Ward Stories 1 : Hope

  || Hari Om || || Shree Ram || || Ambadnya ||

|| Naathsanvidh ||

Dear readers ! For those of you who don't know me, a brief introduction: 

I am a 3rd year Resident Doctor in Internal Medicine at KEM Hospital, Mumbai.

Residency is always a roller-coaster ride, full of  struggle and hardships, but also full of the most wonderful memories. Moments to be treasured forever.

I am starting this series to share some of the beautiful experiences and interactions that I have had during my residency. These incidents have really inspired me; and they are God's Supreme blessing, which have carried me through many difficult times. Hope you enjoy reading them as well.

Now, on to the story ! 

 

Ward Stories 1 : Hope

There are many times during the practice of the medical profession that we feel that we are fighting a lost battle, and all our efforts are going to be futile. We feel that we are swimming blind in a sea of darkness, fighting a many-headed enemy that we cannot even see. It is in such situations that we are truly humbled, when we realise how little we actually know, and how little is in our control.

The best we can do is not give up, and keep fighting, with whatever it is that we have.

The story I wish to share highlights this principle. 

The story is of a young boy (for the purpose of this story, his name is Hope) who presented to us with Refractory Status Epilepticus. Avoiding technicalities, this basically means that he was in a state of continuous seizure activity. He required constant sedation and was on a ventilator in our ICU for life support. His seizure activity was not controlled on more than 5 different anti-epileptic medications. Finally, he was introduced into a state of drug-induced coma. Any tapering of the medications, resulted in an immediate recurrence of his symptoms. He was in this state for more than 60 days.

His relatives were very poor and not well educated. They were very simple people. Our morning rounds used to always end with speaking to them at length. It was heart-breaking for us to explain to them everyday that our best efforts were not working. More so because of two things: it would have been almost impossible for his parents to understand what was wrong with him, since it was far beyond even Our understanding; and because they always looked to us with great hope and faith. They believed in us, even though we felt then that we were fighting an enemy we could not hope to defeat.

During my tenure, I have seen him requiring 3 inotropes ( life support medications) just to maintain his blood pressure, completely on mechanical ventilation. He used to throw a new challenge at us everyday, and we used to respond as best as we could. But it was like fighting a forest fire with a water bottle. But, we never gave up on him. And his family never gave up on us.

And one day, after a very long time, Hope woke up!

 He opened his eyes and began gesturing with his hands. Gradually, with careful monitoring, he was now off the Ventilator.

 Literature tells us that seizure activity persisting more than 30 minutes starts causing irreversible brain damage. Well, this was more than 60 days ! Who knew what state his mind would be in ? Would the parents get their son back, or just a shadow of what once was ? Here, again, he surprised us all.

 He woke with no deficit, completely recognizing his relatives, as if the last 60 days just hadn’t happened. The best start to our new year as that we spoke to him, and he spoke to us. And his parents, the simple farmer family, showed us such love, such as is difficult to come by these days. The smiles on their faces are something that I will carry as a talisman for the rest of my life.

We had tried many novel treatment modalities, something must have worked eventually. 

But, the bottom line for me is what one of my seniors at MICU said while we were discussing his recovery:

“ We kept him alive, God saved him”

I am not disregarding our efforts, for countless Faculty and Residents from various departments, Staff Nurses, Ward Mamas and Moushis (Helpers) have invested their hearts and souls in this struggle. But there is forever a part of the battle that is not really in our hands.
 

There are many times when we lose, and fall over and over again. The only thing that we can do is to keep rising and keep fighting. Victory is never guaranteed, but the effort is what we can and must give. It is easy to get tired and frustrated, to think of giving up, but even if you win only once in a hundred battles, it is worth it for that one person, that one family! 

Hope woke from his slumber, and in doing so, became a beacon for a hundred medicos. The next time that, we are stuck in the darkness, fighting an invisible enemy, fearing defeat, we will look back and say: “ We will give it everything that we have. Hope lives on, for all of us”

SETH G.S. Medical College & KEM Hospital

-Dr ArnavMHT
( This story has appeared in print in The Larynx: the college Newspaper)

My older blog posts are listed at the top of the page.
If you liked this post, do read the others as well ! All comments and feedback are welcome.

  || Hari Om || || Shree Ram || || Ambadnya ||

|| Naathsanvidh ||

Poem: The Burning Forest

|| Hari Om || || Shree Ram || || Ambadnya || || Naathsamvidh || 

 

The Burning Forest

There was a forest great and green,

A beauty to behold,

Filled with colour and beasts and birds,

And trees noble and old.

