Instruments of destiny

 Instruments of Destiny.

12.45 AM.Dubai. 22nd Nov.2020.In a hotel in the City Center. I'm fast asleep in the warm comfort of my AC suite. I'm rudely woken up by a call on my Cell Phone. My international roaming was active. 

11.15 PM. 21st Nov.2020. ICU, D.Y. Patil Medical College,Department of Neurosurgery, Pune.

  A 65 year old lady who was unconscious and critical was referred to our Department from the medical ICU. Her CT scan showed a chronic subdural hematoma- ( a liquefied clot between the brain and the dura )which was severely compressing the brain and she was almost on the verge of losing her life. My student calls me and tells me that, the patient's blood clotting is defective, as she was on long term blood thinning medicines, following intervention for a cardiac problem years ago. She  cannot be taken up for open surgery to remove the clot till the clotting abnormality is sorted out. She would have surely not survived until then. 

During my residency in neurosurgery, we had a Twist Drill, in our  department. It was absolutely identical to the hand operated drill, that carpenters used in the older days. Not motorised, but the drill beat rotated by a geared hand driven wheel. 

About 7 months ago, I had indented this Twist Drill in my department as it was the fastest way to make a 5 mm hole through the cranial cavity, via a small stab incision on the scalp. It provides emergency access to decompressing the dilated ventricles( the water filled cavities in the centre of the brain). 

My students had scouted for this instrument, procured it after due sanction by the purchase department. It was autoclaved and kept in a sterile steel container.

            I woke up from my deep slumber, and was informed about the patient with the clot.  My student informed me, that he had informed the relatives about the poor condition of the patient, and that surgery would be possible only after the bleeding abnormality was rectified. 

I told him to go to our department, take the Twist Drill that was kept in the cupboard and make an emergency 5 mm hole, right in the ICU with proper preparation of the head. There was nothing to lose, as the patient was anyways very critical. 

Such interventions are difficult to explain to the relatives, as they could be misinterpreted in case of the inevitable. 

        My student rushed to the department, and did the needful. 

        I am woken up at 6.45 am by the cell phone ringtone. My student was calling me to inform me about the patient.

He had performed that emergency bedside  procedure, and it had released the liquefied clot that was under severe pressure. He was met with a rather sceptical reaction by the doctors and staff in the ICU when he went about the task.

 It was almost 5 hours and the patient was now very drowsy, moving all her limbs, and obeying commands. 

    The only explanation that can make any sense of these incredible events- We all were Instruments of Destiny. 

 The access, the communication thanks to technology that makes international roaming possible, the recently acquired twist drill, my students prompt actions and the random decision to go ahead with this intervention when I was 2000 miles away, woken up in the middle of the night across time zones. That lady was destined to live another day, all odds notwithstanding. 

There can't be any other reason.

Dr. Deepak Ranade.

(The objective of sharing this experience is not for personal glory or gratifying the ego. In the present day and times of diminishing faith and trust in the medical fraternity at large, I do hope, that reporting  instances like these will in some measure serve to restore the nobility and sanctity of this awesome science and profession.)