Tag: medicine

Naked Days

By?Jeevani Fernando

October 31 2012

‘He has seen me without clothes mummy, how embarassing‘ said my nine year old a few days ago, when I suggested we go and visit the doctor who delivered her to this world. I reassured her that he had seen her mummy without clothes. She was livid.
Zoe (left foreground)???Shehan Gomez Abeysinghe
Nine years ago today, I sat in the queue at the gyneacology clinic at Sri Jayawardenapura Hospital, shifting my uneasy weight from side to side. ?I tried to stay composed amongst very brave and solid women from all over the country. The discomfort was annoying. Usually I help out in clinics by holding older siblings of babies to come or mothers wobbling around not knowing what to do. ?But that day, I just sat waiting for someone to take care of me.

The nurse made us line up to be weighed and pressure checked. I wobbled on my swollen feet. This one was so different. The other two had been a breeze. I just wanted to get back home. I was standing in the queue trying to hold myself up, when I saw my gynocologist,?Dr Hemantha Perera,at the end of the queue. He took one look at me and his face turned like the halloween pumpkin that suited the day – 31 October. He was a harsh, cold and ruthless but brilliant gyno, the best in the country serving in a state hospital. He could tell my condition without laying a finger on me.
He roughly asked the assistant doctors what I was doing standing in a clinic. ‘She should be taken to the OT immediately’?he said. ‘Does she not care for the baby?’ he asked out loud as if I wasn’t even there. He knew my case from a month back when I had gone to him bleeding heavily but begged him to keep the baby. ?I told him I was only feeling discomfort but there was no show of baby coming any time soon. I had 2-3 weeks more to go. He put me on the table like a cucumber and checked me over. ‘Take her NOW‘ he shouted. I was terrified. The nurses ran around like elves in Santa’s workshop. I got off the examination table and walked away to the reception area and sat down trying to make a call to someone. Anyone. Strange how a mobile phone becomes a lump of metal and plastic when you need to get someone in a hurry. I tried and tried I couldnt remember any numbers. I didn’t want to go in as yet. I was not ready. I wasn’t ready for the C-Section. I wasn’t ready for the baby. I wasn’t ready for anything. I just wanted to lie down and sleep on my father’s lap. And then the phone rang. It was my father. He was 72 miles away but his voice couldnt have been any closer. He prayed. He said, ‘Just do what the doctor says. Dont contradict‘.
I had no bag of clothes, I had no water, I had nothing in hand except my papers and a baby in my stomach. When I stepped out of the lift at ward 9, my doctor was standing in the corridor. I got a barrage of expletives from him. Again he spoke like I wasn’t even around. I was roughly taken to the prep room and shaved and shorn and pricked and prodded. The nurse was so nervous she put the OT gown the wrong way. I stood there with my boobs and swollen belly totally exposed and my butt nicely covered. I had to re-dress standing right there in public. I took off my jewelery and looked around, there was no family to hand it over to. Ear-rings, chain and cross that my parents gave me when I got married. I held them tight in my fist till the cross dug deep into my palm. It left a mark. Doctor saw me fumbling and scowled. He asked a nurse to take it over. I kissed the cross and gave it not knowing if I will see them again. I wondered if the older two had got back home from school. I wondered who will feed them. I wanted badly to go back. But I was lying on a stretcher, turning right when doc said left.
I was left outside the OT for about 30 minutes till the doctor prepped the students and the other assistants. I tried to imagine the next day. It was all a blur. Then I saw green gumboots next to my stretcher. A young, muslim doctor who had seen me in the clinics, was standing next to me, pulling up his green gloves. ‘Don’t worry, all the doctors are here today, you are very lucky Sir himself is doing the C-Section‘ Sir was my doctor. Usually he instructs and others carry out. He was like god to them. I wanted him to be that. ? I wanted him to be kind to me, say one word to reassure me and my baby. But from behind his mask, stared cold, sterile eyes. I wanted to make a connection with him before I was knocked out. When they lay me on the Op table, I grabbed his hand. He glared at me in surprise. For a moment steel eyes softened. He nodded and I guess smiled behind the mask. I will never know. But that was enough. Then he started explaining to me my condition. Not much I could do but nod while the oxygen mask was over my face. Just before the anesthetics were given, he came around near my face, leaned over and said ‘I might have to make some emergency decisions once I open you up, you will have to trust me’ ?I was knocked out before I could answer.?Trickster.
I woke up 4 hours later hearing him scolding me again. ‘Bloody mess you were, that baby is a miracle to have survived. Take her home and look after her carefully‘ and I never saw him again. ?It’s been nine years since that day. I have seen articles about him in the papers on and off. I don’t know if I took care of my baby ‘carefully’ and I don’t know if I have told her enough times what a miracle she is. I don’t know if I have told her enough about the wonderful doctors this country has produced and is blessed with. Doctors who serve their people in difficult circumstances. Who, through all their steely resolves, save lives of babies and mothers. Who have produced even-more brilliant doctors after them.
Zoe has made up her mind to visit him and his ward and is hoping he won’t remember her naked days. But I do want to remind him. And her. That life doesn’t come easy. From nakedness to nakedness, life IS a miracle.

