Did I Really Save Her Life?

CONQUEST OF DEATH 9

Against fervent opposition and resistance, I was selected for a prestigious post on my merit and eligibility. During ward rounds, while presenting a case to my boss, I said:

“Sir, she has high fever and passes very scanty, almost negligible quantity of urine (oliguria/ anuria)”

“She is in renal failure (kidney failure), you have to manage her.”  Succinctly he said, and moved on to the other case.

On completing rounds, saying again, “You have to manage her”, he left the ward.

‘Risus sardonicus’ (sarcastic laughter) was conspicuous on the faces of my adversaries. Without giving any specific guidelines and instructions for the management of this case he left.

That was the time when ‘urology’ was established as a subspecialty in the West. Urologists at the time were thinking about a transistorized, wearable artificial kidney. And here I was struggling to get good laboratory reports at regular intervals, to monitor this case.

It was a testing time for me.

I got an x-ray of her urinary tract done. It was non-contributory. I looked for any obstruction in the urinary tract, but found none. I sent her blood and urine samples for bacterial culture and antibiotic sensitivity test. I sent her blood for various biochemical tests. I started empirical antibiotic therapy. I restricted her fluid intake in proportion to the urine output.

She had effortless copious vomiting, was restless and deteriorating. The next day during the ward round I reported to my boss:

“Sir, her blood pressure has started rising, her pulse is irregular, she is delirious, her breathing”

He interrupted and said: “She is serious. You have to manage her”

Again without giving specific instructions, he left the ward.

Her relatives heard the comment. They were worried. They said “Doctor, we are poor. We cannot spend much. We can only pray God to give you success”

“I shall do my best to treat her” I assured them. 

Three days later, I got her culture reports. I started appropriate antibiotics.

Two days after that therapy, her fever disappeared.

During the round I told the boss, “Sir, her temperature is normal now”

He interrupted and saying, “Good. You manage her” He left the ward.

The next day her urinary output improved. Her vomiting reduced in quantity. Her restlessness reduced.

Every day, she was improving.

One day my boss said, “You are doing a great job.”

I witnessed tears of joy in the eyes of her relatives.

After a long time, she regained consciousness. She was hungry. She began asking for food. Her general condition became stable. Because of this prolonged illness, she became weak. In due course of time she recovered completely.

“This is indeed a miracle”, said my boss.

“He is our God!” exclaimed her relatives spontaneously.

“He deserves this honor” replied my boss.

Humiliated, my adversaries left the ward, never ever to comeback.

She was discharged from the ward.

I should have been appointed on this post for a period of two years. But for reasons unknown to me, I had been appointed only for three months. After this period, I applied for an extension. My boss recommended me for the extension.

Years have lapsed. As I contemplate this case, I ask myself questions.

What was the diagnosis of this affliction?

I really don’t know! Bilateral pyelonephritis? (Infection of the urinary tract), Most probably!

What was the cause of this malady?

Honestly, I don’t know!

Infection? Sepsis? 

Most likely!

About this illness I remember having read in the undergraduate textbooks….

“Renal anuria can be reversible and then it goes through three phases:

1 Phase of oliguria (Passing scanty urine i.e. about 300 ml. in 24 hours.)

2 Phase of diuresis (Passing a large quantity of urine)

3 Phase of recovery.

Did she not exhibit these three phases of the natural course of the disease? Indeed she did!

Am I justified then in saying “I saved her life”? Or Am I justified in claiming credit for saving her life? Or is it that she cured because of natural progression of disease?

Well, I am dumbfounded!!

 

A True Story in Real Life!!

A Drama in My Life!!