The Battle of Ramprasad- and how Modern Medicine lost.

Ramprasad was eighty six. He sat in his backyard, chatting with his friend, Ahmed Yousef. They were neighbours for decades, and had lost their wives years ago. It was natural that they became close friends. Ahmed was also Ramprasad’s personal physician.

“I am ready to die, daktar sab,” Said Ramprasad. “I am always breathless, and even going to the bathroom is an effort.”

“I don’t want to be a burden to anyone. I have a big health insurance. Munna might come once in a while.” Ramprasad said, and panted softly with the effort of talking.

Doctor Ahmed was silent. Munna was Raj Kumar, Ramprsadji’s only son. He was an Engineer in Oklahoma, in that dream paradise of Indian professionals, the US of A.

“Don’t, Please don’t- take me to a hospital. Don’t put tubes up my penis and down my stomach. Painkillers may be nice I guess. But nothing more. I order you, daktar sab! This is my Will- please note.” Ramprasad leaned back in his chair and wheezed noisily as he breathed in and out.

Ahmed nodded solemnly. He did not say- “hey- you are still young- don’t talk about death.” He was not made of vacuous stuff.

When Ramprasadji was around fifty five or so, he had a real problem with vision. A cataract operation needed. But Ramprasad pottered about the house, bumping into things and not seeing properly for four years, waiting for Munna to come and stay for the operation. At seventy, Ramprasad was a very active man, but severe knee pain had made him slow down. A knee replacement would have helped him, thought doctor Ahmed, but Munna could not find the time, and the thing got postponed indefinitely.

Now Ramprasad had severe diabetes, and his heart was failing. He could barely walk to the toilet.

“If I become sicker and you think I might die, please ask Munna to come with my grandchildren. It is a long time since I saw Rahul and Divya.” Ramprasad’s voice was wistful.

Yet, it was just a statement of fact. The old man did not feel the need to be more emotional than that. Hell- what was the big deal? He had lived a nice life, and his only son was a big man in America. Devika, the wife- was long gone.

During his time, he had managed his father’s farm, did some businesses…..

He had fallenl in love with two girls in his late teens. No, not at the same time. One, followed by another. When he told them of his great love, they had asked him to fuck off and mind his business. Because he took their sage advice and minded the same, he had made money and had got married to a nice girl.

After marriage too, in the course of a long life, he had fallen in love with at least ten more women, but none got to know of this fact, including his wife and the concerned ladies themselves. That was how it should be done, wasn’t it?

Once in while he had drank a bit of whiskey and had sung with his friends. He had danced too, shaking his dhothi along with his hips. That was also ok, wasn’t it, dear reader?

Even if you don’t think that was good, you drab old reader, Ramprasad is not bothered by your attitude. Not in the bloody least.

When Munna heard about his father’s words with the neighbour uncle, he thought he should come back to India. You see, even though his father called him ‘Munna’, he was more than fifty five, and his children were almost grown up. He was relatively free. A sudden urge- an irresistible desire- an overpowering ambition- to come, serve and look after his father in his old age seized him by the throat.  The next flight brought him in and he felt good as he embraced his father.

“God- you are really breathless!” He exclaimed. “Ahmed uncle is useless. What treatment is he giving you, father?”

“Ah. Last few years it is like this; Munna. That is ok. I am ok- you are here, son” Beamed the old man.

Ramprasad drank thirty ml of scotch with dinner that day. The son’s arrival was always a celebration.

When he went to the bathroom, he felt a bit dizzy. He lay on the floor, so he did not fall.

“Oh, Papa! What happened, father? Hey, you- call the ambulance!” Munna Raj shouted at Suresh, the helper who looked after the house.

Ramprasad rebelled. “It is nothing, son- we have to finish dinner! I don’t want to go.”

But Raj would hear none of it. The Ambulence with two ventilators (one was a stand-by) came rushing from one of the best corporate hospitals in the city. The old man was bundled in.

