Case studies
When human knowledge ends
Abstract
This is an episode encountered in my early professional life. Those were the days when medical facilities, particularly help and investigations from super-specialist medical professionals, were very limited in our city.
It was a rainy evening. At about eight o’clock I received a call from a junior colleague. He informed me about a child who had undergone laparotomy surgery and was not recovering from the anaesthesia. Though I am not a specialist paediatric anaesthesiologist, I had since my early years got a chance to work with paediatric surgeons and my experience in this field was far more than others. That was the reason my colleague asked for my help.
When I reached the nursing home, a small one as was usual in those days, I found the child in the operation theatre. As he required breathing assistance, he was still being kept inside the OT. My colleague told me the case history and mode of anaesthesia management. After the surgery, the child was not recovering from the effects of the anaesthetic agents and muscle paralysing drugs. The child was not breathing on his own as he should after administering the reversal agents and was lying still like a dead one. His level of consciousness was also not satisfactory. The cardioscope exhibited very abnormal and inconsistent ECG patterns. The only solace was that he was maintaining proper oxygenation. Under such conditions there are a few common protocol-based measures, which any anaesthesiologist would practise and those were already being carried out by my colleague.
Now this was a dilemma for me. My knowledge and experience could not guide me more than what was already being carried out. For about ten to fifteen minutes we continued to provide controlled breathing to the child. Meanwhile my colleague went outside to inform the relatives of the child of his condition and the efforts being made to treat the problem.
While I was alone in the OT, felt that my knowledge ended at this junction and it was necessary to ask for Divine help as I had done many times in my life during times of crisis. While ventilating the child manually I prayed:
“Mother, my colleague has great trust in me and has asked for my help to deal with this problem. I am in no condition to give him any guidance as it is a blind-end ahead for me. Please help me and this innocent child. Bless me with your guidance.”
For a few minutes I sat there with closed eyes.Then just like a miracle a suggestion came into my mind. Calcium! That was something I had heard. When my colleague entered the theatre I asked whether calcium had been administered. He said no. We then administered calcium as per his age and weight, slowly.
Only a few minutes passed and The Mother’s blessings started exhibiting its results. The child’s abnormal cardiac rhythm returned to a normal rhythm and rate. He started moving his limbs, made efforts to breathe and showed all signs of recovering life. As the child was now making full ventilatory efforts we removed the tube from his trachea. We kept the child inside the OT for a further half an hour and then shifted him to his room.
In our social and professional life we encounter such events when we find our skill, strength, knowledge and relations ineffective for solving a problem. This was also such an event and a prayer from the deepest corner of my heart was effectively replied to by the Mother. I am a very modest follower of the Mother and Sri Aurobindo and have not read much of their literature but I have learned the very vital fact that sincere surrender and prayer are always answered in due course.
Dr. Jitendra Belani is an anaesthesiologist practising in Ahmedabad, Gujarat.
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