"Why Did You Save Me?" - 2

 "Why Did You Save Me?" - 2

Dr.Shantu J.Vaidya

Modern plastic surgery can take credit for repairing and reconstructing many a birth deformity almost to perfection. But man has limitations and where severe deformities are involved, there is a limit to what even the best surgeon can achieve.

Pravin and Prakash were brothers. They were well-to-do, married and staying harmoniously together as a joint family. Pravin, the elder brother, had a daughter, Priya, born with bilateral cleft lip and a cleft palate. The lips and the palate were in two parts separated by a noticeable gap. The deformity distorted the face considerably.

When I came into the picture, Priya was 25 years old. She had had about a dozen operations performed for correction of her deformity from infancy onwards both in India and in specialised centres abroad. The results had been far from satisfactory. Priya was ugly and her speech could hardly be understood. Her schooling was incomplete. She was excluded by most family members and she hardly had any friends. She was unable to get any work or employment.

Prakash, the younger brother, was married to Bhavna. Living within the joint family, Bhavna had seen the miserable existence of Priya. Four years after marrying Prakash, she gave birth to a son with a one-sided cleft lip and palate deformities. She was shocked and distressed.

Though the exact cause of this deformity is unknown, 20 percent have been traced to genes passed on from one generation to another.

I came into the picture through the family doctor, for correction of the deformity of Bhavna's child. The result was satisfactory to the parents and the son was socially well-adjusted. A slight scar did show on the lips but speech with a nasal twang remained.

Six years after the birth of her first child, Bhavna had her second child. This was a daughter. She also had the same deformity, but on both sides. I was called to the Maternity Home on the 4th day after the child's birth. Bhavna was in tears. Her husband, Prakash, stood by. What had they done for God to visit this punishment on them, they both wanted to know. My theoretical explanations of embryology was of little solace to them. The family doctor in their presence posed the problem: Bhavna was refusing to go home without having the child's deformity corrected through an operation. She knew the social stigma and ostracisation she would have to face once she left the Maternity Hospital.

I explained at length that the child weighed hardly five pounds and in the mortality risk of a surgical operation at this early stage would be more than 80 percent. To lessen the risk I would have to reduce the operation time and surgery would have to be hurried. Also, the result would be better if we operated on the child six months later.

But the couple had already made up its mind and was adamant. Both husband and wife said they were prepared to take the risk and were ready to face the consequences. The family doctor's intervention, too, failed. A very sensible, educated and concerned couple had come to the solemn conclusion that it was worth taking a chance and losing a child than having to live with a deformed daughter. It seemed to me that the husband and wife were almost suggesting that the death of a child on the operation table, legally, was acceptable to them. I declined to be party to the process and left after mumbling my sympathies.

Four days later, I again received a call from the family doctor. Again I went to see the couple in the Maternity Home. Once again the husband and wife made the same request. Bhavna was in turn hysterical, solemn and determined. She was emotionally very disturbed, and not without reason. She did not want her child to grow up and be discriminated against and be an object of pity if not derision. She said it would be far easier to have another child than to undergo the agony of having given birth to two deformed children.

For over an hour, I tried to dissuade them. Then I left. There was nothing that I could do. Two days later, the family doctor phoned me to say that Bhavna's daughter was admitted in hospital under the care of a paediatrician. This experienced child specialist had confirmed the high risk of surgery but was persuaded by Bhavna to do his best to look after the child post-operatively.

I was in a dilemma. Was I justified in undertaking a surgery with 80 percent risk, when the risk would be considerably lower-say, about 10 percent-if the operation was postponed by some six months? Who had the right to take a decision? How was one to balance the agony of a mother in circumstances beyond her control as against the risk of death Did parents have the right to take grave risks on behalf of a child? How would the law view surgery even if it was legally permissible? Should an armchair moralist have the right to sit on judgement on someone undergoing great mental turmoil? Or should we all passively resign ourselves to God's will?

Will the reader be the judge?

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