The Evil


It takes only few telephone rings to wake me up. After all these years, I still cannot sleep comfortably when I am on call. It was 2.30 in the morning and I guessed it must be something serious. The call was from the on call physician from the ER. A Bengali man had been just brought in with severe shortness of breath. There was no more history. Those who had brought him had left him in the ER and disappeared. He was found to have severe hypertension and was not improving on the usual lines of treatment.
I discussed with the doctor  and decided to shift him to the ICU and also requested to alert the anesthetist, in case we needed to place him on ventilator. By the time I reached the hospital, he was in ICU. He had severe breathing difficulty and was unable to answer any questions. His blood pressure was too high to be recorded, and it stayed so, in spite of receiving medicines through I V line. That was unusual. I guessed it must be no ordinary hypertension, and must have some serious underlying reason. We gave him a large dose of a diuretic    (a medicine to force the kidneys to produce urine) and another medication to reduce blood pressure. The lab results came in by this time. He was in end stage kidney failure. And that was why his lungs got flooded, making him struggle for breath.
It was impossible to get any history from him. Medical practice, without proper history, is almost like veterinary practice. In fact, half the diagnosis is made from what the patients tell us about their illness. When a patient is critically ill, the doctor is under the worst stress, the patient probably would have lost his consciousness. It took us a lot of stress and effort to get the many test results to come to a conclusion. He had severe hypertension and renal failure due to end stage kidney disease. He needed emergency dialysis. By this time the medications had started taking some effect. His BP was coming down and breathing getting easier. We alerted the nephrologist for emergency dialysis. The patient would die without it.
It was when I started to chart his file that I found he was removing his oxygen mask and calling us by gestures.  Morphia had taken its effect and he was drowsy. He couldn’t talk still, but was desperately trying to say something. Through the gasps for breathe I could gather some words
“ Kapda !, mera kapda !” (Clothes! My clothes!)
I couldn’t make out first. But he was frantically looking all around for something and again removed his oxygen mask and repeated
“Mera  kapda”
I understood it then. In the ICU, the nurses had removed his own clothes and put on him the hospital gowns .I told him there was no need to worry and his clothes would be given to him when he leaves the ICU. He was not satisfied and again kept on repeating the same slogan.
I was close to getting irritated. We were desperately trying to keep him alive, and here he was, worrying about his clothes!
 I asked him  “Bhai, why are you afraid ? No one will take your clothes. They are kept in the cupboard”.
This time he added” Hamara Paisa”, (My money!)  and I understood. His purse was in the shirt pocket and his money was in it. The nurse told him” Brother your purse is with us, and we have counted and kept 120 dirham also’

He appeared bit relaxed after that. He kept his oxygen mask back in place.

Comments

  1. Money .. ah money does mean every thing at times, but then was it because he had to pay for his stay at the hospital he was thinking about his purse? But on the other side, even in such a bad state a person is worried about worldly things? Is it because of his ignorance? May be thats good in a way to make him not panic ... a nice narrative..

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  2. Phew!!!! What to say? did you check his BP? It might have gone close to normal after he learnt his money was safe. Good God!

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  3. So many things to worry about. Money certainly meant a lot to him, whatever the reasons. Probably the answer will surface when he is in a better state.

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  4. PAisa yeh paisa yeh paise ..
    we love it more then our own life so true.. and it is natural i think.. I remember I was in a accident and was taken to A&E unconscious and the first think that came to my mind was when i woke up was my Warrant card it had all my credit cards and all :)

    so natural i think... its a materialistic world and we got to save all the pennies we have

    Bikram's

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  5. In Malayalam there is a saying : 'Panam illathavan pinam!'. One without money is a dead one. He couldn't have known that his kidneys are near-failed, that he is near death. After all most of us refuse to believe that we will die one day! The 120 Dirhams he had was probably his hard-earned money, so guess it was natural for him to think about it, and rest easy when he learnt that it is safe.

