What you need to know:
- As a surgeon, I am used to disease and death staring at me in the face all the time.
- It’s a duel I constantly fight. Many a time, I emerge as a winner. But some battles cannot be won.
Doctors are known to make very bad patients. I can only think of three reasons for it. They have been on the serving counter all their professional lives and do not like to be on the receiving end. Two, they know the complications of every medical procedure and surgical operation, and are firmly convinced that they will develop all of them. Third, interestingly, doctors cannot take pain. They shirk at the sight of needles, drips, enemas, stomach tubes and other painful and sometimes undignified procedures.
The fear of developing all the complications in the book reminds me of my long-standing anaesthetist, who broke his thigh bone a number of years ago. The fracture was plated by a competent orthopaedic surgeon. A week later, the patient was found to be safe on crutches and was officially discharged.
To everyone’s surprise, he declined to go home and asked if he could stay three more days. He strongly believed in the power of the planets and the stars. Before arranging any important social functions, like an engagement date, marriage or entertaining a business proposition like buying a new property, he always consulted the family astrology to find out if the stars were propitious for such an undertaking.
I attributed his reluctance to go home to some extra-terrestrial impediment. However, my curiosity was overwhelming and, in view of my long-term professional relationship with him, I asked him why he was not keen to take a discharge when he was fit to do so.
As much as his explanation was flabbergasting, it proved my point. “You remember the good old days when we had no bone specialists, and you used to plate fractures?”
As I nodded in agreement, he went on, “I recall anaesthetising a patient who had fractured his femur which you plated.”
As I wondered what he was driving at, he added the punch line: “Everything was fine until the tenth day when he developed a clot in his lung and died. I just wanted to be in the hospital until I crossed that critical point!”
Sohrab, my professional colleague and long-term friend, underwent all these vicissitudes and more. He and I first met when we were undergraduate students at the Grant Medical College in Bombay. He was a local boy who came from a wealthy Parsi family. Parsi’s are the most Westernised group of the Indian society. They derive their origin from Persia, a country they fled centuries ago because of religious persecution. They migrated and settled in India through hazardous trade routes. In no time, they made their mark in business and industry and introduced icons like Tata.
He was responsible for, among other enterprises, opening the first Indian airline under the banner of Air India. The commonest topic of conversation at the cinema was what we wanted to do after graduation. Sohrab was crystal clear about his future career.
“I want to be a heart specialist.”
When I told them that my ambition was to be a surgeon, his immediate reaction was, “surgery is a manual science and requires only a good pair of hands. Medicine, especially cardiology, is cerebral and needs greater brain power.”
Not to be easily cowed, I put him right straight away. “You know the latest definition of a surgeon?” He is a physician who can also operate! It implies he has both a good brain and dexterous fingers.”
It was many years later when calamity struck Sohrab.
“One night, I suddenly found out that I couldn’t pass urine” he said to me. “My wife Maureen rushed me to the hospital where I worked and they proceeded to pass a catheter. You can imagine the embarrassment of having all of the young nurses and doctors you have trained over the years, inserting a catheter into you and doing a rectal examination to feel your prostrate.”
I could see the mortification he must have felt, visible on his face. He was 50 at the time – a bit young for prostrate, but there was no doubt. “Worse still” he continued, “the blood test showed that my PSA was very high, arousing suspicion of prostrate cancer.”
He was referring to a prostate specific antigen which goes up in the blood when one has prostate cancer and can easily be checked by a simple blood test. He paused knowing that this was a nasty turn his life had taken. The brief pause gave my jarred shock absorbers time to recover.
“My surgeon did a TUR on me.” Sohrab used surgical jargon. This meant that the surgeon chiselled out the prostrate and widened the passage to enable Sohrab to pass urine spontaneously. This technique did not require a cut on his abdomen. Of course, the scrapings was cancer.
Sohrab sighed. “It is a vicious type of cancer. I need to undergo – both radiotherapy and chemotherapy. In addition to that, I need Zoladex injections which, as you know, reduce potency and libido to zero.” Being a professional colleague, he was candid.
Over the next few years, he lost his hair and his skin became pale and coarse. Worse still, he lost his oomph. I wished I could do something to liberate him from his unbearable pain. As a surgeon, I am used to disease and death staring at me in the face all the time. It’s a duel I constantly fight. Many a time, I emerge as a winner. But some battles cannot be won.
In the case of Sohrab, I had lost professional objectivity as well which, like thick skin, all surgeons develop over time. I sat like a helpless onlooker, feeling the pain my friend was going though. In the end, he found his own salvation and relief in an unconventional but equally tragic way.
A few months later, one evening at home in Nairobi, our phone rang. It was Sohrab’s wife, Maureen. “You’ve lost a good friend” she said, “and I have lost a wonderful husband.” She was choking with emotion and I struggled to comfort her. It was later that I learnt of the last moments of Sohrab’s life. The night before, he took Maureen out to their favourite Thai restaurant, ordered their favourite dishes plus a bottle of house champagne.
On returning home, and after Maureen had fallen asleep, he shot himself in the heart. Upon waking up in the morning, oblivious to the events that had taken place in the night, Maureen found a note beside her favourite bunch of yellow roses in the kitchen that said, “couldn’t take the pain any longer. I love you darling. So long - till we meet again.”