Thursday, September 1, 2016

Forgetting Shyam!

I had been in a woman's conference for two days and then in Lalitpur to see my good friend Sheba.Coming back to work ,it was ward  rounds with my juniors as usual.In the male ward ,a young boy gave me an unabashed heartfelt smile and told me 'my father is coming today'.I was taken aback wondered if the boy was a little behind in the growth milestones?
When I asked Max to update me the history,I realised it was Shyam.How could I possibly not have recognised him.
On one of my duty days he was wheeled into the casualty cold and clammy ,unconscious with a heart-rate of thirty beats ,ECG showed a complete heart block and a barely recordable blood pressure.
I thought we had a case for pacing but just a dose of atropine saw the heartbeat returning to normal sinus rythem and that gave us some time for some history and basic bloods.His ABG was nothing to write home about.
Shyam had followed a truck driver to Mumbai was what the father said.The truck driver had dumped an unconscious Shyam into the government facility from where the father had picked the boy up in that sorry state and brought him to our hospital.He had no other history.
His counts were as low as can be with the total counts in hundreds and the platelet at thirty thousand with borderline renal failure.The boy had a GCS of 7/15 which did not revert with correction of hypoglycaemia.We hit him with antimalarials , covered for sepsis and arranged for a fresh pint of blood to be transfused.I was a little concerned he might have bled into his brain but there was no knowing since the bystanders were not happy to take him for a CT scan .
From then onwards it was a slow but a vigilant recovery.
Over the next four or five days Shyam's GCS improved and he started responding to our queries albeit a little unclear.I would make it a point to call his relatives inside just to strike a conversation with him.He mumbled umpteen number of unclear words much to the chagrin of his relatives.His maternal grandmother was the only person who could get through to him.
One day two sturdy men entered the ward and Shyam's face brightened when he saw them and he raised his hand in greeting.The feeling was mutual.
My hunch was he was on the way to recovery.Four days I was away I presumed he would have gone home.
I was overjoyed to see him so well ,he looked much younger now that he was sitting up and swinging his legs from the bed.I asked him if he recognised me and he shyly nodded his head in an affirmation.I asked him the other question all of us were dying to know.That was if he remembered what happened to him and where had he gone without informing his family?
He said he remembered everything and he had gone to Punjab to pick apples?On his way back he had fallen sick.
Little do our patients know how much joy they bring into our lives when they give us beautiful surprises the way Shyam did.
Doctoring has it's heartaches but it has it's own share of wonderful rewards,like an unabashed heart-felt smile from a patient who has been through hell with you and back .

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