“Put the bleeding siren on, man! isn’t it money that I am paying?” Munna shouted at the driver.

“ooo…ahhhh…….ahh…, ooo…ahhh….” The Ambulence blared plaintively. Munna leaned back in his seat with satisfaction.

 Ramprasad closed his eyes tightly. He was terrified. Promptly two pretty nurses jumped on top of him and started pressing his chest. He opened his lids and screamed in pain. The nurses stopped, and glanced at each other, abashed.

At the hospital, the Doctor stood up after examining Ramprasad. ‘Nothing seems to be wrong. We will just observe him for an hour and send him home’- this was what the Doctor wanted to say. But before he could, Munna intervened.

“Doctor- do everything. For my father- nothing is a constraint! Nothing should happen to him! Nothing!” His voice rang out resolutely across the emergency room.

Munna really loved his father. But he did not ask him what he wanted. And what did Ramprasad want?

He wanted to go back to his house. He wanted to finish his drink. He had only had thirty ml of the whiskey. The rest thirty was waiting. That was bad. The aloo- bhindi left uneaten was something he liked. He had to have it, damn it! With the roti!

And he wanted to talk with his son. When was he bringing Rahul and Divya to see him? They must be so grown by now!

Ramprasad watched himself being thrown into the bowels of an ICU, in helpless horror. An inserted needle drew a hundred millilitre of blood and it was sent for three hundred different tests. Twenty electrodes were connected to various parts of his body and four or five monitors lit up and emitted rhythmic beeping noises. “Beep, Beep” – Went one. Lub- Dub- Went another. Still a third hummed and hawed in a complaining tone, as if it was annoyed with Ramprasad’s life story.

Ramprasad’s serum beryllium, uraniuam, sodium, calcium, and even vitamin zee was checked. Blood gases were assessed. Many were found wanting. Further tests had to be done.

Doctor Ahmed came running. He was allowed into the ICU.

Dakter sab, save me- Ramprasad cried.

Ahmed came out, and suggested tentatively:

“Raj; shall we take father home? That is his wish.”

“His wish!”, Munna sputtered- “Who asked what his wish is? This is about treatment. Uncleji, I will look after my father’s affairs.”

Doctor Ahmed returned to his house and slept.

The night in the ICU is like the movie- “The night at the museum”.  Nurses ran to and fro. Machines buzzed, emitting a cacophony of discordant noises. It was like an orchestra from hell. From a nearby bed, a patient with a tube down his throat stared at Ramprasad with bulging, unseeing eyes.

By morning, some fuses and connections in Ramprasad’s old cerebrum got jumbled up.

“Where the fuck is the rest of the whiskey, man?” He asked the Doctor. He said the same thing to the nurse, and Munna, when he visited him inside.

“I want my aloo- bhindi with my roti, you asshole.” He politely asked the ventilator that was towering over his bed, patiently waiting.

A special species of cockroach, that thrives on disinfectants, dressing materials and other hospital chemicals, and who was a permanent tenant of the ICU ran over Ramprasad’s chest. He asked it:

“Hey- where is the rest of the whiskey, you stupid thing? Where is my aloo bhindi? Did you eat it?”

“God- his neurology is screwed up!” An engineer neighbour exclaimed. By this time, relatives and friends, enough to fill a classroom, had gathered outside the Intensive Care Unit. Most of them had never visited Ramprasad in decades.

“He will need a CD scan. An NRI scan too”- opined a distant cousin’s son, who ran an auto repairing shop in the town.

But the Doctor said- “We need to shift him out of the ICU. Let him relax and talk to people.”

“The Doctor doesn’t know anything.”, “He is a fool.” Many voices gave a unanimous verdict. “We need to get him to the star medical centre in the big city.”

By this time, things had gone out of Munna’s hands too, and the treatment of Ramprasad took on a life of its own, like a temple elephant in musth prodded in the testicles by an overzealous mahout. Or like a fleet of MIG twenty ones taking off for a suicide mission. The battle- or the wild run- was on, and nothing could really stop it.  