I am going to Die on Monday at 6 15 pm

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When Marc Weide’s mother who was 65 was diagnosed with terminal cancer, she chose euthanasia. Here, we publish his shockingly frank diary of her final days

Monday February 11 2008

5.30pm: Dad is bent over the toilet bowl with a brush in his hand and a scowl on his face. I walk up to him. “Shall I give you a hand?” Dad begins to snicker, abandoning any attempt to make sense of the situation. We stand shoulder to shoulder with our backs to Mom, who paces around the patio with a newly fitted catheter in her hand.
The catheter has been put in by her nurse, Marianne to enable her doctor, who will be with us in half an hour, to give Mom a lethal injection. But instead of having a moment of peace with us, as Marianne suggested, Mom demands that we clean the toilets. Both upstairs and downstairs.
My brother, Maarten, is sitting on the edge of the bathtub, staring out of the bathroom window.
“Imagine,” he mutters. “Her last hour, spent like this.”
This is the Netherlands, where voluntary euthanasia is permitted, as well as physician-assisted suicide. This is the day my mother has chosen to die, and the toilets need to be spotless.

Three months earlier

I’m on a writer’s retreat in the UK, where I have been living for the past three years. I’m working on my novel when my mobile phone rings. The display shows it’s Maarten, calling from the Netherlands. Mom’s test results have come back.
“It’s secondary cancer in her lungs.” He pauses. “They think she’s got two to six months left.”
Continue reading “I am going to Die on Monday at 6 15 pm”

The light on the rooftops

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Choto Khalu (little uncle) was the likeable sort of uncle you could tease, and tease him we would. About being the fashionable one in the family. About using a knife and fork, when the rest of us would use our hands. About insisting on the interior d?cor in his house being just right. About his fancy stereo set. About being a dandy.
We were scared of Choto Khala (little aunt) when we were kids, and were surprised when we saw pictures of her, all trendy and hip, with her braided hair in front, sometimes on a bicycle. The outgoing young woman in the photographs didn?t seem as scary as we had imagined. My uncle enjoyed music, fine food, photography, reading, and their life seemed much less mundane than ours. We would giggle at how ?modern? this couple was. A word that had risqu? overtones in those days.

Choto Khala and Khalu in their Banani flat. Shahidul Alam/Drik/Majority World

He was my Abba?s (dad?s) best friend. Marrying my mother?s younger sister, was perhaps a way to strengthen their friendship, but this fashion conscious young man also had an eye for good looks, and had chosen well. They were the perfect couple. They lived in Azimpur 66A, we were on the floor above, Flat 66C. Besides using their garden to raise my chicken, ducks and turtles, wandering through their flat on the way to the garden, was a treat for a young boy. Even in those low income days, Choto Khala and Khalu, found ways to make their modest home stand out from others. My special treat was to listen to ?The Laughing Policeman? on his fancy stereo set.
As one of the few Muslims who had made it to Calcutta Medical College, their friendship went back a long way. Choto Khalu had sought out my dad, known for his academic brilliance. They had crossed over in 1946 to Mymensingh, gauging the scene well to leave the day before the riots, and had taken up teaching together. Partition followed and they never went back. As young professors, my dad, the studious academic, and my uncle the debonair doctor, must have made quite a pair. Both couples went to Britain for further training. My dad stayed back to teach upon return. My uncle made a return visit to Newcastle to complete his PhD.
Choto Khalu was easily the more outgoing of the two. Abba concentrated on his research, developing Monsur?s Media (named after him), and setting up the School of Tropical Medicine. Choto Khalu meanwhile became president of the Pakistan Medical Association and the Commonwealth Medical Association. He had been awarded the Gonoshasthaya Kendra (GK) Medal for the ?Favourite Teacher? in 2007.
On hearing of this death, the founder of GK, Dr. Zafrullah Chowdhury commented, ?Professor SIMG Mannan holds many laurels for teaching a most difficult subject – anatomy with great ease and humour. He is the first Asian whose name is recorded in the medical bible Grey’s Anatomy for his discovery of pascinian corpuscles. Yet he would always advise us to read Last’s Illustrated Anatomy as it would be easier for us to grasp. His refrain with us was ?serving humanity is much more important than the nitty-gritty of anatomy.?
It is ironic that the Bangladesh Medical Association in 1991 cancelled the membership of Professor Mannan, an erstwhile President of the Pakistan Medical Association and the Commonwealth Medical Association because of his participation in the formulation of the National Health Policy of 1990. His call for universal coverage of health care and the prohibition of private practice by government employed doctors to be compensated by 200% increase in salaries and extension of retirement age to 60-65 years was the cause of this wrath.
He knew all his students by name and attended to each student’s needs and difficulties. Great loss for me personally.”
My interactions with Choto Khalu involved kibitzing their bridge games, occasionally discussing poetry, and at a later stage, photography. His backlit black and whites were no accidental family snap shots. While others in the family valued fame and success, it was he, who was curious about my work and appreciated the craftsmanship. When the Royal Photographic Society made me an honorary fellow, it was Choto Khalu who reminded everyone of what an honour it was. An artist trapped in a scientist?s body, he continued to indulge in non-material pursuits that his peers found frivolous. He insisted there was more to life than mere living.





