A Doctor's Dilemma: To Kill or Not to Kill?

“Have you ever seen a brain dead patient?” No, why? “I saw for the first time in my career. I saw his organs removed and remove him of life support to let him die.”
Whether to choose between medicine and engineering is the question that most Odia (People from  the state of Odisha and its not Udisha) boys and girls ask themselves in their late teens. In the last two decades engineering and medical colleges have mushroomed in many major educational hubs of India. Especially, engineering is a major business and employment generator. But medicine, that’s a tough call. Not just cracking the entrance, but the course that follows later is equally gruesome.  Despite the fact that, almost a decade of a person’s life is devoted to become a full doctor and all the lack of smart techie look – the white apron profession in the Indian society is the most respected and sought after career, undoubtedly.
My doctor friends did their graduation in medicine from different colleges in India; those who doubted their capability to crack the PMT did it from China and never came back (though to Indians,  Chinese food in India, tastes better in India than in China). One of my very close friends from Odisha, who in my view was absolutely unfit for the doctor’s job made it through the PMT and got into a government medical college. Unfit- not because she was not meritorious, unfit because she was emotional. In a small towner’s experience – doctors and hospitals and nurses and all that’s medicine, leaves you with an unfading memory of rude people, using harsh tone, and totally unsympathetic. Hospitals are places where you never want to be. Your illness may be painful but the experience in a hospital is sickening beyond your illness. The dirty toilets, the stinking corridors, the rude nurses and the egoistic doctors who speak to you like you were a savage African slave in the 19th century and the latter were white colonizers from civilized lands. My friend was nowhere close to those egos, she was totally capable to become a doctor but utterly useless when being like a doctor.
“Today morning I was informed by my chief that I had to be present as an anesthetist for a cadaver donor. Cadaver? Okay! In that case I will have to maintain the blood pressure, till they remove the desired organs. At 12 pm sharp I was there. I walked into the ICU to bring the cadaver. For the hospital it was celebration time, as the recipients were going to pay a huge sum for the organs. A team of surgeons from Chennai had gathered near the cafeteria, gathering calories for the long surgeries – ready with video camcorders to record their performances. “
I slowly walked passed them, entered the ICU and was led to the last bed by the concerned nurse. “Ma’m, we received him last night, brain dead. He is on noradr and vasopressin, ventilator connected and vitals maintained. “
In front of me was lying a 5’10’’ tall body, still and stiff. Apart from this introduction, in front of me was lying a young handsome man in his early 30s. Since my days in medical school I have seen N number of deaths, have disclosed to families also. But a brain dead one was a first time experience. As a Post grad student of medicine specialising in Anesthesia it was my work to maintain the vitals until the removal of organs was successfully over. As an anesthetist it’s always my job to ensure the patient doesn’t feel pain of the surgery, whether local or general. No studies have clearly revealed that a brain dead patient can feel pain or not. Some say spinal reflexes are intact. Some say as brain stem is dead, there’s no question of pain. But, who’s got so much time or thought for a brain dead patient, here we were ready to rip open his chest and abdomen to pull out the bounty of his organs of liver, kidneys, heart one after the other.  Interestingly, it’s not the inability of the patient to feel but to speak which gives us all this power to operate on him.
The monitor showed that of a living person BP 156/80, HR – 99, saturation 100 per.  While taking him to the Operation theatre his friends and family rushed to him, saw his living body, and touched his face for one last time. I couldn’t help keeping my tears. Inside the OT my chief said, no medication required. But I gave him Morphine and Fentanyl. What if he feels pain, I didn’t want him to die with that pain. I never revealed this to anyone.
The operation started, he was cut open. The organs were removed one by one. Then came the toughest part for me – CUT OFF- remove life support. The BP came down gradually 60-20, 50-20 finally 0/0. The ECG line was flat. I removed the tube from his trachea. It was easy killing a man.
In my heart I saluted his family, his newly married wife for having the courage to give consent for the organ donation.
Just  another day in the life of a rude, unsympathetic doctor.

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Santwona Patnaik June 28, 2018 at 1:34 am

This whole description puts the spotlight on what a doctor actually goes through. Life of a doctor is definitely not easy. What a great post!

Madhav Anand June 28, 2018 at 9:51 am

Thank you. A doctor lives under terrible stress and sometimes when they are rude – its just human.

Jigyasa Singh June 28, 2018 at 2:27 am

Sad reality depicted in an extremely relatable manner! I don’t know who to feel for, the doctor, the patient or the family! Equally saddening to all.

Madhav Anand June 28, 2018 at 9:50 am

True that. This was a genuine account of my friend who experienced it first hand. Yes, its painful for all.

Sailee Brahme June 30, 2018 at 6:59 pm

Wonderfully written. Gut-wrenching experience though. And the reality of the medical profession and hospitals in India is truly appalling.

Madhav Anand July 1, 2018 at 8:52 pm

Very truly said. All command equal empathy.

Comments are closed.