Surgery that snatched my brother from jaws of death

One more emotional surgical episode... It was Christmas time and as usual, we were in Mombasa. My younger brother, Ghaffar, an eminent chest physician, was looking for me to inform me of a family tragedy that was brewing in Karachi.

He first rang my office in Nairobi, which was closed for the festive season. Knowing that I am a creature of habit and was likely to be at our beautiful Coast, he traced me through his wife’s friend who lives in Mombasa. Eventually, when he got hold of me, he said, “It’s about Umar.”

He was referring to our elder brother. “He started with a chest infection that developed into septicaemia, which has now settled in the liver as an abscess.” As I was wondering if he was preparing me for the worst, he added. ”He is very ill and wishes to see you. I have a few doctors working on the case, with me and none of us holding any hope.” He concluded.

My mind was quickly made up because it sounded like the wish of a dying man. In those days, one had to complete various formalities before flying out of Kenya, and there were two working days between Christmas and New Year to complete them.

We flew back to Nairobi and I obtained permission from Central Bank, foreign currency, airport tax and visa for Pakistan and was on the Emirate flight to Karachi on the last day of 1991. Being New Year’s Eve, the plane was empty, and so I could rest and reminisce.

I remembered my childhood days in Bantwa when Umar had bought me ice-lollies from the street vendor, when he had caught me playing truant and taken me back to school. He had helped me with my homework and thumped me when I was naughty.

Meagre scholarship

While I was in Mumbai, he took me to the Indian Coffee house, and he often took me to watch an Indian movie. And all this from his meagre scholarship to study law! He had played cards with me to amuse me when it was raining outside in monsoon; we had eaten from the same dish and shared a bedroom.

Now, he was dying on the other side of the world and I had an opportunity to snatch him back from the jaws of death and repay him for all his favours.

From the airport, I went straight to see him at the hospital with Ghaffar and rang D Aziz, the surgeon on the case. Medical protocol demanded that I took his permission before perusing his file or examining him, which he graciously gave after fully putting me in the picture.

Having detached myself from all sentiments, I examined my brother in a strictly professional manner. He barely recognised me. It was obvious that Ghaffar had understated the severity of his case to soften the blow. His abdomen was tight and I felt a big tender mass below the liver.

Ultrasound showed a large mass on the right side, pushing the gas in the intestine to the left.

As I was looking at other reports, Dr Aziz arrived to discuss the case in person. I suggested another ultrasound and depending on the result, an operation on the patient. Dr Aziz thought that Umar was too ill to withstand surgery. By now it was 9pm and time to call it a day.

 Ghaffar drove me to my eldest brother’s house, where Jan-Mohamed, Sattar and Zainab, my two elder brothers and sister, were waiting to hear my opinion about Umar. I told them that leaving Umar alone was condemning him to certain death, while with surgery, however hazardous, he stood a fighting chance.

Put in such brutally candid terms, they agreed with my approach. With their carte blanche, I slept fitfully that night, fearful of the big onus I had undertaken. I woke up early the next morning and was driven to the hospital.

I examined Umar and found that his abdominal mass had increased in size, more suggestive of my earlier diagnosis of an abscess. Repeat ultrasound located the abscess more accurately in the liver.

Dr Aziz arrived soon after me and I told him of the family conference I had held the previous evening, and he veered to my opinion regarding surgery on Umar in view of the latest ultrasound findings and the family’s blessings. He organised the theatre and the anaesthetist within an hour.

Funny bone

I took the consent form for Umar’s signature. As he was signing it, I said, “I don’t want you to sue me if anything goes wrong.” I thought, he being a lawyer, it would tickle his funny bone, but he was too ill to appreciate it.

We both scrubbed and I did so with an intention of assisting Dr Aziz. But when the theatre sister handed the scalpel to Dr Aziz, he held it for a minute and then came over to my side and handed it to me saying. ”You are my senior, so you operate and I will assist.”

It was not the time or place to argue, so I complied, fully realising the heavy responsibility I was carrying. Overwhelmed with emotions, I made an incision on my brother’s belly and could not relax until I incised the abscess and pus. Blood and liver debris flowed in the suction bottle connected to my sucker.

Ghaffar, who was managing the medical side of the case and busy changing the suction bottles, triumphantly shouted: ”The total amount sucked is four pints.” I felt, I had struck both gold and oil.

After closing the abdomen, I thanked everybody in the theatre, especially Dr Aziz for his cooperation and unfailing courtesy to me. In an emotionally charged voice, he muttered. “Thanks for teaching me not to lose my head even when dealing with matters pertaining to my heart.”

I flew back home on Sunday, January, 5, 1992, thanks to my nephew, Bashir, a business tycoon, who against all odds, obtained a confirmed seat for me.