OS: The emotional dilemma of the Neurosurgeon
Renowned Neurosurgeon on his current times, Dr. Ashutosh was one of the leading super-specialists in his field in the country. What not kind of surgeries didn't he perform in his career spanning over two decades, with the complex to hardest, he had handled all. His deft fingers wiggled with such precision, and such was his deep knowledge into the subject that his name was an international recognition, with umpteen numbers of consultations he did with doctors abroad.
Love and marriage came to him at a ripe age of 42, when almost all his colleagues were settled into families. It was miraculous to fall in love for the first time at that age, with a 24 years old lady, and get married despite difficulties convincing families and facing societies. But as many difficulties came, his love, his wife, Nidhi was way strong headed than he needed to worry for. She took everything into stride, way better than he did; answered way tactfully than it was to worry; needless to say, Ashutosh was head over heels in love with this lady of his.
A year into marriage, and they were ready to welcome there first new-born. Ashutosh was on the ninth cloud. It was one thing to find a love of his life at that mature age, and it was another thing to complete his family with such abundant feelings. Nidhi was a lot more satisfied seeing his happiness. She had completed her M.D. Paediatrics when she came to know about her pregnancy, and through the tough times of her gestation, she continued her fellowship, completing it just in time to go for her Maternity break.
Though Ashutosh had dearly wished to be with Nidhi at the time of birth of their baby, but the life of a surgeon is never in his own hands, but that of his patients' needs. He had to rush into immediate brain surgery at the Trauma Unit resulting from a road collision; leaving Nidhi to the respective doctors and their families. Once in an OT, Dr. Ashutosh didn't think much other than saving his patient, and thus, the 6 hours long surgery had him fully consumed.
After shifting the patient into the ICU did Ashutosh went to the Obs & Gyn Unit to be finally there where his wife needed him to be. Much to his dismay, Nidhi was already in the Labour room, in between the process of birthing, and there was nothing much that Ashutosh could do at that moment. He had to go back to his work, promising to return in sometime when Nidhi and the baby come out. The nurse was already instructed to inform him once the procedure was done, thus, Ashutosh was yet again busy with work.
It was a week later; Nidhi was discharged and were back from the hospital with their daughter. The naming was to be done a tad bit later as per Dadi Bua's instructions. Nidhi sat on the bed, feeding her baby, caressing the little head with light fingers, she again felt something unusual. Being a paediatrician, she had touched hundreds of babies, and felt how it is like. But there seem to be something unusual when she touched her baby's head. Not like it felt like that all the time, but many times it felt that way. Nidhi was pondering certainly.
Later that night when Ashutosh retired to the bed, and was about to close the side lamps did Nidhi finally say- "Dr. Ashutosh, can you please see a patient right now?
"Now? At this time? Whom are you talking about? he asked seriously.
"Dr. Ashutosh, I sometimes feel some lump kind of at the back of baby's head. I am a little worried. Nidhi imparted the news.
Ashutosh had immediately taken the baby from Nidhi's arms to examine, as he asked- "Switch on the rest of the lights too... he had his nimble fingers at the back of the baby's head to examine with the touch. He felt nothing. He turned the baby stomach down slowly on his palm on the bed, as he slowly touched all over the head and neck if there was any lump, bulge, nodules or anything. He felt absolutely nothing.
"Nidhi, the baby is too small; the skull is not very solid, that is probably why you are feeling lumps... There's nothing as such there... Ashutosh assured her.
"Dr. Ashutosh, main ek paediatrician hoon, I have seen too many babies. I know their skull is very soft, and I know how it feels. But at the time of feeds, I have felt lumps. Nidhi was still worried.
"Nidhi, as a doctor, we have a very clinical point of view. We have examinations, and reports, and we certify if the baby is healthy. But as parents we get very critical, worrying about every small and tiny thing about our children. And right now you are thinking like a mother only. Ashutosh explained her.
Nidhi nodded uncertainly. Her gut feeling said that she certainly felt something really unusual, but Dr. Ashutosh was also right, she was worrying too much being a first time mother, and everything kept her on edges though she knew things as paediatrician that were pretty normal. She exhaled a heavy breath. She readied herself for bed, the baby might wake up soon, and she needed to catch up some sleep.
