “The years when you have seen only one set of footprints, my child, is when I carried you.”

This was perhaps one of my first exposures to the concept of God. You walk, I will walk with you, and when you cannot walk, I will carry you. That day I said to myself, ‘How simple….how uncomplicated……how great’.

A similar story happened with me a few days back in OT 5. But there was a difference. The angel didn’t carry me, I carried the angel.

She was a girl just 2 days old, I don’t even know her name (guess her parents had n't even named her). She was born with a congenital malformation which caused an incompletely formed intestinal tract. Thus there was no opening in the gut lumen (called High ARM with imperforate anus). So she had to be operated in emergency to create an opening (colostomy) or else her intestines could rupture once she started feeding. I met the baby one day prior in the NICU and saw her sleeping peacefully, oblivious to her grave condition and the surgery to follow.                                                                                        

The next day at OT I was told to get the baby in. I went to the pre-op beds and saw ‘angel’ sleeping comfortably in the arms of her mother. I explained to her mother that she will have to give the baby in my arms so that I can take her into the OT. The mother was apprehensive and I was shit scared. Scared because I had no idea about the right way to carry babies and I didn’t want to inadvertently hurt her. She was all of 2.2 kgs by weight (only a little bigger than the rats on my ship). Gathering all the courage in my heart, I took angel in my arms. I could feel her heart beating, at about 120 beats per minute. I don’t know if she felt mine, 240 beats per min almost fibrillating!!

Sensing some change in warmth and utter discomfort in my arms, she opened her eyes. She looked like Neytiri of Avatar, sarcastically gesturing to me how terrible I was in carrying kids. And then she closed her eyes and went off to sleep. Oh how hopeless I felt that moment.

It didn’t take us much effort in putting her to sleep. The surgery began but and soon we realized that the anesthesia ventilator could damage her tender lungs. So I was told to use the Jackson Reese circuit and bag the baby all through the surgery. Oh God….. My heart was skipping beats regularly now. Bagging the 2 day old baby was a nightmare, it was so easy to injure her fragile lungs but ventilating her was necessary to keep her alive and asleep. The surgery took about an hour and I continued to bag her. She needed just about 20 ml gas per breath. It was a unique and satisfying experience to give anesthesia to such a small baby. I’m sure my teacher must have had a quiet laugh at the way I was scared to manage the anesthesia. All went off well and we reversed the baby and I volunteered to hand over the baby to the mother. This time I did a better job I’m sure. It was such a relief to hand over the baby back into the safe arms of her mother.

The baby will need another surgery at the age of 8-9 months. I hope she comes back to us. I’m looking forward to give her anesthesia. This time I assure I ll do a better job.

Amma Rediscovered

      I got busy in my ‘high-adrenaline’ job and quietly forgot about amma. Six days after amma’s surgery, I was on night duty and we got a call that a GI case will be re-opened for a certain complication that had developed. When I reached OT, no points for guessing, it was Amma being wheeled in. She was the same since I saw her last. She still had no idea why she had come back to OT. She had the same expressionless face, same inquisitive stare, downward looking gaze and not a word to speak. The only difference was that she had become weaker. Yet, ‘the purpose of all life….first…is to preserve life.’ She was struggling hard to do the same.

      I recognized her. But she didn’t remember me. We took her into the OT again but I dare not look into her eyes. We straight away knocked her down. She was cut up once again and stitched back once again. All of this to see that she survives. This time she went to the ICU after the surgery. Few hours later, she opened her eyes. “Thank God”, I said to myself, “I think she’ll live.”
      She continues to struggle each day, to preserve that precious little life that someone told her is “God given”. Each time I go to the ICU to meet her, she gives me a blank stare. Then one day, I went close to her when she gave that look of hopelessness. She held my hand and gently squeezed it. I got the message- “Thank You” (she recognizes me now).
      Since then, she has been in and out of the ICU and ward, struggling hard to live to die another day. Each time it seems as though she wants to give up on this painful life, she is back on it saying “Not yet….not yet”. I see her regularly in the ward now, from the corner of my eyes, lying quietly.
      And then I say a silent prayer.

Amma

      It was the beginning of another busy day at lower OT. 0730h seems like the dividing line between the end and beginning of two different worlds. I knew it was General surgery OT that day and there were 2 “small cases” and after which there was a big onco case, which the surgeons wanted to do it in the end.
So I put the first gear and finished off the first two “cases” quickly in the sikhlaye hue tarike se. Then I had my coffee and energy toffee and went to this last case. As I came closer to the pre-op beds, there was this 4 ft 3 inches, seventy something,30-35 kgs amma waiting patiently among a crowd of other patients. She had a jaded look on her face and the innocence of a 3 year old kid.
      I announced “Hanumanth kaun hai?” The amma replied “Hum hain” and she quietly gathered her belongings and started walking, slowly but steadily with me towards the OT. I took the documents from her and had a quick glance at her face. It was absolutely expressionless. And there was this momentary disquiet inside of me. She was thinking, looking downwards…but what? I glanced through the documents and guided her into the OT. I told her to climb over the table and lie down on her back. Without uttering a word she promptly followed my command. Then I told her that she will have to take her sleeves off the gown. Quietly and obediently she followed the command. The silence was making me very uneasy. Was I being rude? No I wasn’t. I speak to my patients with due respect.
      She started to shiver in the state-of-the-art air conditioner of OT 5. I noticed that. Then I gave her a prick in order to insert the IV cannula. She gave out a brief whimper and then…silence. We started to connect hundreds of monitors onto her but she did not even complain a wee bit.
      Then I held the oxygen mask onto her face and waited for Alok sir to inject Thio. In the next few moments, I had the chance to stare deep into her eyes. I was told that her son is a soldier and he brought her to our hospital with history of weight loss and anorexia. She was diagnosed to have gastric carcinoma.
      She had absolutely no idea of what is happening to her, what disease she had, or that we were going to remove her stomach (gastrectomy is the technical jargon) and may be take a loop of her intestine and stitch it onto the skin and call it a colostomy. She had absolutely no idea of what was to come. The only thing that she had was unending faith that we guys are educated supermen of sorts, and that we won’t harm her. Her eyes portrayed complete submission…..submission into our hands. Hands of daactar sahibs. Could it be so basic, so elementary? Am I missing something?
      I saw basic human instincts come into play that day. She shivered when it was cold, cried when there was pain, tachycardia on seeing the oxygen mask and so on. But not a single expression on ammas face. Why wasn’t amma scared? She was constantly looking down….was she thinking…if so what? When I was a child, I once learnt “The purpose of all life on this earth is first, to preserve life” May be this was it. Her purpose at that time was to preserve her life, rest can wait.
      She became unconscious within a minute. The surgery began, went on for a long time. But I couldn’t forget those eyes. I left OT after about 5 hours because of a class I had to attend. The surgery finished well beyond. Did amma wake up? And what happened when she found herself in a dilapidated state may be with a tube jutting out of her throat?
      The only words she spoke to me were “Hum hain”. It was unusual silence from a patient undergoing surgery (usually they keep talking until we knock them down ) She never spoke a word but her eyes gave me a lesson for life. Her eyes pleaded with me to treat her gently, not to poke her in the forearm or smother her with the face mask. That she was not a ‘case’ of 35 kg body weight so that we could immediately start calculating drug doses on seeing her. The eyes said “I’m human too, not a case.” May be she should have said it out aloud in the OT.
    My class finished in the evening. I didn’t have the courage to call up the OT and ask about amma. Should I?

    I hope she is breathing !!