Untouched it was, far out of time

For years steadfast and same.

A fortress mighty, a haven safe,

Until the fire came …

At first it was a humble spark,

That did begin to feed.

Until none of the forest dwellers,

Could sate its endless greed.

I watched the fire as it ravaged,

The lush green forest floor.

Green to black, black to ash

 And the beauty was no more.

The beasts did flee, the birds did fly,

The ancient trees they fell.

As the haven, so lush, serene

Became a fiery hell.

Now the creatures have no home

All is consumed by the blaze,

In its hunger, devoid of mercy

The forest it did raze.

But is the fire the sinner here,

Guilty of this vile deed?

Nay it is the fire starters,

Arrogance, contempt and greed.

They are the ones that spark the flame,

Within the human mind.

That causes men to lose control,

Become selfish and blind.

Not the fire but man indeed,

Does leave the Earth so sore.

A single spark of greed, of lust

And the beauty is no more.

Now I see an empty plane,

Where ash does stain the mud,

And the sky is lit a fiery red,

Or is it the red of blood ?


 -Dr. Arnav H. Tongaonkar

My older blog posts are listed at the top of the page.
If you liked this post, do read the others as well ! All comments and feedback are welcome.

|| Hari Om || || Shree Ram || || Ambadnya || || Naathsamvidh || 

 

Connect

|| Hari Om || || Shree Ram || || Ambadnya || || Naathsamvidh || 

I have written this based on  my experiences over two years of residency. This article was awarded the 1st Place in the online competition- Innovative Ideas in "Ascension 2019", a conference on Medical Humanities, at Seth. G.S. Medical College and KEM Hospital.

Connect 

A disclaimer: this may not be what you were expecting. This is an idea, a feeling that has grown over two years of residency, born from a thousand moments and fragments of memories and feelings. There is enough innovation ongoing in the science of Medicine, this is a thought from the Art of Medicine.

Consider this less of an innovation, and more of a renovation.

The idea is fairly simple, and nothing very new. What I am proposing is simply restructuring an existing system. So : “Connect”. A social network with a twist. A social network for patients and their relatives to interact with their treating doctors. A platform for the Doctor to get to know the people they are treating better. Simple.

Now, to get to the thought process behind this. Currently, there has been a lot of discussion about the shaky nature of the doctor-patient relationship and the conflict that stems thereof.

I feel that one of the major reasons behind this is that just as Doctors tend to visualize

patients as a group of symptoms rather than a person, the relatives tend to visualize the treating Physician as a cold-hearted harbinger of bad news, who is cruelly reminding them that thei

loved one is ill and may not make it.

Neither side is right, neither side is wrong.

 

What is unsaid here is what stands between the two parties like a wall of glass. The Doctor has not seen the patient as the happy member of a loving family, a father, brother, mother sister, spouse or sibling, perhaps the soul and spirit of the home in their health. He treats the person who is ill, tries to keep the relatives well informed about the nature of the disease and tries to be as objective as possible.

This objectivity is not coldness, it a survival mechanism. It is a way to stay afloat and avoid being swept away in a tide of emotions. But, very often, the Doctor with the stoic façade is silently shedding tears inside, and not showing those tears is perhaps one of the greatest sacrifices we make as Doctors.

I know the tears that I have shed, both in joy and sorrow.

The incident that comes most prominently to mind, is when a Doctor had the privilege of extubating a lady who had been ventilator-dependent for 45 days. Shortly after that, she was visited by her young children. I think the Doctor cried more than the relatives that day.

His tears did not go unnoticed, and they remain in touch to this day.

The reason I am quoting this incident is that I feel this “social network” will help patients and their relatives understand that the person treating them is no machine, no deity, but a flawed and simple human being just like them.

And the treating physician will get a better idea of what his patient was and what restoring that life means to so many people. I have the seen CPR being performed with twice as much intensity because a child was clinging on to the hand of the one who had collapsed. Simple things, but they go a very long way!

These stories are often shared on existing social media as anecdotes, but in the turbulent ocean that is the internet, they are unable to bridge the divide as they should.

Thus, I am looking to create a sheltered Social network with just the healthcare workers and their patients, both current as well as past. A place for them to show to each other the people they are. Not Doctor. Not Patient. Person.

Here, they can share anything that they choose about themselves. The only filter that I would like to place is that there will be no Online consultations, something that most practitioners dread! Also, any negative comments from either side should never mention names. We are here to grow together, not to hurt. There will be problems and mistakes, but that is what makes us human.

