Growing Up

Author: 
Vinod Puri

Born in 1941, Vinod Puri was brought up and educated in Amritsar. He attended Government Medical College, and subsequently trained as a surgeon at PGI, Chandigarh. He left for USA in 1969, and retired in 2003 as Director of Critical Care Services at a teaching hospital in Michigan. Married with two grown sons, he continues to visit India at least once a year.

Jack was an aging biker. He was over six feet tall, burly with a flowing beard and long hair. He was in an accident, so as doctors we got a look at his bare body, which was totally covered with tattoos. He had dark skin of someone who habitually lived outdoors. Jack had been riding pillion when in trying to avoid a speeding car, he was thrown off. His injuries were serious. He had broken many of his ribs, injured the lungs and suffered a fracture at he base of his skull. Jack was having difficulty breathing and ended up on the breathing machine. His stay in the surgical intensive care unit of our trauma hospital was memorable. I was director of four different ICUs. On weekdays, I preferred to make rounds in the surgical ICU.

It was unusual to see a man in his fifties engage in activities, Jack seemed to habitually enjoy. In the sanitized eighties, Jack appeared to be a throw back to the unruly sixties. Before I started my rounds a Monday morning, I was informed by several of the young doctors and nurses that I would be surprised to see Jack’s wife and family. The man, who had lived a rough life, had a very yuppie looking wife and children. This was Jack’s second marriage and children from the current wife were too small to come to the hospital. But the two young men in their twenties were clean shaven, wore the customary Polo and L’Coste shirts. Jack’s wife Debbie was well turned out in tailored clothes and hairdo. I heard that one of Jack’s sister had a huge tattoo on her back and that it was Jack’s hobby. I could imagine the big man as a tattoo artist, stroking his beer-belly while he practiced his art on his sister’s back. I never got to see this sister, but his other sister was perfectly middle class. She was quite concerned about her brother and asked several questions. We found out that Jack was a builder of houses in a small rural town in Michigan. A perfectly respectable citizen! His wife Debbie was now helping with the real estate business.

If it was not for the fact that Jack was seriously injured but salvageable, we may not have come to know him and the family too well. Most of the nurses were scared of him. His periods of confusion alternated with perfect calm. He had little patience, demanding instant attention. He wrote us notes, was unhappy that he had to lie on his back. He wanted ice and water all the time. The strong pain shots barely touched him. We suspected alcohol and drug abuse. He was not drunk when he was brought to us. Debbie said she did not think that her husband had a problem with alcohol. “Oh yes, he is short tempered.” I assured him over and over again that we would remove the tube from his throat as soon as he could breathe adequately. He would make the OK sign with his right forefinger and thumb. I noticed that part of the index finger was missing. He would soon lapse into erratic behavior, pulling at tubes and dressings. For days his breathing did not improve.

Jack was becoming more unmanageable. He was restless, confused and belligerent. He always indicated that he did not pull out an intravenous. Thinking that if he could just talk, he would be easier to care for, I decided to remove the tube from his throat. He seemed like a different person. He was hoarse but explained that he ran a business, at one time employing 50 people. Now he had only four employees. He also owned four bikes, all Harleys. This phase did not last very long. During the night, Jack went berserk. He could not breathe, so he was again connected to the machine. He pulled out two tubes from his chest, which were there to drain blood from his injured lungs. The last time he had his hands and feet tied but he hooked his feet into the tubes coming out of his chest to pull them out.

Next morning, the poor young doctor looked beat! He had worked all night with Jack. Jack had bled some more in his chest and now he was heavily sedated. We also discovered an infection in his brain due to broken skull. Now we did not know how things would turn out and Jack’s wife was very concerned. In addition to treating the brain infection, we essentially let him sleep for the next three or four days. Debbie asked about permanent brain damage, I could not reassure her. She asked about taking him to a bigger hospital, we were not sure they could do anything different. ‘Wait and see”. I said. That was not so easy on the family. We were beginning to get calls from other doctors who had been contacted by Jack’s wife and sister.

Almost two weeks after Jack’s accident, it appeared that Jack’s meningitis was clearing up. I gave Debbie the good news. She was happy. She would spend several minutes every day with the doctors. She even worried about infecting her six-year-old from kissing Jack. Finally, the tube came out of Jack’s throat and he could talk. I asked if he had seen his wife. “She ran away.” Was his reply.

Jack said he did not remember much. He certainly did not remember being wild or difficult. By now, we had given him a shave and a trim. It would be easier to keep him clean, we explained. “No”. Initially he recoiled at the idea of shaving his beard, then relenting and asking his wife’s permission. Debbie was amused to hear that, “I have not seen him without a beard since 1969!” she replied.

The young doctors tried to warn him about riding motorcycles. “It wasn’t bike’s fault; I wasn’t even driving one.” He said his skull had been crushed once before. The driver was not hurt in his current accident, so Jack reasoned that it was safe to rid again! Having lost weight and without his beard and long hair, Jack looked normal. Of course he still had those wild tattoos covering front and back of his body.

Epilogue - After spending a few more days in a regular hospital room, Jack was ready to be discharged. The chief resident had told me that before he went to the operating room. Jack came down to the ICU in a wheel chair with his wife Debbie and two older sons to see us. The nurses and resident doctors were happy to see him and they all hugged him. He invited us all for a ride on his bikes at his farm.

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