It was a few months after the incident that Nidhi quietly kept examining her daughter, Anshi; yet again. The skull was getting harder, true, but she started feeling the lump more often. Sadly it wasn't visible on the surface, and it worried her to no end. Ashutosh kept on having a critical eye on both Nidhi and Anshi ever since, and it was also getting on his nerves seeing Nidhi so worried all the time. He didn't like the manner of keeping on ignoring her worries. He didn't want Nidhi to be paranoid about their daughter's health, but she is a parent too, and it must be something that she observes and he is missing on. He sat tiredly next to Nidhi one day, as he hugged her shoulders. "Nidhi, the paediatrician in-charge did examine Anshi, isn't it? She approved of the fitness that is after which we took her home. Hai na? Then why are you so worried?
Nidhi nodded at his first question, though her eyes were brimming with unshed worry for his second question. "Dr. Ashutosh, trust me, there is some lump, I feel it when I hold her head while feeding. It doesn't surface all the time, but the frequency of the surfacing has increased. Trust me Dr. Ashutosh. It's not about being a paranoid parent.
Ashutosh cupped her cheeks in concern-"I do trust you Nidhi. And I do not doubt your capabilities as a doctor. And of course you are not mad to be feeling it out of nothing. May be I don't hold the baby that often as you do, and it is just sheer coincidence that whenever I held her, I never felt anything unusual. Let's do one thing. Come along with me to the hospital, let's take Anshi's CT scan, and I will examine it myself without any prejudice, just to be sure. Is that fine? he pacified her. She nodded being determinant.
***
Ashutosh kept on looking at the CT scan of his baby's head. Such a tiny soul, and so much to bear. He just couldn't move his limbs, why does he always have to be fixed in such a spot. Once his father, and now his daughter, both facing Neurological problems; the field of his specialisation and expertise. Thousands of cases he has seen, dealt, solved and brought back lives, but it is so critically difficult for him to treat his loved ones.
Nidhi sat in front of him, reading his blank expressions. Being a doctor, she knew how to read a CT scan report, yet the diagnosis had to be given by Ashutosh only. She knew already that there is some lump, she was already suspecting it. But Ashutosh's immobility was scaring her. What was the severity that is making him so numb? Steadying herself for the hardest, she stood up from her chair, walked to the other side of the table near Ashutosh, swivelling his chair a bit, to make him face her, she strongly looked at his levelling her face to his- "Brain Tumour, is it?
He just nodded a bit, and a suppressed cry came out of a tired exhale of breath, as he said- "I'm sorry Nidhi!
Nidhi shook him lightly by his shoulders as she sternly said- "You were the one who taught me that I'm sorry should not come out of a doctor's mouth unless he couldn't do anything to save the patient. Are you telling me that you can do nothing for your own daughter?
Ashutosh looked shaken into Nidhi's eyes. There were no tears, no fear, no shaken grounds in her eyes, just pure angst towards her husband, whom she thought has given up on a good prognosis of their own daughter.
"Of course not Nidhi! That's not what I meant. I meant sorry, that you've been suspecting this ever since, and I was being negligent. Had I had been more cautious, Anshi didn't have to be going through all this while. Ashutosh was repenting.
"This is not the time to think all that right now Dr. Ashutosh. Get on your feet, and decide the course of treatment for your daughter. Set up a surgery or whatever it is needed to cure her, but in any case I want my daughter back, hale and hearty. Nidhi was desperate.
"Me? I won't do the surgery. Are you mad? It is not right to perform a surgery on your own family members. One is not in the right state of mind to operate when your loved one is on the tables. Ashutosh stood on his feet, pacing around the room.
"Who do you think can perform her surgery in Lucknow? Nidhi was prompt.
"I don't know. There's no surgeon I think is capable enough here in Lucknow to perform a Neonatal Neurosurgery. Ashutosh was subconsciously scratching his nails against each other.
"Do you think we can fly anywhere else, to get her surgery done? Who seems to have the most success rate in Neonatal Neurosurgery till now? Nidhi asked, simultaneously searching on internet on Ashutosh's laptop about the same.
Ashutosh didn't answer her; his answer was before her eyes, on the laptop screen. Neonatal Neurosurgery- a success now by the experienced hands' an online medical journal's headline was what greeted Nidhi's eyes, which accompanied the reference to a Medical Paper submitted by Dr. Ashutosh Mathur, the Neurosurgeon behind plenty of successful Neonatal Surgeries both in India and abroad.
Nidhi bit her lower lip reading that. Her first hand experience at convincing Ashutosh to conduct surgery on Bade Baba had been an earth shattering experience, where baba could at least voice his opinions. This time it was their daughter, who is too small right now to voice her point of view, just her body was protesting against the pain with high fever and a constantly cranky infant. How is Nidhi supposed to convince Ashutosh to cut open his own baby's head to cure her, or for that matter not leave their baby into the hands of fatality?