“Aaaa…eeee…., aaaa…eeee” cried the Ambulence as it took Ramprasad to the new hospital. As soon as he came in, Ramprasad had a tube put into his penis to take out urine, and a CT scan, MRI scan, Galliam scintiscan, and a Positron Emission Tomography scan was done. Munna and all the relatives were very proud. Pedo podo gram, angiogram, electro cardiogram, and pernicious calculogram were done as a routine.

That was when the small prostate cancer was found. And a centimetre sized papillary carcinoma nestled in his thyroid, unknown to anyone.

“Robotic prostatectomy is best;” Informed a new doctor excitedly. “At the same time we can do the robotic thyroidectomy, but an intra aortic balloon pump will be necessary to stabilize his heart condition for the surgery.” All this, He informed them, was pure routine. They do things like that all the time. That was what doctors were for.

“He wanted to have knee replacement done; Ramprasadji had told me this ten years back.” Another nephew piped up.

“Oh; that is easy,” Said the Doctor, “Our Orthopedic Surgeon is an expert in replacements”

When he became conscious, Ramprasad was in the ventilator. There were tubes emanating from all the orifices of his body. He had become part of the woodwork; a component of the machinery- a mere cog in the health system itself, as it were. No one talked to him, or looked at him; but incomprehensible things were done to him, hour after hour.

Suddenly, a strong and ardent desire to see a photograph of his dead wife rose within him; and an irresistible hunger to look at his grandchildren Rahul and Divya overcame him, and a terrible longing to bite into the piece of chicken in the Biriyani served at Dr Ahmed’s house, which he often enjoyed, filled his mind. He summoned all his strength and moved his arms and legs, to attract someone’s attention.

“The patient is restless!”

The Doctor gave him an injection of vicuronium to paralyze his muscles, and Ramprasad did not move after that.

Ramprasad remained on the ventilator for a few months. He had many attacks of infections, and antibiotics costing tens of thousands of rupees brought him back from the brink every time.

At last one day, Ramprasad’s heart just stopped. It had enough.

“Code blue, code blue”- The nurses shouted.

The skilled team members of the code blue team rushed in, weapons at the ready. Many climbed into the bed and pressed on Ramprasad’s feeble chest, with an urgency reminiscent of Hollywood thrillers, and DC shocks were given.

Many of Ramprasad’s ribs were broken, but that was ok. This was war. Death is the enemy of us Doctors, and we will fight death to the death. The Doctors want to eliminate death from the world, and our Utopia is one were death is something that is not talked about. Even thinking about the possibility of death was an anathema.        

After the funeral, Munna Raj went to bed, satisfied. He had to cough up a lot of money, for the Insurance limit had long been exceeded. But that was fine. He had the satisfaction that everything possible was done. All relatives praised Raj for looking after his father so well in his old age. He slept.

That night, he had a strange dream. In the dream, Ramprasad appeared, naked. Tubes were up his nose and throat, and a tracheostomy hole yawned in his throat. A urinary catheter hung from his penis.

“You bloody asshole!” He shouted.

“What is it Papa? What is the matter?”- Asked Munna, anxiously.

“You will also die like this, you bloody moron- with tubes up your everywhere, alone and uncared for!” Ramprasad Cursed.

Munna Raj woke with a start. ‘Uncared for!?” Goodness. What was the problem with his father? Everything possible was done, wasn’t it? Ungrateful old man. Modern Medicine is the culprit. If it couldn’t save his father, how was he to be blamed?

Munna could not understand it. (Jimmy Mathew)

Dr Jimmy

I am a Doctor, Writer and Science Communicator. I am a member of Info- Clinic, and have written a few books. This site features my blog posts and stories. Thank you for visiting. ഞാൻ എഴുതാൻ ഇഷ്ടമുള്ള ഉള്ള ഒരു ഡോക്ടർ ആണ് . നിങ്ങളുടെ താത്പര്യത്തിന് നന്ദി .