MALPRACTICE AVERTED

Deepak was a twenty one year old graduate student living with his parents in the suburbs of Jammu city. It was the month of August and the heat was stifling. He had slept outside on the verandah of their kutcha house the previous night. He woke up at dawn as usual, took his morning bath, and sat down to study as his final exams were just around the corner. Suddenly he felt some vague discomfort in his stomach, which he chose to ignore. But the discomfort gradually started to turn into pain. It was initially bearable and he thought that it would pass off after he had his breakfast. But food offered no relief and within a couple of hours he was writhing in pain. His father was away from home. His worried mother called the neighbours for help and took him to the government hospital at nearby Jammu.

            Dr. Reetika was a lady doctor, if one can call someone who swore like a sailor a ‘lady’. Her ambition had been to be the wife of a business tycoon, but she had instead been forced by her parents to enter the medical profession. Her rich and powerful father had bought her a seat in a private medical college, and then had paid an awesome amount of money to get her a permanent job in the government hospital at Jammu. She was least concerned about the welfare of the patients, usually doing them more harm than good. All she was concerned about was taking home her hefty monthly salary. The salary, she thought, she more than deserved for putting up with the stupid patients, and cursing and screaming at them eight hours a day for seven days a week. It was this very same lady that attended to Deepak at first, and it is not surprising to note that he would have died had it not been for the efforts of a Dr. Pathak.

            Dr. Pathak was the younger of two siblings. He father was a civil servant and his mother a homemaker. He was a young lad of about ten when he watched the movie Anand, and from that day on he had dreamed of becoming a doctor. Unlike Reetika, he got his seat into the government medical college on the basis of his merit, and had passed out with a few gold medals to his name. He had then applied for the post of resident doctor at the hospital at Jammu, where he impressed all the interviewers with his formidable theoretical knowledge as well as razor-sharp clinical acumen. Add to that his sweet disposition and he had fast become one of the most loved and dependable doctors of the establishment.

            Back to the story. So Deepak’s mother brought her son to the hospital. By that time, he was in the throes of agony. Dr. Reetika was playing Angry Birds on her smart phone inside her cabin. Her lips curled down in disdain when she saw the groaning Deepak wheeled in on a stretcher by an orderly, accompanied by his mother.

            “What happened?” she enquired from where she was seated.

            “My stomach is paining,” the patient said through gritted teeth.

            “Since when?”

            “This morning. It started suddenly. I thought it would go away once I had my breakfast. But it has been increasing ever since.”

            “You study?”

            “I am doing my graduation.”

            “How much alcohol do you drink?”

            “I don’t drink ma’am.”

            “How many pegs did you take last night?”

            “I told you I don’t…

            “Shut up, you idiot,” the lady screamed. “You take me for a fool, huh? You must have downed half a bottle last night, and now you have acute pancreatitis. And your foolish mother brings her dear son here thinking he is oh-so-sick. Wasting my fucking time.” She turned to the attendant and said, “Take him to Radiology and get an ultrasound. Also ask the nurse to send all the blood investigations.”

            “Will you not even examine him doctor?” Deepak’s mother asked.

            “So now you are the doctor? Go on and treat your good for nothing son yourself, then. Why don’t you give him some more whisky? He will be fine then.”

            “He is a good boy, madam. He has no bad habits.”

            “Are you trying to teach me, you illiterate woman? Get out and get the investigations if you want this bastard to get better,” Dr. Reetika said and promptly got back to the paused game.

            An hour later, Deepak was still in the Radiology Department waiting for his turn and his health was deteriorating gradually. His speech was starting to slur, he was finding it hard to keep his eyes open, and there was no respite from the debilitating pain. At last the ultrasound was done and the patient was taken back to Dr. Reetika.

            “Hmmm it is a normal scan. Let us wait for the blood reports. Take the patient to the detention room and give him pantoprazole and diclofenac injections,” Reetika said, barely looking up from her smart phone.

            “Won’t you at least examine him? What kind of doctor are you?” Deepak’s mother sobbed.

