Sunday, July 17, 2011

You have 4 more weeks to live...........

Way back in  nineties I was appearing for my second M.B.B.S. exams.One fine morning I woke up with a high grade fever .I popped a tablet of paracetamol and 2 tablespoon of sulphonamide syrup ( which I had taken in past as well with no side effects).Within few hours I started feeling a  severe difficulty in breathing.My head was reeling badly and my joints were swollen and body was full of rashes.I had a very bad reaction with sulpha drug.It almost looked like serum sickness.I was alone in my hostel room and was just two days away from my Microbiology exam.It seemed the end was near.And suddenly someone knocked at my door.I gathered my strength ,opened the door and was surprised to see my mother who had come to see me from Patna to Gaya,as she felt that something was wrong with me.(I don't know whether it was just a coincidence or some supernatural help but fact of the matter was that she was there with me).It gave me immense confidence and after 7 to 8 hours I was still miserable but wasn't deteriorating any further.

Two days later I appeared for my Microbiology exam though it was a very painful experience as I was short of breath and was barely able to speak with very painful joints.Somehow I managed and with my mom I left for Patna ,where my parents used to live then.

Slowly I started feeling better but my swollen joints got worse.My brother who at that time was undergoing his postgraduate training in internal Medicine took me to his assistant professor who had returned from UK with a MRCP degree to his credit and was considered quite knowledgeable and smart.He listened to my whole history and advised CBC and Rheumatoid factor to be checked.

When I along with my mom went to the pathology lab to collect my reports,the technician asked us to wait as the pathologist wished to see the person whose blood had been tested.When he saw me, his looked visibly sad and gloomy.He forwarded the test report to me and said that he would like to perform a repeat test on me.
One look at the report and I knew the reason of his expression.My myelocytes and Myeloblasts were in very high numbers and my total leukocyte count was very very low.Myelocytes  and blasts are present in the blood of patients having blood cancer.My mom asked anxiously to the pathologist , 'what is wrong in the report'?
Before he could reply,I said mom he suspects that I have leukemia.He was shocked and asked me that how could I read the report.I told him that I was a medical student and that made him visibly more restless.I could sense his anguish with the idea of a young life which will be lost soon.He repeated my tests and same were the findings.He suggested a bone marrow test to confirm the findings.

In the mean time I got in touch with the Physician.He announced - you have atypical leukemia as the total counts are low rather than high.Visibly scared I asked him the prognosis expecting a comforting reply.He told me in a matter of fact tone,you are a medico,you know it that you don't have more than 4 weeks to live.(Not playing Chinese whisper here,actually these were his words)Ask your parents to arrange for money to take you to USA for a bone marrow transfer.

I contested,Sir to me it looks like ,that due to the drug reaction I had a bone marrow suppression and that explains my swollen joints.Total count is low,which again goes in favour of this.And a high myelocytes and blasts show that my body is trying to overcome this suppression.He looked at me and said .not at all!!I told you, you have leukemia .There was a tone of finality in his voice.He was an MRCP and I was just a second year medical student who was talking theory read in microbiology and pathology.My logic stood no chance.

I was scared.I didn't want to die at 17.My parents were upset and so was my brother.Life came to a stand still.I went for my bone marrow test.My sternum was pierced with a thick needle and then had to wait for 48 hours to get the report.It looked as if I was waiting for my death sentence.All the time I was measuring my temperature,as in Leukemia one can have fever.And with stress i did develop low grade fever.

I was again and again looking at my skin to see any purpura( blue spots) seen in leukemia.My mom was at Hanuman mandir and so was I.Death was very very near.My parents could not have afforded a treatment in USA.

Finally the wait was over.My brother had to collect the report but he just sat down hiding his face behind the news paper.May be he was crying.Ultimately after 10 to 12 visits to washrooms my dad gathered the courage to go and collect the report.

He came back,looking all relieved.There was no evidence of cancer.So ultimately my logic was the right diagnosis.I gave a victorious call to the physician,who sounded disappointed as his diagnosis had gone wrong.

That incident taught me empathy.whole throughout these years when ever I remember this incident I just wish if that Physician was little more compassionate and thank God that it was just a bone marrow suppression and I am still alive to share this story with you!!

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