Choto Khalu (2nd from left) with his father and siblings. His mother was behind the screen. Photographer anonymous.





Apart from when Abba died, it was over a photograph that I saw him grieve. Taking down an old framed image from the wall, he shook as he said, ?She was alive then. But couldn?t be in the photograph. She was there, standing behind the curtain. Had I been more aware, I would have dragged her out, to be photographed with the rest of us. She had never been photographed.? His mother died when he was eight. Still never photographed.
It was the day before Eid that Rahnuma and I went to visit them. Rahnuma had carefully chosen the books for them. Choto Khalu kept talking about the books, about how much he would enjoy them. Taking us by turn, he took us to their little verandah. ?See when the late afternoon light hits the rooftops. When that slanting light hits the edges. Just before the sun sets. That?s when I stand here watching the light. The road in front with all those trees. It must be so wonderful to walk through. They are so lucky, the ones who live in the house with the slanting tiled roof. I wonder who live there. Have never seen them on that lovely roof.? Even at 93, the joy of life had never ebbed.
Ignoring Rahnuma?s pleas that I was getting too fat, he insisted on me eating the sweets that we had brought. Then he spoke about the light again and how much he?d enjoy the books.
Unusually for them, they came out to the lift, both waving as the gates began to close. Rahnuma and I looked at each other and said nothing. It was the following night, on Eid, that my sister Najma, rang to say he?d been taken to the hospital. They were already there when I arrived in the morning. It was a different Choto Khalu. One with pipes and catheters and strapped to monitors. A body stuck to machines had replaced my uncle. I would go to see him late at night. It was after visiting hours, but the hospital staff didn?t mind. I would just be with him on my own. Stroking his forehead, waiting for a sign. He was too far gone to respond, but I felt he knew. The doctor on duty asked who the decision maker was. I knew what that meant. I spoke to my sister, and we agreed to have a ?meeting? in the morning. She later rang back to say, perhaps we wouldn?t need to. In the morning she rang to confirm that we didn?t.
It was still morning, but many people had already dropped in as he lay in the coffin in their flat in Banani. Old doctor friends, students, family. I remembered feeling proud when people like the former Bangladeshi president Badruddoza Chowdhury and other prominent doctors mentioned they had been mentored by Abba and Choto Khalu. Today when the ex president came to pay his last respects, all he did was to call us together to lead us in prayer.
Tonight, as I look out of my window to see the orange moon, and call Rahnuma over to see it, I wonder if Choto Khalu is watching the moonlight dancing on the rooftops. I have a feeling he is.

Doctoral Complicity in State Terror

By rahnuma ahmed

I take liberties with English language as I write “doctoral” to indicate the complicity of doctors and hospitals, both public and privately-owned ones, in short, the Bangladesh medical establishment’s actions which aid and abet state functionaries who have committed acts of terror?whether those in the police force, or RAB (Rapid Action Battalion), or in any of the military intelligence agencies, such as the DGFI (Directorate General of Forces Intelligence)?to cover it up.
Doctoral, as an adjective, refers to a doctorate, the highest degree awarded by a university. But as a transitive verb, as in doctoring, it means to change something in order to make it appear different from the facts. From the truth. In other words, to deceive.
Is that what doctors did in the case of Anu Muhammad? Did they doctor the facts to cover up marks of police brutality? Anu, a well-known and widely-respected public intellectual and activist, also a professor of economics, was brutally attacked by the police on September 2. Did they also doctor the facts in the case of F M Masum, crime reporter of this daily, who was tortured by RAB officials just because he had asked them why they were beating up a woman? Did doctors in either, or both cases, work against the good of their patients, in violation of their Hippocratic oath? Did they utter or write down words, undertake actions that? were not to the best of their ability, ones that were intended to make grievous injuries appear harmless? Ones that prolonged their patients injuries instead of helping them heal?
Is medical ethics taught in the medical colleges? Do students see their teachers practise it?

