Skip to main content

The Lesson of My Life

As a medical specialist, armed with voluminous knowledge of diseases, skills and several years of experience, I had started exuding a good degree of confidence, somewhat more than what my wife felt was desirable.
It was around then that a frail, 83 year old lady came to see me for abdominal pain, jaundice and fever. She was as apprehensive of me as a doctor as I was of her old age. The duct through which bile flowed from her liver to the intestines was blocked and converted into a bag of pus with stones. It was not without trepidation that I offered to pass a rather thick endoscope down her throat to the intestines, pass an electric wire into the lower portion of her bile duct and cut out and clear the passage through ERCP. I did not mince words in explaining to her sons the considerable danger that the procedure carried in her vulnerable condition. The patient on her part agreed to take the chance.
With two of my juniors keeping strict vigil on her pulse and respiration, two nurses assisting me with the instruments, and innumerable beads of perspiration breaking out shamefully on my forehead, I gently manoeuvered the endoscope  past her vocal cords into her foodpipe. Then it seemed to descend effortlessly down to her intestines.
I inserted the electric knife into the lower end of the clogged bile duct, pressed on the footswitch slitting the narrow opening and letting out a gush of pus and dirty bile into the gut. The procedure couldn’t have been more perfect. Several of her children, grandchildren, well-wishers and friends looked admiringly at me as I explained with pride the complicated lifesaving feat that I had accomplished.
Encouraged by her dramatic improvement at my hands, her daughter-in-law came to consult me for gallstones, one of which had slipped into her bile duct. She was around 40, young, pretty and appeared a picture of perfect health and happiness. I proposed the same ERCP to her.
This day somehow turned to be another day.The bile duct opening was sticky and blocked and wouldn’t let the electric wire-knife in. I changed the angle and tried again and again, but did not succeed. I went on trying all the tricks I had learned during my training fellowships in Japan and Germany, but failure haunted me. My clothes were soaked in sweat when I finally gave up.
I lay in bed soaked in shame and hurt, trying to rerun the events of the day in my mind, wondering where I had gone wrong. After wandering through the catacomb of logic and science without a meaningful answer, I began to realize there was perhaps something quite beyond my brains, my hands and my skills. As the thick crusts of arrogance began peeling off my heart, I could hear the words of Ambroise Pare, a 16th century French surgeon, echo in my ears:” I cleaned his wounds but God healed them”!
Valuable lessons often come from unsuspecting sources and in innovative ways. 
As published in HT City( Hindustan Times) dated 2 October, 2011.

Comments

Popular posts from this blog

Teaching and Learning – is there a trick?

One of the big mistakes that we as parents and teachers often make, and that could stifle the mental development of our children, is to treat them as just small adults! In fact, it is this attitude of grown-ups that could be leading our next generation to become stereotyped conformists rather than original thinkers and innovators. And if we intend to drive home health messages and inculcate healthy habits we need to tailor our efforts to their cognitive potential. That children indeed think and discover the world differently was first noticed by a Swiss scientist Jean Piaget in the early 20th century. He studied his own three children grow and was intrigued by how they behaved, played games and learnt at different ages. With further observations and experiments, he propounded the theory of ‘cognitive development’, placed great importance on the education of children and is hailed even today, 30 years after his death, as a pioneer of the constructive theory of knowing.  He...

The Doctor’s Dress

The familiar white coat worn by physicians as their distinctive dress for over 100 years, has started generating  murmurs  of controversy. It is not uncommon to find the blood pressure to be higher when measured by a white-coat-wearing-doctor in the hospital or clinic than the readings obtained at home by relatives.  This is due to the anxiety that the white coat and the hospital setting evokes in patients, and has been termed “White Coat Hypertension”. Mature clinicians often routinely subtract a few points from these measurements when entering records in case charts or calculating the dose of anti-hypertensive medications to be prescribed. The white coat scares children too.  Kids often express their dislike for this dress by crying and screaming and by denying access to their bellies or chest for examination by paediatricians in this attire. Many pediatricians across the world have folded up their white coats and taken to informal colourful dressing to...

Food Fads in Liver Disorders

In an attempt at trying to do well to those they love, spouses and parents often enforce diets on patients of liver diseases that often turn out to be detrimental. The commonest food fad is pale insipid boiled cabbage being doled out to nauseous patients suffering from hepatitis that makes them puke even more.  The liver, in a way, is a buzzing manufacturing unit that requires lots of energy to keep its multiple functions going. And it derives all this from the food we eat. During disease, such as during an attack of jaundice, when many of the liver cells get killed, the liver attemptsdamage control by trying to regenerate quickly. For its cells to multiply however, it requires a generous supply of energy that comes from carbohydrates, and protein, the building block for its cells and tissues. Boiled green vegetables unfortunately have neither of these. Hence the situation often progresses to that of a starved liver unable to recuperate due to cut-off food suppl...