            “Shut up and do what I say, you old hag. Otherwise take your stupid son to a private hospital. There are too many patients here as it is. All of you come here to get admitted and have free meals. Bastards,” she said and gestured to the orderly, who wheeled the patient out.

            Ten minutes went by and the nursing orderly brought in the blood reports. All the investigations were normal. Finally, she reluctantly got up from her chair and went to the detention room to examine the patient.

            “Yes, what’s your problem?”

            “Pain here,” Deepak slurred, pointing to his abdomen.

            Reetika brutally jabbed at his abdomen. The patient grimaced in pain. “I am also seeing double,” he managed to add.

            “Your son is a drug addict,” Reetika said with complete authority.

            “No!” his mother vehemently opposed.

            “Yes. You just aren’t smart enough to know it. Otherwise you would have been a doctor too,” she said with a smug smile. “These are withdrawal symptoms. Give him some of whatever shit he takes and he will be all right. A bloody junky wasting my time.”

            “Please save him, madam. He is my only son.”

            “You should have thought about it before giving him money for drugs. Or does he steal to get his kick? Drug addicts can go to any lengths to get money, even murder.”

            “Don’t talk like that. My Deepak is a good boy. He has no bad habits.”

            “I can see that,” Reetika said with another smug smile.

            Deepak was rolling about on the examination bed and his breathing was starting to get labored. “Please do something!” his mother entreated.

            “Okay, okay. Take him to the Psychiatrist. It’s his case,” Reetika brusquely said and walked back to her cabin, slamming the door shut behind her. She picked up her phone. Damn, three missed calls from her boyfriend. All because of a stupid fucking junky. She dialed her boyfriend’s number.

            Meanwhile, Deepak was being taken to the Psychiatry wing by the orderly when Dr. Pathak came across them in the corridor. Seeing the condition of the patient he enquired what was wrong. “He is having stomach pain since morning. Now he can’t speak properly and says he is seeing double. The doctor there says he takes drugs, but my son is a good boy.”

            Warning bells began to ring in Dr. Pathak’s mind. “Drug addict my ass,” he told himself. His sharp mind flew into overdrive and quickly started eliminating conditions which would present with similar symptoms. Two remained: myasthenia gravis and krait bite. Myasthenia gravis is a neurological disorder in which there is progressive weakening of the muscles leading to double vision, slurred speech, paralysis of the respiratory muscles and ultimately death. Krait bite is another not dissimilar condition having the same end result. Kraits are snakes of the cobra family. Their venom stops nerve conduction and causes muscle paralysis. Bite marks of kraits are notoriously hard to find, Dr. Pathak knew from experience. “Rush him to the ICU immediately. I will inform the Anasthetist and get there.”

            Dr. Pathak examined Deepak thoroughly in the ICU. His blood pressure was falling and his pulse rate was high. He could barely keep his eyes open, saliva was drooling from the angles of his mouth, and his breathing came in labored gasps. “Nurse, give him a shot of neostigmine injection. Let us rule out myasthenia first.” It didn’t work. The patient was deteriorating fast. By that time the Anaesthtist had arrived at the scene. “Sir, I think he needs to be put on artificial ventilation,” Dr. Pathak said. The Anaesthetist nodded and got to work. Within a minute Deepak was breathing with the help of machines through a tube inserted into his wind pipe. A more thorough examination revealed a couple of small bite marks in the patient’s right armpit. “Krait bite,” Dr. Pathak muttered to himself. “Nurse, give him injection hydrocortisone. Then we shall start him on anti snake venom. I think we still have a chance to save his life.”

            The diagnosis now established and a plan of action charted out, intensive management was initiated within seconds by the highly trained staff of the ICU. He was fed through intravenous lines, and antibiotics were given to prevent lung infection due to aspiration of stomach contents. The multivalent anti snake venom did its magic and the patient slowly but gradually recuperated. He was weaned of the ventilator on the fourth day and declared completely fit on the seventh. He was discharged on the eight day. Deepak’s parents could not hold back their sobs and the flow of their tears as they bowed down with folded hands in front of their God: Dr. Pathak. Thus, malpractice was averted. Or would it have been murder?