I was pleasantly surprised when a patient’s relative asked me whether I play the violin. He had looked me up on Facebook! Then we had a conversation. A real conversation, as people. And on that foundation, the consultation continued.

From a Doctor’s point of view, I can vouch for the fact that nothing beats the feeling of seeing your patient getting better. This is the feeling that needs to be shared not just with our colleagues, but also with our patients. 

Let the doctor know more about the PERSON he is treating, let the patient know more about the Doctor as a PERSON.

 At the end of the day, we are people treating people. As simple as that. The pedestal that was once privilege for a Doctor now just makes us an easy target. Its time to step down and walk among the crowd.

This is my idea: the simple use of existing internet infrastructure to increase the “ Connect” between us. Upon admission, the patients and relatives have access to the Profiles of their treating team, as well as to stories posted by the Care-givers and their former patients.

They get to know more about the people looking after them. They are encouraged to share stories about the patients in health as well as in disease. They get to see that their Care-giver is also a person, the much loved child of some simple family who is now toiling day and night to keep their loved ones healthy. A person with dreams, hobbies, talents a aspirations. Just like them.

And as the conversations grow, the barriers melt away by themselves.

I hope that this innovation will help reshape the future of the Doctor-Patient relationship.

It will help restore the Human touch. We are here to touch lives, and the lives we have touched will stay with us forever, also shining as a beacon to other lost souls.

At the end of the day we will realize that whoever we are; Doctor, Patient, ill or healthy;  we are not so different. It is when we realize this, that we will truly connect.

-Dr. Arnav H. Tongaonkar

Resident Doctor, Internal Medicine

 Seth G.S. Medical College and KEM Hospital

My older blog posts are listed at the top of the page.
If you liked this, do read the others too!

|| Hari Om || || Shree Ram || || Ambadnya || || Naathsamvidh || 

Poem- Reflections

||Hari Om || || Shree Ram || || Ambadnya ||

I recently had the privilege of attending a conference at Kochi, which is a truly beautiful place.
This Poem is dedicated to one of the best Sunsets ever, spent in the company of friends.
I hope I manage to convey a fraction of the feeling. #ApiconKochi

[The photographs used are my own :) ]

 

Reflections

In the gentle light
Of the setting Sun
Here the sky and
Sea are one

 

 

The scent of music
Fills the air
Leaving neither
Fear nor care

 

 

With the tide and
Ebb and flow
The boats at peace
Do gently row

And as the light
Gives way to dark
Into a different realm
We embark

 

 

Where all the glistening
Lights from shore
Light up the sea
With so much more

 

 

Like Fairy lights
From a distant past
Upon the waves
Their glow they cast

And in the reflections
A different world
A secret, covert
Place unfurls.

 

Just inches from
The Sandy beach
But across the mirror,
Out of reach

 

 

Shadows, light
And rustling trees
The ripples dancing
In the breeze

 

 

Single steps turn
Into miles
And much is said
In silent smiles

 

 

The present soon
Becomes the past
Mirrored upon
The rippling glass

 

 

In a heartbeat, fleeting
The moment's gone
And reflected as a memory
It will live on!

-10/2/19
-Dr. Arnav H. Tongaonkar
|| Shree Ram ||
|| Ambadnya ||
|| Naathsamvidh ||

The Doctor's Soul

    || Hari Om || || Shree Ram || || Ambadnya ||

|| Naathsamvidh ||

 I am blogging after a very long time. This post finds its origins in something that I had written for a competition, sometime in the remote past.

It was in a forgotten file, lost in piles of junk, accumulated over the years in a neglected, dusty laptop. I could say much the same about my mind.

Somewhere along the line, I had ended up forgetting that I am a writer at heart.

Finding this, was like my past self shouting across all those years to wake me up! 

I think its time I follow my own advice :)

The Doctor's Soul

Let's keep this simple. No clichés.

 The Hero of our story is a young doctor. He could be any of us. At his core, he is all of us.

Well, this is how I see it. At the end of his journey, when he has finally achieved the success he have always dreamed of, he will get a bit of free time. A few moments of peace.

But he has nothing to do! The workaholic doctor, immersed in work or books throughout his life, now has no hobbies left to enjoy. They were all cut away to make place for "success". There would always be time for them later. And that "later" never came.

So the shades of all the lost loves he buried in the past continue to haunt him, and instead of looking with content upon what he has, he is stuck with a long list of regrets.  " If only I had..."

He has become so used to seeing pain, that he no longer notices his own. He is so used to declaring bad news, that he fails to notice that it costs him a piece of his soul every time. So many times he wants to shed tears of joy, of fear, of compassion. But work must move on. There is always someone else to treat. So he must move on.

