LUCK FAVOURS THE BRAVE - 6

DR SUBHASH J. DALAL

Experience has made me wise and taught me one very important thing in life: howsoever serious or life-threatening a patient's illness may seem initially, I never give up trying to save him or her. I do not allow negative emotions like, 'Oh well, the patient is not going to survive this illness, anyway' to cloud my mind. The following two examples will certainly justify my positive approach whilst dealing with patients suffering from so-called 'terminal illness'.

About 27 years ago, sometime in the early sixties, when the word Cancer forebode doom, a 6-months old girl was brought to me at a Bombay Hospital. Her mother gave a history that the baby was passing some tissue in her urine. After evaluating her thoroughly, we came to the diagnosis that she was suffering from a malignant tumour of one of her kidneys, known as Wilm's Tumour. Her general condition was very poor and she was getting spikes of high fever.

My first thought was that this 6-months old infant will not survive more than one or two years, so why enhance her torture? But soon better sense prevailed.

A chance of survival for more than two years, later blossoming into a beautiful girl. She visited me regularly for a medical check-up to make certain that the dreaded disease had not recurred.

However, one day, this now fully grown young woman approached me with a grim look on her face. She complained of a pain on the side of the abdomen. I panicked. Was the other kidney playing truant now? But how could that be possible? For Wilm's Tumour is a childhood malignancy and she was in remission for the past so many years. All the same, I got her fully investigated and to everybody's relief and joy she was certified N.A.D. (Nothing abnormal detected in her condition)

On one such visit, after an initial hesitation, she shyly confided me that she was soon going to be betrothed to the fine young man who always accompanied her in the recent past, during her medical check ups. I was struck by the nobility of this fine man. He was fully aware of her childhood condition and yet had accepted her with open arms.

Meeting such people surely enriches one's life.

The second story is that of a 6-year old girl who was suddenly struck by a very virulent malignancy. The biopsy of the surgically excised specimen was proof enough that it was a high-grade malignancy. She had to be treated with chemotherapy injections (anti-cancer drugs) after which she got a remission of about six months.

Sure enough, considering the virulent nature of her disease, she soon developed secondaries or what we call metastasis (spread of cancer to distant organs) in her lungs. These had to be surgically excised following which another course of chemotherapy injections was mandatory. Her parents wanted to fly her to the United States where she could avail of the latest anti-cancer drugs.

I realised the futility of their action since it now seemed to me a terminal state of malignancy. The experts in the United States too had cautioned them against expecting any miracles.

However, they were adamant and wanted their precious daughter undergo more torture-yes, this is what I thought then. No amount caution dimmed their hopes. But today it gives me great pleasure in informing my readers that the fond hopes they nurtured for their child have paid very rich dividends!

Today she is a young vivacious girl and on her last visit she was accompanied by a very amiable young man her boy friend! Both are contemplating matrimony in the near future. Had I neglected the so-called 'terminally ill' patients, I would have certainly been guilty of moral turpitude. We, doctors, certainly cannot decide who is to live and who is to die. That 'final verdict' should unambiguously be given by HIM!