World Cup 2011 Finals- An experience to cherish!

The journey began at 11:45 am.. A long wait for the fellowship, which comprised 2 kids and 4 adults, to arrive and then we were off! Walking all the way from Napean Sea road to Grant road station. The walk in the scorching sun had a weirdly calming influence on my grey matter which had not rested even a minute since morning. Was India really going to win the cup? Was it worth going to the stadium? Am i being a fool for not selling my ticket for a LAC plus INR?

 

All the questions somehow were answered by the amazing confidence that every by passer exuded. And with every step i took towards the station, i somehow stopped thinking as much and started enjoying the sheer craziness that cricket brings out in us Indians!

The roads were choc-a-bloc with cars honking, cutting lanes, trying every possible manouvre to get to the Wankhede stadium as quickly as possible.

Every passer by seemed to take notice of our company, what with each of us (besides me) dressed in the Indian jersey. A few known faces too emerged from amongst the unknown to wish us ‘good luck’ as we were going to a place that 1.2 billion Indians would kill to be in.

 

After a 15 minute walk we reached the station, where a few shady customers tried to bully the kids for tickets to the game. A train to Churchgate almost immediately roared into the station and we managed to get into it. 10 more minutes to churgate station and we were almost there! The unofficial MECCA of cricket- the WANKHEDE stadium. The Churchgate station resembled a fortress with heavy security, blocked exits et al. We managed to find an exit eventually and proceeded towards the entrance gate for the Pavillion stand, encountering a lot of ‘ INDIAAAA, INDIAAAA’ chants. Its amazing how cricket manages to galvanise the very people who are divided by petty politicians with vested interests!

A few known faces and a little bit of luck got us into the stadium in no time and even then waiting in the line wasn’t futile cause all of us got a glimpse of the DEMI-GODS entering the stadium in their spacious Volvo’s.

Into the stadium and the crowd had started screaming an hour before the match even started. The mood was set, people were confident, so it seemed nothing could go wrong!!

The drama started with the toss! Neither the home team captain nor the match refree heard the opposing team captain call for the toss! There was a huge mutter around the ground that the toss was fixed. But before those rumors gathered momentum, the coin was re-tossed and SriLanka won the toss! India had to chase to win a Final on home soil! To top it all the team composition for the match seemed suspect, picking Sreesanth, a pacer ahead of R. Ashwin, a spinner on a Bombay wicket which is usually a turner.. It couldn’t get any worse! The crowd was groaning and rightly so.

India have never been good chasers and SriLanka had a strong lineup both batting and bowling.

 

Eventually the match got underway in an amazing manner. The indian bowling, barring the erratic Sreesanth bowled very well, picking up wickets at regular intervals and limting the run rate. It was a feast for the crowds, who cheered loudly after each maiden over and went ballistic every time a wicket fell.

But, somehow there was the feeling that something will go wrong.. And it did!

A silent crowd witnessed the brutal hitting force of the SriLankan batsmen in the batting powerplay. It was time for the Lankan fans to go all out. And that’s exactly what they did, as silent Indian fans looked on. The match seemed to have tilted in Lanka’s favor.

The Indian run chase got off to the worst possible start, losing the 2 openers in the first 7 overs! The SACHIN TENDULKAR wicket silenced the very crowd that had revved up the decibels just moments ago. What was heartening to see, though, was the standing ovation The Man got for playing what could’ve possibly been his last match on His home ground.

Time went by, a few wickets fell, but this Indian team was different from the others. No target was unchaseable, no team was unbeatable. With that same conviction, Dhoni, the captain, Gautam and Yuvraj kept the scoreboard ticking. Every dot ball was dreaded, every single was cheered as if it was a boundary and when the boundaries were hit the 30,000 plus crowd in the stadium, be it the Ambanis, the Mallayas or the common man in the east stand, roared in appreciation and delight.

Victory seemed nearer when all of a sudden Dhoni went ballistic smashing a couple of boundaries. Confidence grew and everyone awaited the winning moment.

 

One of the greatest bowlers in World cricket today was up against one of the smartest batsmen. 3 runs were required in 1 and a half overs. Lasith Malinga stormed into bowl at Dhoni at 150 kmph.