    Money is not evil, doc, it is energy. It is men - like the Kalmadis and Rajas and whatever who are evil.

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  6. Let's think kindly of him. Probably, he needed to send some money home?

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  7. Dr Antony,

    You made a good point. Yes money means a lot to all of us.

    But on the flip side of this case- correct me if I am wrong - he was under Morphia - that means he is not able to think clearly - under the circumstances he may just speak what was last in his mind. You knew he is terribly sick and so as hospital staff - but he probably did not....

    May be we can give him benefit of doubt.

    As usual very very interesting read.

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  8. I cannot say how a dying man feels but i would have expected money to be the least of his worries.i don't mean to say that it is not important but as the saying goes- "money is not God but it is not also less than God". Your narrative seems to underline the fact that money is actually no less than God!

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  9. Doc,
    the hospital got it wrong, miserably wrong.
    What he needed was not dialysis , but a few wads of currency notes. Think of all the expense he has to meet upfront in the nether world.
    "Man what a creation that defies reason"!

    "Doctarae , panathinu meethe parunthum parakilla"

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  10. it was very interesting!I actually giggled when read.."mera kapda"
    ..its like I admire you guys..and your skills..to save a patient and keep up patience!
    BTW..money does create panic!

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  11. doc,you narrated the experience so well.I kept on holding my breath as I read and when I reached the last line, I took a sigh of relief.I know sometimes people care so much about materialistic things rather than their own self!

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  12. I thought that your patient was looking for his wallet so he can share his meds/ history with you and the hospital personel. I guess I was wrong. Money would be the last thing on my mind. I would just be thankful for being taken care of.

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  13. I hope he recovered fully and got to use the money for whatever pressing needs he had at his death bed... Please post a follow up on this story with the latest updates...

    Thank you again for sharing the case with us @Doc. Makes me want to do the best for my hard working kidneys... Most times we take our good health for granted...

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  14. Emmm.perhaps he was very poor Doc?

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  15. may be he needed that money and was going somewhere with it.........life has different stories, we never know which mask veils a sad story that can never be revealed.

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  16. Poor guy... 120 Dhs must be his many days pay. When I read incidents like this I feel guity

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  17. Strange how we fixate on the small things when the large things are right on top of us.

    Interesting story... and nice to meet you dr.antony!

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  18. Money the cause of all evil ?
    Maybe that explains the phenomenon of the wealthy stashing away crores and crores when he very well knows that he cannot carry it with him when he crosses the finish line. Or does he?

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  19. @AS
    I was wondering at that time,and also getting irritated.because he was continuously removing his mask.His savings were minimal,and probably most important to him.
    @Insignia
    This man was in to lot of problems.His visa had expired and he had not visited his family for almost five years.That money must have been his total earnings.
    @Keats
    Yes.Like I mentioned before,he was in to lots of problems here.
    @Bikram
    All of us would probably do the same. Last year there was an earth quake..some kind of tremor I felt.When I woke up,I heard people were running down the stairs.I took my passport and file of documents and ran downstairs too. But I didn't forget to collect my wallet too.
    @Balachandran

    His story was real sad.I felt real bad when I learned later.His visa had expired four years back.he was staying illegally and working at a place making bricks.That money must have been his life's earnings.
    @A
    Not much.We give only small doses of morphia.He behaved better after he learned his money was safe.But his story was real sad.
    @Hipma
    yes,money is important.What if someone is sick and doesn't have money.
    @Anil

    He was really poor. I regretted later when I learned the truth.He was staying illegally.Not visited his family for five years.And his total earnings in that purse.Cant blame him at all.
    @Harman
    Bengalis do not speak Urdu well.They have a funny slang.Most of them speak only Bengali language.But they pick up some Hindi after coming here.
    @Raji
    He was in real difficult situation.
    @Munir
    Thanks for the visit.
    He was not aware of the seriousness of his illness.He was really concerned about his total earnings in his purse.

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