In Our Days to Your Days (Part 1)

M. P. Vasudevan hails from a small village in Kannur district of Kerala state. After post-graduation in Zoology he worked on a research project at the University of Calicut that was aided by the Swiss Government. He joined the Central Board of Excise & Customs (CBEC) as a Preventive Officer through the Staff Selection Commission (SSC) exam. He started at Goa Customs in 1981 and was then sent to Mumbai Customs on deputation in 1988. He got his first promotion in 1996 and became Assistant Commissioner in 2014. He retired on superannuation in June 2015. Post-retirement he devotes most of his time to maintaining his website www.referencer.in which serves as a reference library for both tax officers and tax payers under Government of India.

I always regarded myself to be strong both mentally and physically but it lasted only until I landed in the ICCU (Intensive Cardiac Care Unit) of Dr L H Hiranandani Hospital, a super-specialty, new-age, private hospital, on the 18th July 2015. My admission to ICCU was due to a few extra beats of my heart which refused to recede, commonly called palpitations. In medical terminology this condition is known as atrial fibrillation.

M. P. Vasudevan retired from the CBEC in June 2015.

It was a fine Saturday morning when out of the blue my heart started beating abnormally fast. This was something new. There, absolutely, was no reason as I, was a low BP patient. Moreover, I was just beginning to enjoy my peaceful retired life (I retired on the 30th June 2015). Hence tension free. It came as a huge surprise. It shook me up.

Immediately, I pulled out the ‘Omron’ Automatic Blood Pressure Monitor and checked. The machine showed error in gauging the blood pressure as well as the heartbeats. Suspecting weak batteries to be the culprit I immediately changed the batteries and checked again. Alas, the machine refused to help me at such a trying time.

Changing gears, I contacted my family doctor who advised me to go to Dr LHH Hospital straightaway. As that day was a holiday, my son who was at home drove me to the hospital, which was around 25 kilometres away. Naturally, my wife too accompanied.

AT Dr LHH hospital I witnessed a highly professional, efficient and extremely coordinated response as soon as I stepped into the Casualty Ward. I was taken straight away to a bed walled with white curtains.

The on duty doctor rushed in, asking one or two questions regarding my condition promptly put in a request for a check-up by a cardiologist. In the meanwhile the Emergency team checked up the blood pressure and the heartbeat.

I quickly changed into a hospital dress. I was promptly hooked into an ECG machine and the various parameters came under constant scrutiny of the staff. Although my chest pain and breathing difficulty subsided but the process of monitoring continued.

A Multi-Parameter Patient Monitor, which continuously displays the heart and lung operations, arrived shortly thereafter. A few electrodes were stuck to my chest, hands and legs leading to the machine. Its display came to life; it also started making various alarms and beeps.

On the screen, I could see my heartbeat count varying from 200 to 220. Three times the normal rate of around 70 beats per minute. An I.V. infusion set was attached to my left hand and a wristband with my name written on it was put on the right hand. The staff carried out all these activities in a well-organised and professional manner. This sort of handling impressed me as if I was in the right hands.

Dr L H Hiranandani Hospital, Mumbai.

Within minutes, a Cardiologist arrived and after hushed discussions with the duty doctor, further course of action was determined - admission in the ICCU for observation with drug infusion. Within the hour I was shifted to ICCU on the third floor.

“Don't worry; many big hospitals have been built in the country spending crores of rupees. If I don't pay for at least for one day to support them how will they survive?” I whispered to my wife.

She merely smiled weakly and continued to pray silently.

Surprisingly, in the ICCU, I witnessed an entirely opposite “chalta hai” approach in comparison to the efficiency of the Casualty Ward.

To my dismay, I found that I was the lone patient in the ward, which had eight beds.

“How are you uncle?” the only 'Sister' (Nurse) in the ward came over and greeted me.

“Uncle, you are the first patient,” she continued.

“It’s fine, we may get some ‘Fairies’, ‘Ghosts’ or ‘Spirits’ for company,” I said in lighter vein.

It later transpired that the ICCU was under renovation since long and the said nurse was diverted temporarily from some other ward as I was sent to this cardiac unit unexpectedly.

I did not know whether I should consider myself a VIP inaugurating the ICCU or a guinea pig being used for testing its usability!

It was a large room smelling from the fresh coat of paint and polish. A few barren beds with pillows without covers was the only furniture in the ICCU. The windows stood naked without curtains. Even the air-conditioner was not functional!

