The Defiant Destitute- II

pancreas-and-kidneys

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.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s