Written on November 30th about the events on November 24, 2011
Back To The Curtainless Theater
I was a miserable melange of hope and fear on Thursday morning.
"There is definitely great improvement," Achan tried to be reassuring. "I will make sure there is no pain for you today," Amma guaranteed. It was as if 30 years had been shaved off my life and I looked up to them for all the guarantees I could get!
Amma waits at the hospital reception to make sure she caught Dr. Haridas as soon as he arrives. He walks in through the door.
She meets him and asks "Enthu patti, chetta?" (What happened, brother?)
A seemingly harmless inquiry into my state of health. But I think emotionally charged way in which she delivered it conferred an unexpected but an equally valid meaning for that query in that great physician's mind.
Dr. Haridas, that epitome of care and surgical expertise, took it as a question about the successful nature of the surgery itself. We realized this misunderstanding from the lengths to which he went to reassure us for the rest of the day.
Dr. Haridas reconfirmed that the fluid situation, though considerably improved, was still worrisome. "Arun is happy, but I am not happy," he said as we exited the examination room. He went to his desk, took out his pad and began to draw.
A slightly upward curving horizontal line was penned down first.
Like the reluctant smile of a British stiff upper lip.
I realized this was my lower abs in its most rudimentary representative form.
Below it to the right he drew a small balloon and to the left a much bigger balloon, both hanging from the curve like honeycombs.
"Let me explain, " he began, "You had bilateral hernia. I meet such cases one in 500 or so. The left side was much bigger. So once we pulled the intestine back from there, the hernia left a sac inside which tissue fluid that the body naturally releases in events of trauma, has filled up. Also some of the fluid comes from the washing we do during surgery. Usually the body absorbs it. But since it is so large in your case, it hasn't happened."
As the detailing of the explanation began, Amma realized that her simple question earlier had probably touched the doctor in a very different way.
"What I do are not simple surgeries!" he said
"I know, doctor, I have seen the youtube video about your expertise in SILS (Single Incision Laproscopic Surgery)" I wished to convey to him that we never doubted one bit the success and the expertise with which the surgery was performed.
Once every three months, doctors from metropolitan cities of India come to the Lords hospital to train in SILS from Dr. Haridas.
In fact, just that weekend, doc had been flown into Ahmadabad to operate on the relative of an ex-Central Minister and an IAS officer because they didn't want anyone else doing it.
"Get a scan. If there is 75-100ml of fluid, I would like to remove the sac itself as soon as possible," he summed up.
"We will make him more handsome," he turned to Amma, "I have told the other doctors that he is my nephew."
We wait outside the scanning room. The bald attendant passed by and stopped. "Pinneyum kettiya?" (Are you being admitted again?) he asked. I realized in a flash that the crude language was his nature, not a reflection of his sensitivity. I smiled and bobbed my head to affirm, "kurachu fluid undo ennu samsayam" (There is doubt about some fluid). "Athu saramila" (It won't matter) he said with his fingers imitating the sprinkling gesture and walked on.
This time I did glimpse a glimmer of Asanga in him. It felt good.
In the scan room, I asked Dr. Visakh if he remembered me, the one with big bilateral hernia. He vaguely remembered. "Are you able to calculate the volume of fluid inside?" "Yes," he said while rubbing more gel onto the scanner's head. I presumed with finger taps on the keyboard he was adjusting the resolution on the monitor. After a minute or so, he began speaking out the results for the nurse on the other side of the curtain to enter into the computer.
"Multilocular cystic fluid formation in the left scrotal sac 75ml. Small fluid formation in the right sac 10ml. No hydrocele detected. Testes and epididymis normal" -the final report read.
Many times in my life, I have wondered if my love for the theatrical arts creates dramatic events in my real life.
'75ml' it had to be!
The absolute lower limit at which Dr. Haridas wanted a corrective surgery.
If it was 74ml, may be I would have bought more time.
Quickly glancing at the scan report, Dr. Haridas said, "Innu ucha kazhinju in between surgeries njan ithu cheyyam. Oru muri edutholu. Innu rathri ivide. Nale veettil pokam. Breakfast kazhichile? Ini venamengil enthengilum bread kazhicholu,kurachu kazhinju onnum kazhikanda" (I will do this in between the surgeries scheduled for this afternoon. Take a room. Stay here tonight. Tomorrow you can go home. You had breakfast? You can have some bread now, don't have anything after some time.)
