I thought that I had seen the worst railway accidents had to offer…I had seen bilateral amputations, skulls splintered open, horrible open wounds, the entire gamut….a result of overcrowded Mumbai locals and crossing busy railway tracks…..
I was called to the trauma ward post haste to see a patient of a “run over” accident….When I entered the trauma ward, the atmosphere was grim….There was a young man lying on the stretcher….He was ashen, sweaty, but fully conscious….He wished me a very good evening in a feeble voice….He was covered by a blood stained sheet….He seemed to be only two to two and a half feet tall….A dwarf?
I pulled aside the sheet and nearly collapsed with surprise and horror…..This young man fell under a moving train that passed over his lower torso neatly severing the lower body below L2 level…..
Surprisingly there was little blood….The venacava and aorta had been crushed and transected and had clotted….Ureters and the sigmoid colon were hanging loose in the wound….
“I will be all right na doctor?” he asked….Turns out that he was recently married and was to go on a honeymoon the next week….
I was in a dilemma……Do we go all out and resuscitate the young man, perform multiple surgeries and leave him, literally, half a human being dependent on the world at large? Do we practice passive euthenasia and allow him to slip away? What would be the quality of life he would lead if he survived? What kind of support could he expect from him lower middle class family? How would he look after the colostomy and ureterostomy? Remember that these were tha days of poorly fitting Dundas colostomy bags that were notorious for leaking..Would we be right in creating a helpless cripple?
On the other hand, what right did I have to decide on someone Else’s life? Who was I to play God?
Finally training won…We sutured the IVC and the aorta, constructed a sigmoid colostomy with ureteral implantation and closed the wounds…. He did not survive the accident and died of MSOP after a week…….
The most abiding memory of this patient was my fervent prayer to God “Oh God, I have treated this man….Please let him die”