Saving Sight, Bringing life!

Saving Sight, Bringing Life!

The buzz word these days is work-life balance. As a medical student, I had fantasied about creating space for things outside my medical practice. I made professional choices based on those very things. I have always maintained that one’s profession shouldn’t define that person. I did succeed a fair bit to be able to do a lot of things outside of core medicine. However, as a practising surgeon I often found that there was no thick red line between my profession and personal life!

I love my work too much and it always bleeds into my personal life. My work would possibly appear like a constant mistress to my wife, Priyanka- a non-medico. She would often complain at me spending time on surgeries scheduled at odd hours often cancelling a dinner date at the last minute or reaching late for a planned outing, travelling to countless conferences (within India & abroad) and regular surgical mission trips for the non-profit I work with. Even back home, I would spend hours reading up the latest medical literature and watching surgical videos. I also spend a lot of my “free time” religiously archiving and admiring the pre-operative and post-operative clinical photos of my own patients while also planning for the challenging cases that would be coming up in the following weeks. There was many a time that I would be in the midst of a movie or a conversation- my mind would wander and worry about a patient I had operated earlier. This has been an inevitable part of my life as a doctor. However, I have been lucky to have a far more accommodating non-medico spouse than I would have been if the roles were reversed. This anecdotal story however is both personal and professional at the same time. This is also a story I’m writing to keep this memory for posterity to share someday with the grandchildren!

My story starts with a family of three- a mother, a father and their son who were part of a dreadful road traffic accident. The mother expired on the way to the hospital and the father reaches the hospital in critical condition battling for life. Their 14 year old son on first glance appeared to be not very grievously injured and given just first aid when he first presented at the casualty. A routine referral to ophthalmology due to a small eyelid wound prompted the ophthalmology resident to send clinical photos for my opinion. Seeing the photos, I asked for a detailed eye evaluation and a CT scan to rule out any brain injury and face/skull fractures. It was a sunday and everything took more time than usual and I had almost forgotten about the case.

I had every reason to be distracted and distant from my work that day. Priyanka was 39 weeks pregnant and diagnosed as having high blood pressure just the previous day. Her obstetrician said we would need to induce early labour to prevent complications and now that the baby was full term, there was no advantages to waiting any longer for things to deteriorate. I promptly cancelled all my appointments and elective surgeries for the following week preparing for the impending hospital admission and delivery of our firstborn. However, as per Murphy’s law, things rarely go as planned.

The CT scan films of the boy arrived in the evening but the radiologist hadn’t reported it yet-being a Sunday! Looking at the films the resident sent me, I noticed an intra-orbital hematoma (a blood collection within the eye socket) pressing on the nerves of the eye. I immediately asked the resident to examine the patient again for changes. She called back alarmed that the child’s eye was proptosed (protrusion of the eye) along with deterioration of the vision in that eye and it was progressing fast. I was highly annoyed with the resident for not keeping a close eye on the child even though there was nothing in the initial presentation to suggest the rather dramatic turn of events.

Coronal showing Subperiosteal Hematoma
CT Scan of the child

Back home, we were preparing to get admitted to the hospital. We were packing stuff so that we could get admitted to the hospital early. I was really in two minds as to what to do when the resident’s urgent call came. I wouldn’t have time to find another surgeon at short notice to drain the clot. If we waited any longer, the boy could lose his vision and his eye would be permanently damaged. I also wanted to be there for Priyanka, while she was experiencing a very tenacious period of our life- the birth of our first child. Both of us were worried about the latest developments as well as an early unplanned labour. When I told Priyanka about this case, I expected her to be upset and get angry at me for this situation. However, she told me to go quickly to the hospital to save the child’s vision and that we can possibly delay her admission to the hospital by a few hours. I instructed my parents who were at home to take her to the hospital if anything happens in the time I’m not there and then rushed to the hospital for the emergency surgery. As I rushed to the hospital, my very capable residents and the anaesthesia team had mobilised the child to the OT for the emergency general anaesthesia and surgical procedure. Almost in a TV-series like scenario, I ran to the OT and immediately decompressed the orbit (drained the eye socket of the blood clot) and repaired the eyelid laceration (cut). The surgery was a simple one but had to be done at the right time. The child’s eye immediately recovered on table. This below is me aspirating the blood clot- just in time

Aspiration picture crop
Aspiration of the blood from the orbit (eye socket)

All through the journey from the home to hospital, surgery, post op and ride back home, my mind wasn’t far off from my wife and the impending birth of our first child. Her blood pressures had risen up suddenly without warning and there were early signs that it was going to deteriorate. Fortunately the fetus was healthy full term and not under any distress. Hopefully we had caught the condition of pre-ecclampsia pretty early.

My wife and I proceeded to the hospital to get admitted and she was promptly induced for labour on the instructions of our obstetrician. Being her first pregnancy, her cervix wasn’t dilating as fast as it should be. After a while we could see there was fetal distress as the labour wasn’t progressing. The obstetrician said we needed to go for an emergency Caesarean section. I accompanied the team to the OT. As it turned out, the fetal distess parameters we were observing on the monitors were because the umbilical cord was looped around the neck of the baby preventing it from coming down as well as strangling the child when the uterus was contracting. This was the reason why the labour wasn’t progressing. Here too we made the call just in time to prevent anything untoward from happening.

It’s a girl!

We both were proud parents of a 3 kilo baby girl. It is hard to describe the joy I felt when she opened her eyes for the first time to see me right in front of her. Nothing I have experienced till then came anywhere close to the happiness I felt then. Back in the hospital that I had operated, the boy was making good progress and his eye completely recovered from the emergency condition. Our daughter made a momentous entrance to the world just after her father would have the opportunity to save the vision of another child. When I joined back work the same week, I had two happy children- one to bid me good bye at home and another for me to greet at the hospital.

Saving Sight

There have been many incredible moments during my career as a surgeon but this story has to be the closest to my heart and will be for a long time to come. Both of us were earlier battling with what to name our first child- but after this chain of events there was no argument which name among the short-listed had won.

We have named our daughter Iksha-meaning “Sight” in Sanskrit!

Published by Dr. Raghuraj Hegde

Free thinker| Poet| Writer| Traveller| Doctor| Ophthalmic Plastic Surgeon

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