Dhoni, not having a care for reputations heaved him for a SIX over long-off. THAT WAS THE MOMENT. 30,000 anxious Indians in the crowd jumped up in celebration of the one cup that had eluded India for the past 28 years. Dhoni stood at the centre of it all, absorbing the atmosphere created by his heroics. Sachin & Yuvraj were in tears, Harbhajan and Virat were jumping and Raina and Sehwag were just absorbing the fact that they were the WORLD CHAMPIONS.

 

“For the past 21 years Mr. Sachin Tendulkar has shouldered the burden of Indian cricket, it’s about time we carried him on our shoulders.” Virat Kohli, barely a few years old when Sachin started playing cricket put his words into action and carried Sachin all around the stadium! Gary Kirsten, who played one of the most understated role in the success was also carried around. The humble captain stood away from the limelight.

The World cup was ours!! A walk through Marine drive signified how Sport unites the un-united. There was dancing, singing, people sitting on the roofs of cars, firecrackers and a lot more. And rightly so.

Not only was it a feather in the illustrious cap of Sachin Tendulkar, it was also the defining moment for a certain man named MAHENDRA SINGH DHONI.

A small town boy from Ranchi, Jharkhand has won all the titles that there are to win, the IPL, the CHAMPIONS LEAGUE, the WORLD CUP T20, the limited overs WORLD CUP, the BEST TEST TEAM & with this win the best limited overs team!

What a night, what atmosphere, what a stage to deliver.

Him and Her

They met through common connections. She was dating someone else and so was he. They became friends. She would call him for favors every now and then. He would gladly oblige, as he would for any friend.

As time passed, they severed ties with their respective partners and began spending a lot of time together. Movies, pubs, restaurants and even heritage tours. She fell in love with him. He wasn’t so sure. She repeatedly asked him for an answer. He was confused.

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He started working, she was still studying. He had 16 hour work days, she had a lot of free time. He was always tired and busy. She always wanted to meet him and spend time with him. She went to his work place and waited hours at an end, so that she could steal him for a quick snack. He wasn’t there for her, at most times. There were days when they didn’t speak at all.

She still persevered. He wasn’t so sure. They trudged along. Soon, he couldn’t do without her presence around him. He fell in love with her. Not because she was beautiful or because she waited for him, but because he had come to realize that she was a delightful person.

By that time, she was frustrated with his inconsistencies. He was always overworked and under-rested. He’d always get angry and frustrated. He didn’t want to work this hard. She pushed him to work harder. She told him she understood.

Soon after, she was busy preparing for her exams and completely shut him out. He felt lost without her, but knew it was necessary. Nothing remained the same after her exams.

He was now madly in love with her. She was in love with him too. But, maybe the intensity had reduced. He wanted her attention all the time. She was busy with her own life. And it all added up.

Finally, one day she told him that she wanted to part ways. He thought, “I’ll fight for us.” She thought, “If I continue this, I will lose my sanity.” She wondered what life would be without having him around. He didn’t even want to think of the possibility.

Somehow, he managed to pull her back into his life. That was probably his first mistake in that relationship. He didn’t realize that by pulling her back, he was pushing her further away. She thought, “I’ll help him through this phase and then leave before he can say anything.” He thought, “I’ll  shower her with so much love, that she won’t think of leaving me.”

They had their ups and downs. They dove deeper into the abyss of love, or so he thought. She completely shut herself out. He was too busy to notice. She always spoke about him and his day and his insecurities and his feelings, never mentioning how she felt. He was too busy to notice.

She celebrated every birthday, anniversary and special occasion with him. She knew that she had to get him through this phase. As he grew closer to her, she became even more distant.

They had such starkly contrasting personalities. He never thought out of the box, she was always being creative, he  had no sense of humor, she was always laughing and joking, he was a certified pessimist, she loved being optimistic. And still, they’d fallen in love with each other.

He had finished the difficult period in his life. She had just entered hers. He was finally ready to give the relationship his all. He felt energized. He thought he knew how he’d make it work.

She was having none of it. She thought, “This is it. I have been unhappy for long enough. Not anymore.” He thought, “I haven’t paid any attention to her for so long and she’s been so fabulous. I’m going to set everything straight.” Maybe he was too late.

She said, “I don’t love you anymore.” He said, “That’s not true! That can’t be true.” She told him, “Believe it or not, it is. Please let me go.”

