(Sobhanacharitham Onnam Khandam)
Amma wins her battle against
cancer, at last. 1.5 years of distress ends (at least transiently). Thanks to
God, Dr. V. P. Gangadharan and his Team at Lakeshore (hugs to Dr. Anupama
ma’am, high-five with Dr. Arun Sir).
I still remember the moment when
Amma rang me up and said, ‘’Da the report says M Band present…is that something
to worry about?”. I said with all the courage left,
“No Amma, nothing serious.” The diagnosis of Multiple Myeloma changed the
entire course of our life. What followed
was a marathon of agony and depression. Being a doctor, being a son, being a
bystander…never before had I struggled so much. Amma was determined to fight
this crab off her body. She learned the A to Z of her disease; nothing could be
hidden or manipulated. But she did ask me a couple of times, “Da will I live
long enough to watch you grow? I don’t want to die before your marriage.” I
would joke, “Kollam, avasanam thonnooru vayasuvare okke jeevichirunnu
menakkedavallu” (Great. You’d live long, better don’t make it over 90 or
100!!!). The real answer however was, ‘I don’t know amma’.
She is one hell of a fighter.
When the doctor drilled her bones and asked, “Does it hurt too much?” she said,
“No, it is okay”. At times when I miserably failed and reached the nadir of
depression, she’d try sitting up, pat my head and say, “Illeda, enikkonnum
pattilla. Nee dhairyamai iri” (Don’t worry dear, I’ll be alright).
Achan was a silent listener. He
never talked with doctors or asked doubts. Behind his mask of iron will and
courage, he was just a child weeping all the time. He would ask me secretly,
whether things went well. Sometimes I said ‘yes’, at other times ‘no’. He was
in charge of Amma all the time; I have barely seen him sleep adequately during
the past two years. He took charge of the kitchen; never let me hire a home
nurse. During stays at the hospital he would always ignore the expensive hospital
canteen for himself, but never let me or Amma do that.
The initial days following
diagnosis were the worst. I repeatedly cursed the physician who misdiagnosed
Amma’s illness, for not having taken a simple plain X-ray that would have
allowed an early diagnosis. I would stay inside the hospital room with my
parents, I would then get a phone call. I would sneak out of the room, start explaining
Amma’s condition like a recorded message to the caller. By the time the call ended, my face
would be wet, eyes red. Then I would walk searching for tap water, clear my nose,
face and return to the room as if nothing happened. Nightmares became a part of my life. So often did I see my Amma lying motionless in dreams that I finally began to fear falling asleep.
Bad news kept on walking in at
every point of treatment. The orthopaedist referred her to the Dept. of
Oncology, Medical College. I hoped that the Pathologist would confirm it to be
a cancer in its initial stage. But things were always bad. Radiological studies
and pathology reports revealed that had we delayed further Amma would’ve lost
the power of her legs. My Aunt, a Radiotherapist, rushed to do what was required
to prevent a vertebral compression. Chemotherapy was initiated as per the latest guidelines after discussion
with the Regional Cancer Centre Trivandrum (RCC). But none of those drugs worked, her myeloma remained resistant. The result of every
serial bone marrow study turned out to be painful.
Days of admission at the Medical
College were tiring and stressful. The diagnosis, admission at the pay ward, doses of radiation, initial confusion...all of these happened while I was doing my internship. I would run panting like a dog searching for
wheel chairs, fight and shout at Nurses-in-charge for securing bone marrow biopsy sets
(strange but true). There were times when I hid my stethoscope inside my pocket
to avoid insulting it; for I would be pushing a handicapped wheel chair through
the verandas, drenched in sweat. Sometimes we had to run through extra floors
when one of the usual lifts were damaged or jammed (often done purposefully by lazy
operators). I realised how tough it was for normal people (meaning who don’t
work at that hospital as Doctors) to stay at the medical college as patients or
bystanders. There were hardly two nurses for two three floors of pay wards.
The RCC was no different. I
climbed stairs up and down, ran hither and thither between labs. There were
instances when various labs even mixed up results. These would have gone unnoticed
if I was not a part of the medical fraternity. To err, definitely, is human. A lot of unnecessary and unwarranted confusions that drove in at the most unexpected
times made matters worse.
Amma’s condition worsened despite an initial breeze
of hope. The imported-much touted revolutionary drugs (such as Velcade) admitted their failure in Amma’s case. The expert Oncologist who supervised my Amma's treatment explained to me a poor prognosis. I was
shattered. He said it was time to switch to a new regimen, but the chances for a positive response are low. A question that he
asked afterwards electrocuted my brain, “How is the patient related to you?”
May be his patient load was too high for him to remember that it was my mother.
I was not confident to leave my Amma’s life in his hands anymore. Moreover, when you hear that
your mother doesn’t have much time left, your neuronal circuits go haywire.
All of sudden, as if God sent, a relative of mine who had been out of touch with our family for ages made a casual visit and on learning about all that is going on he asked why don't we try a second opinion. He helped us to
get an appointment with Dr. V. P. Gangadharan, and rushed to Tripunithura,
Cochin. He flipped through the reports. After minutes of thought he broke
the silence. “Nithin. The disease doesn’t have a complete cure, as you already
know. But bring her, we’ll try all that we can." My Aunt, who was still her treating physician, still clung on to the decisions of RCC. I had to defy her. It was a tough call but I did not have a choice.
