“Have you ever seen a brain dead patient? No, why? I saw for
the first time in my career. I saw his organs removed and remove him of life
support to let him die. “
Whether to choose between medicine and engineering is the
question that most Odia (ethnic group from the Indian state of Odisha) boys and
girls ask themselves in their late teens. In the last two decades engineering
and medical colleges have mushroomed in many major educational hubs of India.
Especially engineering is a major business and employment generator. But
medicine, that’s a tough call. Not just cracking the entrance, but the course
that follows later is equally gruesome.
Despite the fact that, almost a decade of a person’s life is devoted to
become a full doctor and all the lack of smart techie look – the white apron
profession in the Indian society is the most respected and sought after career,
undoubtedly.
My doctor friends did their graduation in medicine from
different colleges in India; those who doubted their capability to crack the
PMT did it from China and never came back (though Chinese food in India, tastes
better in India than in China). One of my very close friends in Odisha; who in my view was
absolutely unfit for the doctor’s job made it through the PMT and got into a
government medical college. Unfit- not because she was not meritorious, unfit
because she was emotional. In a small towner's experience – doctors and
hospitals and nurses and all that’s medicine, provides you with an unfading
memory of rude people, using harsh language, and totally unsympathetic. Hospitals are
places where you never want to be. Your illness may be painful but the
experience in a hospital is sickening beyond your illness. The dirty toilets,
the stinking corridors, the rude nurses and the egoistic doctors who speak to
you like you were a savage African slave in the 19th century and the
latter were white colonizers from civilized lands. My friend was nowhere close
to those egos, she was totally capable to become a doctor but utterly useless
when being like a doctor.
“Today morning I was informed by my chief that I had to be
present as an anesthetist for a cadaver donor. Cadaver? Okay! In that case I
will have to maintain the blood pressure, till they remove the desired organs.
At 12 pm sharp I was there. I walked into the ICU to bring the cadaver. For the
hospital it was celebration time, as the recipients were going to pay a huge
sum for the organs. A team of surgeons from Chennai had gathered near the
cafeteria, gathering calories for the long surgeries – ready with video
camcorders to record their performances. “
I slowly walked passed them, entered the ICU and was led to
the last bed by the concerned nurse. “Ma’m, we received him last night, brain
dead. He is on noradr and vasopressin, ventilator connected and vitals
maintained. “
In front of me was lying a 5’10’’ tall body, still and
stiff. Apart from this introduction, in front of me was lying a young handsome
man in his early 30s. Since my days in medical school I have seen N number of
deaths, have disclosed to families also. But a brain dead one was a first time
experience. As a Post grad student of medicine specialising in Anesthesia it
was my work to maintain the vitals until the removal of organs was successfully
over. As an anesthetist it’s always my job to ensure the patient doesn’t feel
pain of the surgery, whether local or general. No studies have clearly revealed
that a brain dead patient can feel pain or not. Some say spinal reflexes are
intact. Some say as brain stem is dead, there’s no question of pain. But, who’s
got so much time or thought for a brain dead patient, here we were ready to rip
open his chest and abdomen to pull out the bounty of his organs of liver,
kidneys, heart one after the other.
Interestingly, it’s not the inability of the patient to feel but to
speak which gives us all this power to operate on him.
The monitor showed that of a living person BP 156/80, HR –
99, saturation 100 per. While taking him
to the Operation theatre his friends and family rushed to him, saw his living
body, and touched his face for one last time. I couldn’t help keeping my tears.
Inside the OT my chief said, no medication required. But I gave him Morphine
and Fentanyl. What if he feels pain, I didn’t want him to die with that pain. I
never revealed this to anyone.
The operation started, he was cut open. The organs were
removed one by one. Then came the toughest part for me – CUT OFF- remove life
support. The BP came down gradually 60-20, 50-20 finally 0/0. The ECG line was
flat. I removed the tube from his trachea. It was easy killing a man.
In my heart I saluted his family, his newly married wife for
having the courage to give consent for the organ donation.
Just another day in
the life of a rude, unsympathetic doctor.
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