However, the nurse seemed to be a hard working type. She, a young girl in her 20s, was running in and out struggling to get the air-conditioning started, to get the stationery and supplies of essential medicines; to get the computer system operational, etc. She took the help of the security staff outside to pass on her messages to her friends in other wards since the landline telephone was also not operational. And the nurses are not allowed to carry mobiles with them!

Yet, all the systems became operational and the whole ICCU was ready within the hour.

However, the ICCU-in-charge who came in later started scolding her for her inability to arrange for the window curtains! Surprisingly, there was no word of appreciation for the good work! The ‘Boss is always a Boss’, may it be in the private Sector or in the Government Department.

Once everything was in place I started receiving medical attention. A specific drug, namely, ‘Cordarone’ was to be titrated to estimate the daily dosage to control the heartbeats.

A special programmable pump to inject the drug in measured doses at predetermined intervals was connected to my wrist vein through an I.V. set. Cordarone started flowing in the blood and by four o’clock in the evening my heart became normal. 400mg of the drug had gone in as per the nurse. Another day’s observation of oral administration of the drug was mandatory as per the Cordarone drug administration rule.

Curtains also came without much delay. They were light blue in colour and seemed quite expensive and impressive. I recollected the shabbily hanging curtains made of thick green cotton cloth in some Government Hospitals in Kerala.

The special foldable beds made of reinforced polyurethane/plastic body having roller coaster wheels, remote controls for height adjustments, soft form mattress covered with even softer linen and costing a few lakh rupees were also outstanding once they were ready. These are in no way comparable to the beds in other ordinary hospitals, which are mostly made of welded metal pipes/sheets painted in white, having very hard coir mattresses with green or blue rubber sheet shields for extra protection from liquid spills and white rough cotton cloth covers.

On a time machine …….

Relaxed and semiconscious in the ICCU bed attached to all sorts of wires and machines, even the beeps and mild hoots did not disturb my slumber. Laying on the hospital bed vivid memories of my first hospitalisation in a Government Hospital at Somwarpet in Coorg District of Karnataka State flashed through my mind.

It was in the year 1964 when I was just nine years old, my mother along with me and my younger brother had gone to stay with my father in Somwarpet, for the annual vacation. My father was working as a manager-cum-accountant-cum-driver in a big estate. We were staying in a row house built for the families of the labourers working in the coffee and cardamom plantations.

Bordering it was a thick forest on the right side. Owner’s bungalow and coffee drying yard were on the left. The coffee plantation was at the back. And the coffee processing plant somewhere out in the front.

The row houses looked like a heavenly place nearly twelve kilometres away from Somwarpet, a small town then. Although I was forbidden to go to the forest due to the presence of wild boars and blood sucking leeches, I nevertheless ventured out into the coffee plantation to taste the ripe coffee fruits, which are sweet and juicy.

One of hobbies on these visits was to climb the orange trees bordering the coffee plantation and pluck ripe juicy oranges. May be because of such risky pursuits, I started getting high fever with continuous vomiting. Nausea was so strong that I could not eat or drink anything for days.

I was admitted to the nearest Govt. Hospital. Those days facilities like blood test, liver function test, etc., were non-existent. The only course of treatment was to inject the glucose saline, morning and evening.

Nearly eight to ten syringes filled with some unknown liquids were injected one after the other in quick sequence. The needles were very thick and the prick was extremely painful.

The pain was unbearable. Even with my very high tolerance levels, I used to scream on top of my voice. The rest of the patients and visitors crowded around my bed. To witness the strange treatment.

The quality of present day syringes is such that the prick usually causes little pain.

In those days, most of the nurses hailed from Kottayam a small District in Kerala State. The one attending on me too came from Kerala. She was a fair, tall, beautiful girl in her 20s.

My uncle who used to visit me regularly became friendly with her. In fact he was smitten with her. Thanks to the ‘Inland Letter Card’ of the Indian Posts their affair flourished by the traditional mail.

Use of Inland Card was preferred by lovers over the Postcard. Postcard content could be read by anyone.

Hence the widespread use of Inland Letter card for matters of heart. Those days even telephones were hard to come by not to speak of modern day facilities like mobiles, WhatsApp, Facebook, Instagram, Twitter, etc. Within six months this secret love affair came out of the ‘Inland Letter’. It was a great shock to all other family members.

All hell broke loose!

How could an orthodox Hindu family waking up every morning chanting the name of “Lord Krishna” and going to bed reciting the name of “Lord Rama” allow one amongst them to get married to a Christian Nurse?

