Saturday, May 18, 2013

Patient who taught me - 2



Anotherpatient who taught me something important.

This again happened during my previous stinct at NJH.

It was midnight of a really hot summer. The hospital was not very busy. I was called to attend to a girl, about 12-13 years old who presented to emergency with severe breathlessness.

On attending to this girl whom we shall call AK, I realised that I was dealing with a long term cardiac condition,  most probably a congenital cardiac disease with end stage cardiac failure.

The X-ray confirmed it. Her heart occupied almost the whole of her chest. The veins in her throat were all bulged up. Her eyes were bulging and was very congested. She had central as well as peripheral cyanosis. I could not record her blood pressure.

I put her on the bed in the acute care. I called one of my colleagues who confirmed that nothing much can be done other than make her feel comfortable.

I talked to her parents. In fact, AK had been sick from the day she celebrated her first birthday. They had not shown her to a proper doctor. Only quacks (jhola chaps) and faith-healers (ojhas) had seen her. The family appeared to understand that there was nothing much to do other than pray.

I went to talk with AK. To my surprise, AK also was sure that she was dying. As I told her that I shall see her in the morning and was leaving, she clinged to my hand.

In between her breathlessness she told me, ‘Please ensure that I die here in this place.’ I told her that my nurses will take care of her well. Then she continued, ‘Doctor, I’ve never slept on a bed. I never knew that it is so comfortable. Please let me die on this bed’.

AK died early morning, before I reached for rounds. Her face was so peaceful. Not the contorted faces that I’ve seen in many of my patients who die a horrible death after being breathless.

All she wanted was to remain in the bed on which she ultimately died.

Tells a lot about basic human needs and wants, especially those of the poor. 

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