A Matter of Destiny - 2


Dr Sharad Panday

Some twenty years ago I got a telephone call from a young lady, Stella Dubey, who wanted her mitral valve replaced. I was surprised at the direct reference of the patient as usually specialists such as I am, are referred cases by other doctors. I called her for consultation in my office at the K.E.M. Hospital.

Stella was young, exuberant and good-looking and she hardly seemed ill. However, when I examined her and studied the X-ray of the chest, it was clear to me that she needed urgent surgery for valve replacement. When I told her about my decision, to my utter surprise she took it matter-of-factly. Indeed she was eager to get operated as soon as possible. All that she wanted was to be assured that the operation would be done by me personally. I had just returned fresh from my Canadian training and was full of enthusiasm and I took her up for open heart surgery with great confidence. The operation went off smoothly and we were able to disconnect her from the heart-lung machine.

But what followed turned out to be a nightmare. Minutes ticked away but Stella remained unconscious. The situation was frightening. She was a young woman who had expressly asked that the operation should be done by me alone though there were more senior surgeons in the Department. And what had I done to her?

Throughout the day I went to see her several times and tried in vain to wake her up but Stella was unresponsive. Her anxious husband and innumerable friends began to show their displeasure at me. This only worsened my misery. My reputation had taken a nose-dive. I went about my work like a robot, drained of my enthusiasm.

Then one day Stella opened her eyes and smiled. When the news reached me, I rushed to her bedside, but I was due for another shock. Stella just did not recognise me! I was back in the dumps, wondering what had gone wrong.

But then Stella began slowly to improve. Several days later she awoke and apparently started moving around as if nothing had happened to her. The nurses, ward boys, every one around was summoned to witness the miracle. My joy knew no bounds. Stella celebrated her birthday while she was in hospital. I called it her re-birthday and I was greatly relieved when she was finally discharged from hospital, hale and yes, hearty! Stella had been an excellent patient and a good friend. This story is now over twenty years old and Stella went on to have a child whom she fondly named Sharad-after her heart surgeon.

When I think of Stella, I am convinced that there is something like Destiny and that patients do survive sometimes in spite of all odds, if they are so destined.

Unconsciousness after cardiac surgery was not uncommon twenty years ago. Despite the surgeon's technical virtuosity, things could go wrong, as the equipment available at that time was not as sophisticated as it is today. Even the heart-lung machines were in their early developmental stage. It is not that I am trying to lay the blame for accidents solely on the equipment. Things could go wrong for a wide variety of reasons.

But if I am relating this story, it is to make a point about the reactions of a patient's relatives. One day they could be all praise for the surgeon, but let something go wrong and the same doctor has had it. Let alone the surgeon, even the ward boys are not spared. Confidence in the surgeon ebbs rapidly. The hours of hard work at the operation table, the sustained concentration on the job-all get forgotten. It can have a shattering effect on the doctor's morale. But let the patient improve and reverse reaction sets in. The miracle man-turned-villain, becomes the miracle man again.

In Stella's case, technically my job had been done to perfection and hardly anticipated any problem. What happened was frightening. The only good thing was that the story had a happy ending.

Compilation of professional reminiscences of specialists - edited by M.V.Kamath and Dr.Rekha Karmarkar