He thought, “How can I let you go. This can’t be it.” She said, “It is.”

She walked away. He tried to pull her back again. She was adamant. He was heart-broken.

He tried to enter her life again. He helped her whenever she needed help. He was always there for her, when she needed him. This time around, they spoke only about her. He didn’t tell her how he felt. That he wanted to kiss her every time he saw her and straighten things out. She never asked.

She’d done the same for him. She suppressed her feelings for years altogether. He did it for a few months. Eventually, relinquishing to her wishes. He had travelled a full circle.

He had an urge to travel back in time and straighten things out. Unfortunately it was too late…

The Defiant Destitute- II

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Photo Credit: ADAM

Ganesh’s airway was suctioned dry in the ward, before I arrived and we shifted him on a gurney to take him to the SICU.

We ran down the corridor wheeling his gurney into the ICU.

{ Refer to A Stitch in time Saves Nine-II, the last paragraph}.

I ran down the corridor wheeling my patient into the SICU. Ganesh had aspirated and needed an urgent intubation. I saw a familiar face as I hurried down the corridor, but didn’t pay much attention to him. Ganesh was shifted to a bed in the SICU, intubated………. }

Ganesh was shifted to a bed in the SICU, intubated, his bronchial tree was suctioned dry and he was put on ventilatory support. We started an antibiotic drip to prevent any worsening of the infection that had already set in.

We had lost hopes of any recovery. Aspiration pneumonia (infection of the respiratory tract after aspiration of the gastrointestinal secretions), more often than not spelt the death knell for post-operative patients. Just when all hope was lost, came another setback. He had developed an infection along the nail tracts placed to support his leg bones. Not only did he have a pneumonia now, he’d also developed another serious infection. The odds were heavily stacked against us.

As the going got tough, his mothers and wives deserted him again. He was our responsibility all over again (for everything besides the treatment aspect, for which we were always responsible). The days went by and we worked diligently to salvage the situation. We did not have the luxury of prescribing medicines or ordering materials, that were normally not available in the wards.

Slowly but steadily, he made a recovery. The alcohol withdrawal was the first to go, followed by the ventilator and then the infection, which took the longest. His mother and two wives reappeared once he was better and shifted to the ward. Their habits hadn’t changed. Not that anyone would’ve expected anything better.

As he was recovering from this episode, he plunged into another complication. The drain that was left behind in the abdomen had started draining pancreatic juices. The oversewn duct at the transected edge had given way and was discharging the potentially dangerous juices into the abdomen.

The drain had turned out to be a life-saviour. It did not allow the juices to spread into the abdominal cavity and eat up the tissues. Instead, it drained all the juices directly to the outside. the strategy was to wait and watch for a spontaneous closure of this leak, technically known as a pancreatic-cutaneous fistula.

Ganesh remained in the ward for two full months, before the leak eventually sealed. The drain was removed and the external fixator readjusted prior to discharge.

We heaved a sigh of relief when Ganesh was discharged, not only cause he’d made it and was now going home, but also because he had burdened us with plenty of extra work and responsibilities. No time was wasted in preparing his discharge summary.

We ultimately realized that it didn’t matter who the patient was or which strata of the society he belonged to, we had to treat him on par with all our other patients. It was tempting for the treating unit to leave Ganesh in the lurch, without ever being held accountable or responsible for the same. But that wasn’t the case. He received the highest standard of care possible in the institution. This was nothing less than what he deserved. Here was a patient who had no money, an apathetic family and no sense of self care, with a complicated traumatic injury. Not only did we manage to salvage him, we managed to make him stand on his two feet and walk out of the hospital. Notwithstanding the challenges and the additional burden, his discharge filled us with a sense of pride in a well accomplished job.

The Defiant Destitute- I

    pancreas-and-kidneys

Photo Credit: ADAM

No Surgical resident wants to admit a destitute in their unit. Admitting a destitute in the unit implies that he will be taken care of by the residents of the unit, not only medically, but even otherwise. Its the job of the resident to arrange for clothes, food and accommodation after discharge

I hadn’t admitted too many destitute’s in the units I’d worked in. But Ganesh was an exception!