The strong face that he wears, is much more a mask than any N-95 would ever be.

Was he the only one to suffer ? Perhaps not. Perhaps this doctor, so removed from the art and beauty of the world, may have hurt a few others along the way.

A few patients. A few colleagues.

As we become more involved in our work and study, we may tend to forget that those we hope to heal are also people. At times, we may heal their bodies, but end up scarring their minds. We should always remember that we are human too.

It is true that Medicine is a science, but the practice of Medicine is an art.

So too our lives should be. Not just the bland following of strict rules and protocols, but a little flavour of creative expression. A sprig of music. A dash of poetry. A spot of philosophy for seasoning. And above all, Faith.

What we have at the end of the day is an enhanced Doctor, at peace with the world and with himself. After all, only one who is at peace with himself can bring peace to others.

So all I have to say is: "Physician, Heal Thyself". Find that piece of music that you can hum in troubled times. Find that little novel that you can lose yourself in when things seem dark. Discover a hobby that you can pursue if time permits. Nay, find something you like so much that you MAKE the time to pursue it!

" Then when the shadows overtake us,

   Just when we feel all hope is gone

   We'll hear our song and know once more

   Our Love lives on." 

-How Does a Moment Last Forever
 (Disney's: Beauty & The Beast)


 

Finding light is not achieved by ignoring the darkness. Light is found and preserved by keeping that little flame burning inside. It does not matter what it is. If it matters to  you, it will keep you warm, even if you're buried in the snow.

Then there are those you will remember, because you touched their lives, and they touched yours in return. There is an inexplicable alchemy in the simple smile of someone who is healing. Some lives, some stories resonate with you. And the smiles and love that you have accumulated is the strongest talisman, something that will stay with you forever.

Keep that little flame burning, and it will sustain you .

Then, when your career has reached your targets, your dreams will still stay fresh and life will be just as sweet as it was when you started off.

Never be afraid to try. Never be afraid to fall. Our scars teach us more than we can imagine.

 Our mistake is a simple one. We look for happiness at the end of the journey. And that remains a mirage. One can never capture the horizon.
 Instead, happiness is the journey, and we must live it all the way!  

Light the fire deep within,

Nurture it, let it burn bright,

For the only way to beat the dark,

Is to become the light.

Start! Now! As you are,

Take a single step ahead.

Let the world unfurl before you,

The Earth shake beneath your tread.

You are the chains that bind yourself,

The weight upon your back.

Spread your wings and you break free,

Rise, and don’t look back.

 

                                     || Hari Om || || Shree Ram || || Ambadnya ||

|| Naathsamvidh ||

Poem- The Pianist

                                            || Hari Om || || Shree Ram || || Ambadnya ||

This poem is inspired by the magic of music and its power to cross all boundries of time and space.  

The Pianist

The morning of

That fateful day

His final song

He sat to play

Eyes shining bright

His smile so wide 

His beloved, she sat

By his side

He started slow

A soulful piece

Deep as sorrow

And soft as fleece

The chords and scales

Rose on above

Rich and full

Just like his love

He rose, he stood up

With a start

Incomplete he left,

The final bar.

" My love,

It is now your turn

Complete our song

Till I return "

But his life reached

It's final turn

She was alone

To long and yearn

Never were they

Again to meet

For years, the song

Stayed incomplete.

She was broken,

No longer whole

Music had left her

When she lost her soul

She tried so hard

To bring him back

Played till the keys

Did start to crack

Music could not

Start his breath

There was just no way

Back from death

That last day was different

With hope she woke

As though the Pianist

In her dreams, he spoke !

That last day

She stood up tall

Heart and soul

She gave it all

Once again that

Melody grew

Full of his love

So strong and true

And as she reached

That final bar

The music healed

Her pain, her scars

She saw him now

Within her soul

She was him

And they were whole

She smiled in peace

And closed her eyes

He welcomed her

Towards the skies

The last notes played

The song was done 

The Pianist and 

His love were one.

|| Shri Ram ||

|| Ambadnya ||

|| Nathsanvidh||

|| I Love You my Dad ||

-Arnav H. Tongaonkar

( Charcoal sketch courtesy- Devanshi Doshi)

Click here to read my Short Story: 'The Pianist'- http://arnavht.blogspot.com/2016/05/The-Pianist-Story.html

 If you liked this post, do post your comments and provide your valuable feedback. And do read my other poems and short stories. They are listed at the top of this page. A list of my blog post topics is also provided in the column on the right. Happy reading!)