May be seeing the apprehension and fear which couldn't be hidden behind my weak smile, he said,"I will give you sedation on top of local anesthesia. You won't feel a thing. Don't worry."
A tiny light punctures the end of the endless fear tunnel.
While Achan went to get the room booked, I went with Amma to the canteen and had 3 pieces of bread with a cup of sugarless tea. I called my youngest uncle and let him know about the surgery.
Room 302 was in the labor and post natal care block. Smaller than the earlier room. Non-a/c.
Ajith's parents visited. Menon sir was rather sleepy after watching a Kathakali performance that went on till 2:45am. The conversation was progressing about it when a loud knock on the door brought in a blue coat another attendant.
"Cleaning" said the young man, about the same age as Murugan. Prasad was his name, I learnt later and he had a slight squint. He examined me.
"Do you have to clean me up fully again?"
"Yes" he said
"That's ridiculous. First of all, I still have stitches in my belly from the previous operation. Secondly, doctor needs just a tiny incision in a specific region this time."
He understood and went to the phone to consult with the head nurse. Old nurse Radhamani soon appeared. "Ithrayum bhagam cheytha mathi, mone" (Just do this region, son) she instructed Prasad waving her palm over my lower ab.
As Prasad proceed to work, I engage him in a conversation. He had been working at Lords for six months, had been married for equally long and his wife was two months pregnant. I congratulated him.
Compared to the massive nearly 2 hour cleaning operation that Murugan had thoroughly conducted on me couple of weeks ago, Prasad wound up in 15 minutes.
In between those 15 minutes, a loud knock at the door.
"Prasade thurakku" the unmistakable booming voice of Dr. Haridas. Prasad scampered quickly to the door. Doc peered at me from the door.
"Ente ponnu Prasade, ithokke dharalam mathi." (My dear Prasad, this is more than enough) "Enniku de ithreyum oru incision mathi" (I just need an incision this big) he said indicating with his thumb touching the middle joint of his index finger.
Amma returned. Her younger sister, my kunjamma, came with her. Kunjamma had gone home to check on me and learnt about the new developments only then. She had had hernia operation after her Cesarean delivery of my cousin 25 years ago.
My cellphone rang. Amma answered. It was Dr. Suresh Babu calling from the operation theater. He recognized my name added to the list of surgeries for the afternoon. Amma told him what the issue was. "Tell Arun not to worry, we are all here" This gesture of genuine concern and care from the expert anesthesiologist spiked my already rising level of confidence.
Nurse Shiny and nurse Viji came to insert the catheter needle. They were surprised that I asked them their names.
"Chumma compile cheyyana" (Just to compile) I reasoned.
"Complainto?" (to complain?) Shiny sister got worried.
"Compile alla complaint, sistere" (Not complaint, compile) I allayed their fears.
This inspired Viji sister to insist that her real name was Vijayalakshmi. She was from Shanghumukham. Where was Shiny sister from?
"Njan ividathukari alle" (I am not from here) she said with a fake resignation. Pathanamthitta was her native place.
"I am still sour on the left palm from last time's needle," I said, "Can you put this in the right?"
"Left is preferred, so that other monitors can go on the right and you will have the hand free." Shiny sister was in her mid-30s. "Pathukke kuthane, sistere" (Be gentle, sister) I told her while she started tapping to find a vein and Viji sister did a half-hearted shaving operation in the region between my thumb and the wrist.
"kuthal pedi aano. ethra vayasayi?" (You are afraid of injections. How old are you?) laughed Shiny sister.
"Vayasu okke aayi. ennalum ivan kochale" (Age might be more, but he is still our child) Kunjamma came over to hold my hand and gently stroke it. The insertion was done.
Kunjamma was one of the aunts who took care of me during my first days on this planet. She had named me 'C.S.Omth', C and S being the initials of my parents and 'Omth' being a stylistic form of the Malayalam world for chameleon.
Apparently my skin colored used to changed quickly.
Another sister came to deliver two doses of what she called 'antibiotics'. Later I would learn that one of this was something Dr. Suresh Babu had ordered just in case I needed general anesthesia since I had food in my system.
I felt rather sleepy after the injections. Drifting back and forth from sleepland, I heard snatches of Kunjamma's conversation with Amma and Achan about my cousin brother's education, job hunt and engagement.
At 2:45 pm, Viji sister came to walk me to the operation theater. May be it was the medication, but compared to the scared weakling of the morning, I was a much more relaxed individual walking confidently in through the darkened glass door of the operating theater and ICU area.
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