Do not Resuscitate…..

I had transferred to the Nair Hospital to take charge of the Surgical Gastroenterology services.  It was a very busy service with a plethora of gastrointestinal surgical  problems. I had recently returned from Sheffield, where I had gone on a Commonwealth Fellowship. On an impulse, I had decided to sit for the Fellowship examination and to my utter delight, passed at the first attempt. I had also learnt the basics of laparoscopic surgery. Therefore I was busy translating into practice what I had picked up at Sheffield. Naina and I had met the Prof on my return with the usual offering of scotch that the old man loved to have in the evenings.

“You know Guru, A glass of fine liquor extends your life span by several hours. Pleasurable hours too, i might add. A glass of Black Label at sundown is simply the way to live. Let me tell you Guru, never contaminate good whisky with soda or water. The aroma is best enjoyed when it is on the rocks” Prof rolled his eyes in pure pleasure. Naina, who had disappeared into his kitchen, reappeared with a plate of hot onion pakoras. “Onion Pakoras! Naina, you are an absolute jewel. You actually read my mind. This idiot does not deserve you,” Prof attacked the pakoras.

Prof and I fell into discussing laparoscopic surgery, then a new fad among surgeons. I had done the first lap chole and described to the Prof the procedure. “Guru, seems like a good idea. The magnification that the scope provides makes it easier to dissect. Be very careful how you choose your patients. If you damage the bile duct or have a complication, laparoscopic surgery will suddenly become an untouchable. Henry’ law you know. Naina, can I have some more of those delicious pakoras?” Naina frowned. “You know uncle, fried stuff is poison for you. Only the other day Prof Rajan was telling me that your cholesterol is very high. You are already taking medicines for your blood pressure. The other day, you had chest pain” Prof lit a Charminar ignoring Naina’s disapproving looks. “I have always maintained that the only thing that the internists are good at is to tell you things you shouldn’t be eating or things you shouldn’t be doing. Rajan may be a professor of medicine, but he continues to be a master of theory. Please don’t deny an old man, eh?” Prof Wheedled. We stayed for dinner, ordered from the local Udipi restaurant.

I was very busy with work at Nair. I hadn’t met the Prof for some months. He had retired recently and had shifted to a small apartment in Dadar. Naina would somehow find time to visit him regularly. “I think you should find time to visit your Prof. He gets lonely. He loves to argue with you. Why don’t you find some time off?” She asked me one day. “Sure, we’ll visit him this Sunday. We’ll take Svini along too. She will be good company for the old man. He misses his granddaughter,” I replied.

I was busy in the outpatient clinic. I had a new batch of medical students, who seemed not half bad. The nurse came up to me. “Sir, the telephone operator called. You have an external call waiting.” I picked up the phone. It was Prof Vilas. “Guru, come down to the Sion ICCU right away. PJ is admitted with a heart attack.” The phone clicked off. My mind was in a whirl. I informed Naina. Old Pete and a heart attack? He was more likely to cause one than suffer one himself. Of course, he was seventy and hypertensive. He also smoked like a chimney. Otherwise he was quite the healthy irascible old codger. I hoped that it was reflux or gastritis. I drove like the furies to Sion.

Prof looked old and frail on the ICU bed. He was conscious though. I could see that the chest pain was agonizing by the way his lips were compressed. Naina had already reached. She looked desperately worried.

The ICU doors opened and in walked Dr Bhave, old ‘hemorrhoids’. He too had retired but had a busy practice. He nodded to the Prof curtly and looked at the ECGs. Prof Vilas joined him.

Suddenly, the monitor alarm went off. “Code Blue! Code Blue!” the cardiology registrar shouted. The Prof had gone into cardiac arrest.

The next fifteen minutes were a blur of action. The Prof was intubated and ventilated. His heart came back within five minutes. He regained consciousness. He seemed to be pointing at something. Prof Vilas, Bhave and I hurried to his side. He kept pointing to the endotracheal tube. Bhave gave a grunt of understanding. “The tube is too much in. We have intubated the right bronchus,” Bhave adjusted the tube. The Prof gave a thumbs up. “Just close your eyes and relax, you control freak! We are capable of managing arrests” Bhave ticked off the Prof. But his eyes were desperately worried.

An emergency angiogram revealed a three vessel block. I could see why Bhave was so respected. He did a double vessel stent, while dilating the third one. The Prof tolerated the procedure well. But this was merely a rescue angioplasty. He needed a bypass. Prof Vilas did a triple vessel bypass the next day.

I was visiting the Prof one evening in the VIP ward. He had recovered very well from surgery. He was allowed to ambulate within the ward. A stream of visitors crowded the ward. I gave strict instructions to the In Charge Nurse that only few people be allowed to meet him. We didn’t want the Prof to get tired. Sister Eapen, who too had retired, spent almost her entire day by his bedside. His son and daughter in law had not come. His son Vikram spoke to me on phone. “Doctor, how is Dad holding up? I am at the fag end of signing an important contract. I’ll be able to fly out only next fortnight.”

“Guru, I have something to ask you,” Prof was unusually diffident. “If I have another arrest that looks bad, please don’t try to to resuscitate me. Remember what I told you long ago? Let a man die with dignity….” I nodded, too overcome…..

 

Author: drshirahatti

I am a surgeon, specializing in Gastrointestinal Surgery...I have headed the Departments of GI surgery, General Surgery and Medical Education.....I also was the Dean of two large government hospitals in Mumbai.....I like reading about cultures and like to travel....

One thought on “Do not Resuscitate…..”

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