Wheeled into the emergency ward with an accident on the roads nearby, Ganesh on primary inspection seemed to be, primarily an orthopedic case. His right limb was almost split into two parts by the impact of the accident. Fortunately he wasn’t bleeding as much.

A quick secondary survey revealed some bruises on his abdomen, a tell-tale sign of a blunt injury to the abdomen. Under the influence of alcohol, his partially conscious state made it impossible to extract any details of the accident. Ganesh would have to be cleared from the surgical end before he landed in the orthopedic OR. A CT scan was arranged for Ganesh, while his limb was immobilized and the routine blood work was done.

All the resources are stretched to the maximum when any trauma patient is admitted to the emergency ward. A destitute trauma patient would impose the maximal strain. There were no relatives, friends or policemen, just the doctors, nurses and ward boys.

A quick review of the CT images revealed nothing of great significance in the brain or the abdomen. Ganesh was cleared for a transfer to the orthopedic ward.

As an exercise to test their skills, the senior registrars in the unit reviewed the CT images. Taking a closer look and getting an unbiased opinion always helped. The review of the images revealed a fracture at the tail of the pancreas, an organ sitting in the abdomen just behind the stomach and responsible for regulating the sugar levels in the body and digesting proteins in the gut. A duct (just like a plumbing pipeline) runs through the organ, dispensing the digestive juices into the gut. Fractures of the pancreas disrupt the duct and cause the juices to leak into the surrounding space. These juices are highly active and can digest the proteins in the normal tissue as well, hence causing inflammation and destruction of the surrounding structures, including the stomach and the colon. The spleen is closely related to the tail of the pancreas and in a fraction of patients, the tail is embedded in the spleen.

These findings led to a knee jerk reaction and Ganesh was transferred back to the surgical side.

Ganesh’s problem was picked up relatively early and operating him to remove the fractured part and oversew the duct would probably save him from the consequences of a damaged pancreas. Ganesh was planned for a ‘Spleen preserving Distal Pancreatectomy’, a prolonged and complicated procedure in the emergency setting and was shifted to the operating room.

On opening his abdomen, we realized that we had gone in relatively early. There was minimal inflammation with a very minor leak. However, on inspecting the pancreas it was badly fractured, with the duct completely transected, as predicted on the CT images. The procedure was underway in the operating room, while another procedure was going on in the adjoining room. I was assisting the Assistant Professor, who was performing the surgery. While dissecting the pancreas for a resection, the team on the other table ran into some difficulties. The Assistant Professor had to scrub in for that surgery and permitted me to carry on with the procedure.

Ganesh was a part of the unfortunate fraction, who had the pancreatic tail embedded in the spleen, which made it mandatory for us to remove the spleen. The inability to preserve the spleen actually made the surgery a little easier and faster. After completing the procedure and placing a drainage tube close to the pancreas, the orthopedic team fixed his fractured leg with an external fixator.

Ganesh was shifted to the surgical ICU after the procedure on ventilatory support. Two days after the procedure, he had made a remarkable recovery and was removed from the ventilatory support. Three days after that, Ganesh was shifted to the ward.

This remarkable recovery surprised us, as did the arrival of his mother and two wives, the day after he was operated. Ganesh wasn’t a destitute after all. No doubt that his family reeled in poverty, but he did have a family, albeit a very dysfunctional one.

His mother came in drunk every morning and would pick up a fight with everyone. His two wives publicly quarreled to assert their rights over him. Ganesh, who had been an alcoholic, progressed to a state of alcohol withdrawal. Disoriented and confused, he added to the drama created by his family in the hospital. Ganesh, his mother and his two wives made a living out of selling flowers form a roadside stall. The money generated form sales was used to fund their addiction to cheap country-made liquor and tobacco. How he had managed to shelter two wives in the same house was beyond me. But it didn’t matter. We just wanted him to get better and move out of the wards.

On one such Sunday, immediately after my morning rounds, I was paged by the nurses in the ward. Ganesh’s mother in one of her drunken stupors, had fed his son some food lying by his bedside. Ganesh, who was still in a state of alcohol withdrawal was unable to swallow the food and aspirated the food particles in the respiratory tract.

There was an immediate response to the food particles stuck in the respiratory tract. Ganesh became breathless and blue and vomited large quantities of gastric secretions. Our worst nightmare had just been realized….

 

To  be continued…………..