Iatrogenic death

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Usha Srinivasan: Rest in peace

By ixedoc

The third floor corridor is long and dark. The night duty nurses gently pad across the smooth mosaic floor, entering and exiting from the only one among the three dimly lit rooms in the Intensive Care segment of the hospital. Dank, forbidding and eerie. I stand at the nether end looking at the night sky over madras city. It is two past midnight.: the city is asleep. Once awhile a plane flies overhead, its light flashing against the black beyond. I fear for the patient.

She is sinking. I have been watching her, noting with alarm the rapid change in the physical profile of woman lying half comatose. Labored sounds of breath being drawn in through a face mask delivering oxygen. Half open eyes, a face contorted like mask with pain. She has developed hemothorax, the space around the lungs has been drained yesterday: blood in the pleural cavity has severely compromised her lung?s expansion, starving the already battered body of oxygen. The pipes descending down from an apparatus on the wall behind her head keep her alive.

Once a few minutes she groans, opens her eyes which unable to focus search for familiar faces or surroundings.

This is the Adyar Cancer Institute. I arrived here this afternoon after frantic calls informed me about the deterioration in the patient?s condition. She had smiled at me, squeezed my hand. Thanks for coming, she said, the words hardly audible and badly articulated. She has fought bravely and long, defying the ravages and relentless progression of cancer. Was she laying down arms now?

I looked at her face for answers. She lifted her left hand to her face and adjusted the transparent mask that covered her nose. Yes, she will fight is the signal. She wants the oxygen. She is making sure it perfuses into her compressed lungs ? she inhales deep and hard. This girl will fight to the bitter end. She will challenge Atropos. She will try and defy death. I stroke her forehead, the sparse hair that remains on her scalp bristles against my palm. It was once thick, flaxen and luxuriant. I had seen it swish its serpentine length, bedecked with jasmine ? on this now frail girl, dancing with gay abandon in front of thousands, over and over again, all over the world ? she was a natural born twinkle-toed lass, fostering and furthering a unique genre of traditional Bharathanatyam.

I pace the corridor. The nurses whisper in hush tones, silence deafens. The lady duty doctor is slumbering, oblivious to the battle between hope and despair a few yards away within the confines of the room three yards off.

Sitting on a chair beside the inert lay, is her husband maintaining his twenty-four hour vigil. He himself is a shadow of his former self. The stress and strain of being sentinel is telling on his physique, but he stays on, like a stoic, watching and waiting, for a smile or a word. On the spare bed is her single child , her son. Too bewildered by the unfolding events. Unable to come to terms with the script or score. I am lying on the mosaic floor, a pillow propping my head. The only sound in the room is the hum of the air-conditioner, and the sound of heavily strained respiration.

I hear the husband jerk up with a start. I sense the tension. He bends over the inert form, a beam from his torch trying to see more, better. I jump up and yell for the light to be switched on. I lean over in a hurry, and feel her wrist. There is no pulse is gone. The chest doesn?t heave.

The face is impassive. She is dead. The breath of life is extinguished. The husband goes into a swoon ? I tell him to send for the nurse, quick, quick. Wake the doctor on duty. I suddenly know the drama is over, the curtains have been drawn. The epilogue has ended. I feel the sting of a warm drop pf saline run down my cheek. Then I see it. On the wall, the pipes., yes, the ones that lead from the patient?s oxygen mask to the contraption that shows the flow of life sustaining gas ? the apparatus, the one and only instrument that kept her alive, and kept out hopes for her fighting has malfunctioned. It has stopped working. The patient, this valiant woman who had fought like a tigress, has had her fight stuffed out of her system by a faulty piece of medical equipment.

I know it is too late now. The body is too chill. I cannot even think of external attempt to puff her lungs. The rib cage is too fragile for any physical maneuvers. I hang my head down and weep. Helpless. The very profession that is supposed to help her fight, has now hamstrung her fighting spirit. She may have been emasculated by cancer, but what killed her was something more sinister and deadlier, medical negligence. Iatrogenic death.

Would she have lived longer. Maybe yes, maybe no. To the grieving and heartbroken husband and the shaken son, they would have traded the world for even one extra minute of life. Broken, sick, felled, battered maybe, but alive.

Rage, regret, rancour, revenge, retribution ? adjectives flash into my subconscious. Someone must pay, and pay dearly for this monumental medical lapse.

The gallant lady who stood and fought but was declared loser, was my sister. She passed away on 8th June 2006

She may never receive a Magsaysay Award for her single-minded fight against disease. Mrs. Usha Srinivasan, perhaps deserved it more than some the medical profession that did.

Author: Arunachalam Kumar- India

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