38.A surgery and two doctors

Only a few months had gone by after returning from Delhi. One day morning as I was sitting in the closet, I had a severe pain my lower abdomen. It was not a small pain, just unbearable pain, a pain that I had never experienced earlier. My body sweated profusely and with great difficulty and help from my wife, I managed to reach my bed and collapsed. We could not find the reason for this intense pain. As  I was  lying down, the  pain subsided and after  sending the children to school, myself and my wife slowly walked up to our health centre. At that time there was no RMO, only the lady doctor  Dr.Nirmala  Menon used to come by 9AM. She examined my lower abdomen thoroughly and asked me to cough a few times. She found that just above my scrotum a fleshy part was moving up and down as I was coughing. She diagnosed it immediately as (inguinal) hernia. She said surgery is the only treatment for this type of hernia.

Inguinal hernia is due to the weakness of the  tissue on the lower part of the abdomen. A small hole is formed on the lower wall that separates the abdomen from other parts and as we press our lower abdomen during  defecating etc, part  of the intestine  gets pressed  through this hole into the scrotum on either side of the testicles. Initially, this hole will be very small and the pain will be acute and as times go by this hole may enlarge and the movement of the intestine will be less painful. The bulge seen in the lower abdomen was the portion of the intestine. In the early stages, it is likely that the intestinal part that protrudes into the lower part will be strangulated and if the blood circulation stops to the protruding part and the situation is called ‘strangulated hernia’ and can be dangerous. That part of the tissue protruding out may become bluish and a gangrene may result. A gangrene is a dead tissue on the body which can lead to letting toxic substance into blood stream and may lead to blood poisoning and danger. Sometimes, if we can push the protruding part with our fingers back to its original position, pain will subside. Using an abdominal belt may be helpful, but not in the early stages as the movement is not too frequent. If this happens when someone is travelling, it may be very difficult.

 Anyway, as the pain was too intense, frequent and unbearable I decided to get the surgery done. As per the recommendation from our college doctor, I approached a very good surgeon who was an Assistant Professor in Calicut Medical College. He was a nice gentleman and when I met him at his house, we became friends instantly. He did not even accept the normal fee for home consultation. I told my wife there is no need to inform people at home, we can manage ourselves. Just for her confidence, I requested my brother in law who was working at New Mangalore Port trust, Panambur to come over. We booked  a room in the pay ward and got admitted. Children were entrusted with  our friends and they did  not seem to be bothered as they could get  more time  to play. My wife is too sceptical about things pertaining to our children and me and as she enquired with some other  bystanders of patients in the pay ward, she was told that  post-operative  nursing  care will be difficult  in the pay ward. So, she wanted me to be in the post-surgical ward at least for a day or two. But, to get a bed in the ward, the  Head of the surgical unit should  permit. As the surgeon operating on me was not the unit head, he suggested it is better to meet the unit head and get his  permission.   

The unit head, I was told, was a notorious surgeon who was known to demand  big amounts for surgery. At that time, some revolutionary groups had collected the list of corrupt and inhuman doctors and were planning to have an open court and public trial for these doctors. This unit head was one among those listed. My wife handed over some money to my brother in law and send him to meet the unit head at his house. With some difficulty he located his house and gave him the money. The great doctor   gladly took the money and did not even ask who the patient was. Surgery was done on the next day and I was given a bed in the post-surgical ward  in a corner. But the cot was half broken with its legs wagging and there was a slope from head to feet of about 40 degrees.  It was almost difficult to lie down on it, leave alone taking rest. I thought this special cot may gift for seeing the unit head at home.

More than that, it was a sleepless night for me. I could not find a way to pass urine. Due to the  4 ½  inch incision in the lower  abdomen there was some  swelling and passing urine  was difficult. Moreover, the bath room in the general ward was very dirty and there was no proper door for the bath room. Even otherwise, it is difficult for me to pee without proper privacy. The nursing sisters  asked me to try keeping the water tap open or keep some hot water on my abdomen, but  none of these  worked. I could not pee for almost 8 hours and I was feeling terribly uncomfortable as the blood urea was going up every minute. I was feeling breathlessness and felt that I am breathing my last and in doctors  terms I was showing ‘distress symptoms’. Somehow, I held on till the doctors came for the morning rounds and seeing my difficulty, they allowed me to go to the pay ward. Once I reached the pay ward, within a few minutes I could relieve myself and was able to take rest.

After a few days, we were discharged and returned to REC campus. I did not have much problems except that there was some pain due to gas filling in the stomach. I had to be taken to the surgeon once or twice and by the time I reached him in the tempo van   made available by the college, I was   ok due to the bumping up and down in the vehicle and gas finding its way out. Not even once did my surgeon accepted some money from me. Finally, I had to keep a cover with money under his table clothe secretly and inform him over phone after reaching my home. Since these doctors were working at home during their leisure time, I did not find any thing wrong in their taking a small amount as fees.

I short, I had the advantage  knowing  two doctors, one  who refused  to take a legitimate fees  for the excellent work done by him and another who did not have any hesitation  in accepting a money without doing anything, not even asking who the patient was. Of course, later I could read in the newspapers that this doctor was put to public trial by the revolutionary group. I thought such people richly  deserve such treatment in public.