No, no, no was the Mantra. It was blasphemy in reverse.

After many rounds of arguments among the brothers, sisters and tearful persuasions by my grandmother, the ‘Family Adalat’ ruled that an Inland letter, the last one, should go the Nurse stating that my uncle was already married.

Sorry dear ‘Sister Aunt’, I had no role in it, we the children were mere spectators.

I was discharged after a week, as there was no improvement or hope of any improvement or even survival. I was discharged from the hospital with the attending physician advising us to visit a "Saint/Baba" for some divine help.

The "Sant/Baba" that we visited did not charge any money from us. Instead he gave me a one-rupee coin and blessed me for early recovery!

I was brought back to Kerala in a very bad condition. “Mukundan Vaidyar”, an Ayurveda doctor practicing Allopathy, who was considered as a top physician in a few Panchayats, was called in.

Vaidyar diagnosed the disease as ‘jaundice’. The diagnosis was based on a brief physical examination of the eyes, tongue and inspection of a spoon full of cooked rice put in the urine sample.

That is all - no x-ray, no blood test - not even a stethoscope was used. Ayurveda medicine and strict diet were prescribed by this Vaidyar who cured me in a few months’ time. The wonder medicine was none other than the medicinal herb by name ‘Keezharnelli’ (Phyllanthus niruri).

Just swallow a small ball made out of the crushed and ground leaves of this herb in the morning. ‘White gourd’ or ‘Ash gourd’ boiled without salt was my staple diet.

How could I eat that stuff for a few months is still a mystery to me. When I had ‘jaundice’ in 1991, this herb saved me yet again. One of my friends used to fetch this herb from the IIT, Mumbai campus.

Mukund Hospital, Mumbai, where I was admitted for a few days was receiving glucose saline drips and vitamin supplements only.

Presently, a lot more tests are available and this group of infection has got high sounding name like Hepatitis A, B, C, etc. It was just ‘jaundice’ or ‘yellow fever’ in 1964. However, even today this disease eludes a proper allopathic medicine.

The second stint of my hospital stay was in the District Hospital at Cannanore (the name ‘Cannanore’ has since been changed to ‘Kannur’ as it had become fashionable to re-rename the places and cities renamed by the British.]

The second hospitalisation happened in the year 1970 while I was in 10th class. I was admitted there complaining of severe stomach ache, which did not recede even with the treatment of Mukundan Vaidyar.

I was taken to the Hospital on a Sunday as per the advice of the village elders. I got a bed among the 40 bed male ward.

Those days there were no monitoring instruments in the hospitals. The only similarity with today’s hospital was that the walls were white and the linen too. Lying on my bed, I could see and hear all the patients and their relatives inside the ward.

To my left was the “Prisoners’ Ward” with a locked iron gate guarded by two sleepy police constables totting .303 rifles. I had some fear of the policemen since I heard the stories of the ‘ruthless and cruel police/army men’ from my grandmas.

Instead of beeps and alarms of machines, I could hear the roaring of the Arabian Sea nearby. Two days passed and I continued to writhe in pain. The specialist doctor, a Gastroenterologist, was nowhere to be seen.

He did come but only after his ‘normal’ fee of 15 rupees had been deposited at his residence.

After pressing my stomach here and there with his hand and enquiring whether it was experiencing any pain the doc diagnosed the problem to be a “hookworm” infection!

No test or analysis was necessary to make a diagnosis. By then doctors had not become the slaves of the machines.

Yet a hookworm infection was very much possible as the whole village defecated in the open. The villagers mostly went barefoot.

Although I owned one pair of ‘sandals’, they were used sparingly and only for going to school.

By Monday, the news of my hospitalisation spread among my classmates and teachers. Some of whom came to meet me on Tuesday. Once they left, I also wanted to get out of that place.

With medication I got some relief from the pain. Then I began persuading my mother to pull me out of the hospital and allow me to re-join classes.

I told her missing classes could mean losing my top rank in the first quarter exams. I would surely not be able to retain the “Class Monitor” position which I had held since the eighth standard.

Most likely I would also miss the free trip to Kashmir as I was already selected to represent Kerala State in the Third Students Camp-cum-Seminar on Education for International Understanding to be held at Tyndale-Biscoe School, Srinagar, Kashmir from 12 to 16 October, 1970. (I did miss that chance and after that could not visit the Valley ever).

Unexpectedly, I felt some breathing trouble and fell unconscious.

[Editor's note: Part two of Mr. Vasudevan's medical adventures is round the corner.]