I didn’t wait any further and got
Amma admitted at Lakeshore Hospital, Cochin. Reassessment was done. I did
expect a miracle in the biopsy report. ‘Bone marrow report will only be revealed tomorrow’,
said the nurse. I grew impatient and used my contacts to know what the result was (Dr. Maya ma’am
who had taught me Paediatrics at Medical College Trivandrum is currently doing her DNB in
Gastroenterology at this hospital). What I heard was grave. Amma and Achan were
eagerly waiting at the room in Oncology ward, the fifth floor of the building. I
climbed down the stairs, walked to the car parking lot, moved to a dark corner
and cried like an infant. I checked a mirror thrice to see if my face was clear,
and walked back to the room and said results are not ready yet.
Amma surprised me again when she
calmly took the news (was terribly depressed though) from Dr. Arun. Dr. V. P
Gangadharan (I’ll say Dr.VPG from now on) took control of her mind very well
afterwards. The counselling he gave had a mesmerising effect. He smoothly eased
the tension that we had. Never did he give us any false hopes. For the first
time in my life I saw a new side of medical practice, something that was beyond
textbooks. The three of us did not have any tension about the disease
afterwards. Even Amma’s diabetes and hypertension came under control. All that
was left to be taken care of were the finances. With more than forty lakhs of rupees
converted to medications and investigations, things were never good. We lacked
any kind of health insurance coverage.
I actively entered clinical
duties at a local hospital at Kollam and worked for more than 16 hours per day. Felt sad initially, since most of my pals were working hard at post
graduate entrance coaching institutes. I missed the chance; skipped many of the
examinations that I had registered for. But soon my concepts about life
changed. I began to enjoy clinical practice to the utmost. Let me not expand
this part of the story at this point of time and space (for it is cumbersome).
Months rolled on. The new drug regimen
(different from what the RCC recommended) was physically energy consuming. Amma
lost her hair (tiny news for me, but more painful than biopsies for Amma. Her
previous medications did not have this side effect). One of the medications was
to be infused continuously for four days through her veins. Meaning she had to confine
herself to bed all the time (yeah, Amma was much better, could walk on her own,
could do her personal stuffs all by herself this time). One of her peripheral
veins (the ones in her hands) was literally burnt by the medications! This
forced the Doctors to stab her neck (well, medically it’s called placing
Central Venous Lines, i.e. using veins in the neck. Fewer side effects). By the
end of six cycles of the new regimen, her biopsy yielded clean reports. She was
almost free of cancer and it was time for the silver bullet, an autologous stem cell transplantation that would gift Amma a long disease free period.
Despite the costs, the difficulty and
risks involved, we were all happy to accept the final part of the treatment. Amma, Achan and two staffs were sequestered in the
highly sterile Bone Marrow Transplantation (BMT) room. They could never walk
out of the room; newspaper, magazines and TV soaps like ‘Kumkumapoovu’ let them
cope with stress!!! Stem cell transplantation is a process that technically
replaces your immune system with a healthier one. The rejuvenating procedure
involves risks such as fatal infections, since during the period of treatment
the patient’s immunity would be near zero. I shuttled between hospital verandas
and a relative’s house at Tripunithura, Ernakulam. I spent most of the time at the
hospital reception or in front of the BMT room, reading a copy of ‘The Immortal Life of Henrietta Lacks’.
Arranging people for blood
donation was difficult. Amma’s blood group was O negative. Blood is collected using a process called apheresis, different from the normal
donation technique. This one takes more than an hour, requires healthier donors
with prominent veins! Amma’s blood counts frequently
crashed dangerously, requiring frequent transfusions. Timely help from a couple
of pals and relatives eased the difficulty. One of the first donors was my own
classmate, Manu Vincent. I also happened to meet a number of good souls who were
willing to travel long, keeping aside their own commitments. The 51 years old
professor of Economics (Dr. Ajith Kumar) who donated blood for an eighty second
time in his life was the biggest awe-factor during the week.
Blood Counts stabilised by the fourteenth
day. She was shifted out of the ‘dark room’ (that's how she described it!) yesterday. My
heart is lighter these days. Breathes fine. Feeling happy. Now I’ll have to deal
with my other self. She was always there at the other side with her phone’s
receiver, listening to me. Situations never permitted her to be with me in
person throughout.
I wonder how long this happiness will
last. Cancer is one villainous rascal who can spread its fangs anytime and
return with vengeance. The Emperor of all Maladies has however been defeated by
Amma, for now, or maybe forever. There were moments that made me believe in
fate, in God (once again), and in the goodness of humanity. Responsibility,
which was a heavy burden on my shoulders, now became a strange kind of fun. I rediscovered
myself.
The ‘Sobhana, 56 years old
patient, stage 3 Multiple Myeloma’ tag has anyway finally lost most of its validity.
Image courtesy: https://supermomdecoded.files.wordpress.com/2012/01/superwoman-blog-illustration3.jpg