"Dr. Ashutosh...
"Sochna bhi mat... Ashutosh cut her mid sentence. "Mere haath kaanp rahe hain sochke bhi, main apni hi beti ki surgery kaise karunga?
"Karni toh aapko hi padegi surgery Dr. Ashutosh. Nidhi was defiant now, anger boiling her insides- "Maa-baap apne bachho ki khaatir kya kuch nahi karte. Khoon-paseena baha dete hain apne bachho ke liye, kisi bhi hadh tak chale jaate hain apne bachho ko bachaane ke liye. Aap apni beti ke liye apne emotions par control nahi kar sakte? Look at me, I also am a parent, just like you, and I am fighting tooth and nail with you for her life, can't you fight with yourself for her? her eyes were spitting anger.
Ashutosh kept looking stunned at her. Why didn't he ever realise that she might herself be going through the same torment, yet she is having such a brave front? He looked tiredly at her. He anchored at his last straw- "Will you accompany me in the OT?
"You will need a paediatrician inside constantly to monitor the baby during the surgery. I will go there. I promise I will not lose my grounds there, no matter what. Can you do the same? Nidhi bit her lip yet again.
He nodded submissively. Exhaling a heavy breath he rushed back to his table, sat down, and with a clear mind scheduled the surgery- "We need to take the tumour out as soon as possible. Since she is too small for a biopsy, we can get the check of malignancy of tumour only after it is out. Again, we can't keep her under heavy anaesthesia, because of her age; we need to be very quick with the surgery. So do we schedule it tomorrow morning?
Nidhi nodded in silence.
"Okay then, for that Nidhi, you need to get admitted in the hospital at night today itself. Stop feeding post midnight; we'll give her mild sedatives at night so that she doesn't wake up for feeds. Early morning we'll ready her for the surgery. Ashutosh instructed her as he scribbled the same on one of the Operation charts.
Nidhi got up on her feet when Ashutosh continued- "Nidhi, feed Anshi, and ask Anji or Dadi bua to take care of her meanwhile you catch as much sleep as you can. Don't be sleep deprived before a surgery, since you've not been in the OT for some time now. After the last feed at the night, sleep properly at night because it is going to be really hectic after that. She won't have fever since we've been medicating her. Everything's under control.
Nodding at all the instructions Nidhi left his cabin to work upon the schedule decided.
***
Morning onwards it was just Dr. Ashutosh and Dr. Nidhi on the toes. They didn't really talk with each other as husband and wife or as parents. They had a greater responsibility as doctors right now, which they had to fulfil without any failure.
The surgery began with a bang, and went on deftly for the next few hours without any hitch. Nidhi had scrubbed Ashutosh N number of times, she knew her was a very skilled doctor. But today his fingers were working so quickly that she sometimes would keep staring at his swift movements totally awestruck. The beeps of the monitor would bring her back indicating at intervals that things were running smoothly.
Ashutosh finished an hour earlier than they had planned. The tumour was removed, things seemed clean. None of her motor or optic nerves were damaged or touched. Ashutosh couldn't thank god enough for that one mercy. He didn't want to think of the repercussions otherwise. Now they had to wait for two things, one, the tumour's test report and Anshi's movements and actions once she comes to consciousness.
During the early evening hours when the effect of anaesthesia was wearing off, Nidhi was supposed to go feed Anshi who was still in the ICU. The baby though was hungry, suckled very slowly. She was still under the effect of sedatives. Nidhi quietly looked at her tiny baby, just wishing her well.
The next morning though brought a totally different Nidhi. The mother was back in her. The tumour report negated any malignancy, which relieved Ashutosh to no end. But when Anshi came fully to consciousness and both Ashutosh and Nidhi were checking on her did she finally start kicking her limbs seeing her parents around. A small smile formed on Anshi's face, which reflected on her parents' face. Tears were forming in Nidhi's eyes now as her infant tried forming her first babblings of "Mmmaaa. She had picked her in her lap crying to no end holding her baby, she was moving her hands and legs, she was trying to babble, she could recognise her parents, and everything was fine. Now it seemed okay for Nidhi to cry her heart out, all her fears, and her pains of an extremely worried mother.
Ashutosh felt a lot more relieved now. He had been worrying for Nidhi inside his heart. She wasn't emotionally responding much ever since she knew about Anshi's condition. And he was concerned with her bottling up her emotions. It was pretty normal for her to cry, and he let her have her outlet. He hugged her later on. Things were all well now. The emotional dilemma was over.
~~THANKS FOR READING~~
