CONQUEST OF DEATH 20
(DID I REALLY SAVE HER LIFE?)
Against a fervent opposition and resistance, on my merit and eligibility I was selected for a prestigious post. During the ward round I showed a case to my boss and said
“Sir, she has high fever and passes very scanty, almost negligible quantity of urine (oliguria/ anuria)-----“
“She is in renal failure (kidney failure), you have to manage her.” Instantaneously he said and moved on to the other case. On completion of the round, saying
“You have to manage her” he left the ward.
‘Risus sardonicus’ (sarcastic laughter) was conspicuous on the faces of my adversaries. Without giving any specific guidelines and instructions for the management of this case he left.
That was the time when ‘urology’ was established as a superspeciality in the West. The urologists were thinking about a transistorized, wearable artificial kidney. Where as here I was struggling to get good laboratory reports at regular intervals, to monitor this case.
It was a testing time for me.
I got the x-ray of her urinary tract done. It was normal. I looked for the obstruction in the urinary tract. I found none. I sent her blood and urine samples for bacterial culture and antibiotic sensitivity test. I sent her blood for various biochemical tests. I started empirical antibiotic therapy. I restricted her fluid intake in proportion to the urine out put.
She had effortless copious vomiting. She was restless. She was deteriorating. The next day during the ward round I reported to my boss
“Sir, her blood pressure has started rising, her pulse is irregular, she is delirious, her breathing------“
He interrupted and said
“She is serious. You have to manage her”
Again without giving specific instructions he left the ward.
Her relatives heard the comment. They were worried. They said
“Doctor, we are poor. We cannot spend much. We can only pray God to give you success----- “
“I shall do my best to treat her” I assured them.
Three days later I got her culture reports. I started appropriate antibiotics.
Two days after that therapy her fever disappeared.
During the round I told the boss
“Sir, her temperature is normal now------“
He interrupted and saying
“Good. You manage her” He left the ward.
The next day her urinary output improved. Her vomiting reduced in quantity.
Her restlessness reduced.
Day by day she was improving.
One day my boss said,
“You are doing a great job.”
I witnessed the tears of ecstasy in the eyes of her relatives.
After a long time she regained consciousness. She was hungry. She was asking for food. Her general condition became stable. Because of this prolonged illness she had weakness.
In due course of time she recovered completely.
“You have done a miracle” Said my boss.
“He is our God!” Exclaimed her relatives extempore.
“He deserves this honour” replied my boss to them.
Humiliated, my adversaries left the ward, never ever to comeback.
She was the discharged from the ward.
I should have been appointed on this post for a period of two years. But for reasons unknown to me I was appointed only for three months. After this period I applied for the extension. My boss recommended me for the extension.
Years have lapsed. As I contemplate on this case I ask questions to myself and I only answer them:
What was the diagnosis of this affliction?
I really don’t know!
Bilateral pyelonephritis? (Infection of the urinary tract)
Most probably!
What was the cause of this malady?
Honestly, I don’t know!
Infection? Sepsis?
Most likely!
About this illness I remember having read in the undergraduate textbooks----
“Renal anuria can be reversible and then it goes through three phases:
1 Phase of oliguria (Passing scanty urine i.e. about 300 ml. in 24 hours.)
2 Phase of diuresis (Passing a large quantity of urine)
3 Phase of recovery.
Did she not exhibit these three phases of the natural course of the disease?
She did!
Am I justified then in saying “I saved her life”?
Am I justified in claiming the credit of saving her life?
I am dumbfounded!!
A TRUE STORY IN REAL LIFE!
A DRAMA IN MY LIFE!!
DR. HEMANT VINZE
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