A Light That Never Goes Out

When you work in a line of work like medicine, you meet countless number of people every day. You touch so many lives each day, whether that be as a saviour or as a bearer of bad news. We don't like to think of it that much because it can end up becoming overwhelming. 

It's only when we're on the other side of the fence that we truly get to appreciate how much an impact people we only get to meet once in our lives end up having on us. 

Almost 6 Years Ago

It was the short period between the arrival of final year results and the beginning of internship. I remember it was night. I was woken up at around 2am. It was from one of my father's coworkers. 

My father had gone to Coimbatore for a short business trip. He was staying in a hotel room and doing what he always used to do then in his free time, watch some rubbish Malayalam TV serials on his phone. That night however, something went horribly wrong. 

He started developing weakness over the left side of his body. He had an episode of urinary incontinence. He started losing consciousness. All of this happened quickly within the space of an hour or so. 

My father was lucky in a sense in that a coworker was staying close by in another room in the hotel. So despite it being around midnight, the coworker quickly managed to get my father to a decent hospital. I'd forever be grateful to that man for the help he did that day. But unfortunately, a large part of the damage was already done by that point. 

Thrombolysis

My father was having a stroke. A CT scan of his brain showed that it was likely that one of his major arteries supplying his brain got blocked. Now in this type of scenario, a big decision that needs to be made is whether to do thrombolysis or not. 

Thrombolysis is basically giving a very powerful blood thinner to someone with a stroke in the hope that the occlusion would get removed and the patient would then get better. The problem is that this may cause severe bleeding in a few patients which can then become a major problem on its own. The decision on whether the risk : benefit ratio favours administration of a thrombolytic is often tricky, especially in this kind of case where close family members are not around. 

It was Aunt May who gave the go-ahead for thrombolysis via phone. I was not involved in the decision. Aunt May is the kind of doctor who thinks everyone with any kind of stroke (of this ilk) or heart attack should get thrombolysed (that's not a reasonable approach) so this wasn't surprising. But in this case, it was the right call. 

Unfortunately, for my father, thrombolysis didn't really do much good. His weakness persisted and sensorium continued to be altered. He was intubated and put on the ventilator for some time but was extubated quite fast. 

All of this had already happened by the time the sun rose and I finally arrived in Coimbatore to his hospital. He was in the ICU. 

Understanding the Situation

It was after morning rounds the next day that the on duty doctor informed me of the situation. It was only then that  I truly understood the gravity of what had happened. 

Subsequent scans had shown that my father had sustained damage to around 75% of the right side of his brain. Now at the time, I was fresh out of final year and just about to become an intern. I may not have been very smart then but even I knew this was not good news. 

It was not even one year after my mother had passed. In fact, her first death anniversary was coming in only a few weeks. Needless to say, I was not mentally prepared for trauma of this nature. 

I've mentioned here in the past just how much I appreciated the way the doctors conveyed the situation to me after rounds each day that he was there. They were clear in what they conveyed. They took the time to make sure I understood exactly what the problem was. This was a very busy ICU but the level of care they provided was simply top notch. I simply couldn't ask for anything more from a hospital. 

I had managed to not show what was happening with me on the outside. I appeared calm. Some even criticised that I was too calm. Maybe I was in denial. Maybe I was just very good at covering up negative emotions. But things would get worse. 

Dip in Sensorium

After a couple of days, my father's sensorium began to get worse. He got intubated and put on the ventilator. I accompanied him down for repeat scans. 

I remember waiting outside that CT room. I was distraught beyond words. Nobody else was there with me. It was then that I truly understood the gravity of the situation. I thought my father was going to die. I just started crying there in the waiting room, not knowing what would happen next. 

Shortly afterwards a decision needed to be made. It was becoming clear that my father was going to need a lengthy stay in the hospital. But more urgently, he'd need an emergent neurosurgery to remove the increasing pressure building up on his brain, which had resulted in his sensorium becoming worse. Question was whether to get it done there or shift my father to Trivandrum and get further treatment done there. 

It was difficult decision I had to make in an unfamiliar city. And to be frank, I didn't know and still don't know what the right choice in that scenario was. But after some deliberation with his co-workers and boss, I decided that shifting to Trivandrum would be the next step. Aunt May would coordinate with the hospital back home. 

Making it Easier

I didn't know Tamil. It wasn't that big an issue as the doctors were all fluent enough in English to convey what needed to be said. 

There was a Malayali nursing officer who made things a lot easier that day. She was kind and helped function as a translator of sort in between all the other super important things she had to do in that ICU. Having someone to talk to in your own language in a situation like that was something I'd always end up being grateful for. 

She didn't really have to do that. It was just one of those random acts of kindness where the person who does it soon forgets but the person who received the help would never forget afterwards. 

Unfortunately as is the nature of what happens in most hospitals, be it government or private, I've never really seen something like that ever again. 

Awake but Never the Same Again

My father got the surgery done in Trivandrum. He was in the ICU for a fair few weeks after that. He woke up, became conscious but was never the same again. 

I remember when he first woke up after the operation. He didn't recognise who I was. I don't think there could have been a worse feeling than that for a single child with only a single parent left. Thankfully he did slowly get his memories back over the next few weeks to months but despite what many family members expected, things would never go back to normal again. 

His personality changed. It became more childlike. My father was the most reserved, introverted individual you could imagine. But after his stroke, he'd throw tantrums, use foul language I'd never heard him use before and cry at strange occasions. He was emotionally labile, the exact opposite of who he was before. 

The family dynamic had changed. I would no longer have anyone in life I could fall back on during troubled times. I was on my own, trying to tackle the constant stress of managing terrible finances, trying to get physiotherapy for my father and trying to find a job in Trivandrum that actually paid on time every month. It was the kind of responsibility that I was frankly not ready for, but I didn't have a choice. None of us who've been through the same ever had a choice.

Finding Solace

The day my father had his stroke was the day my life officially started to fade into the black. Things would slowly get worse over the next couple of years. The emotions I went through in those few days are still as clear as yesterday. 

I remember how bad it felt waiting and wondering in those waiting halls. I remember how it felt sleeping on hospital corridor floors with mosquitoes for company. Knowing how difficult and lonely the life ahead would be. 

Looking back though, I also recognise now how grateful I was to have received those random acts of kindness during those times. It reminds you that even through the darkest chapters in life, there are still good people out there trying to bring some good in this world. And that gives you some hope for what's ahead.