Pretty Packaging Outside

I was busily working on my manuscript?the reason for having been absent from the pages of New Age for the last three months?when my mobile beeped: `Anu and other tel-gas cmttee leaders beaten up by police.’
I called and was horrified to hear that the police had targeted him, had charged at his head with batons, an attempt foiled by brave young members of the National Committee to Protect Oil, Gas, Mineral Resources, Power and Ports. They had borne the brunt of the attacks as he fell down on the street. The thousand strong procession was heading toward Petrobangla headquarters?in Anu’s words, “a multinational company base that no longer represents the wishes of the people”?to protest against the government’s decision to award three offshore blocks to international companies.
Anu had been rushed to Dhaka Medical College Hospital, the nation’s most reputed public hospital. His legs were X-rayed before being put into plaster casts. We need to carry out other tests, said the doctors, as he lay on a trolley. But since the hospital was overfull and there were no empty beds, said Anu, my family and friends took me to Square hospital instead. They knew it was expensive, but a recent health insurance policy was expected to cover the costs. He added, they were concerned about whether I had suffered any internal injuries.
So, I prodded him, how was the treatment at Square? It is a hospital that is owned by the Square Group; Tapan Chowdhury, the managing director of the group was the power and energy adviser to the military-installed caretaker government (2007-2008); the hospital, as its website advertises, is affiliated to hospitals abroad (USA, India, Singapore). You had no broken bones, so why is it taking this long to heal, I asked. And I saw all these hotshots flocking to the hospital to see you, Khaleda Zia, government ministers. Why, I believe, even the health minister, an orthopaedic surgeon, went to see you, no? Yes, that was the problem. What on earth do you mean?
Well, you see, at Square they carried out a lot of tests, blood, urine, ultrasound, CT scan, but no one did a physical examination of my feet, legs, no one looked at the bruises, pressed or poked to see where it hurt, whether I could move my toes, during the four days that I was there. Yes, they changed the DMCH plaster casts, I was upgraded to fiber optic casts, they look prettier, but no physical examination was done.
And then, the health minister Dr Ruhul Haque came to see me on the 5th. I was planning to leave the hospital the next day, which I did, but the impression I had gotten from my doctors was that my legs would need to be in casts for a month or more, that I would need to come for regular check-ups. But the very next morning, after the health minister’s visit, the same doctor who had said I would need them for a month, came and got rid of them. And then, all these doctors disappeared. Very mysteriously.
The hospital issued a discharge certificate, it says, I had “improved satisfactorily.” I don’t know which tests demonstrated that. It also said I should use a walking stick. But that was pretty absurd, since I couldn’t stand up for the briefest of seconds. Not for a good fortnight after I left Square.
And what happened after you went home? Well, I couldn’t move, the pain got worse. Luckily, a doctor friend of mine dropped in regularly, he showed me some physiotherapy exercises, he told me how to move my body, how to avoid putting weight on my feet. You mean to say he did what the doctors at Square should have done? Anu grinned, but the smile didn’t quite reach his eyes. And I hear there was pus?? Oh yes, my feet were heavily bruised because the police had kicked at my feet with their boots, they had nearly jumped on my feet, so they were all swollen. And then, another doctor friend got hold of two orthopaedic surgeons. They were pretty shocked when they came and examined me. They prescribed antibiotics immediately, which gradually got rid of the swelling and the pus, and that intolerable pain. If it hadn’t been for them I definitely would not have recovered as I have, now.
While listening to Anu, I riffled through his medical file, looking at his discharge certificate, his blood reports, other reports. A line caught my eye, Thank you for being with Square. Yes, I thought, but is Square with its patients?
Pretty packaging outside. Ugly politics inside.

Discharged in the Middle of the Night

F M Masum, crime reporter, New Age was tortured by RAB officials, first at his home, and then later at RAB-10 headquarters. Not only had he protested, he had dared to ask RAB officials to speak civilly. As they should, being employees of the state, paid by the public exchequer. In exchange, they barged into his house, beat him up, blindfolded him, rubbed salt into his wounds. The torture grew worse, said Masum, when I showed them my ID card. According to them, Nurul Kabir had made things difficult for them. They had “suffered” because of his outspoken views, that’s how they put it.
After Masum’s release was finally secured an excruciating ten hours later, with the intervention of the home minister, his colleagues took him to the DMCH. It was nearly midnight. Were you examined? Well, the DMCH X-ray machine was out of order so I was taken to a private lab, we returned to the hospital with X-ray and CT scan reports. And then? They said, everything was fine and I could be taken home.
Even though you were covered with torture wounds? Even though your body and feet were swollen? Even though you were said to be in severe pain and should have been examined for internal injuries? Well, yes.
Masum was admitted to the Dhaka Community Hospital at Maghbazar Railgate the next day. And how are you now? I asked. Well, my feet still hurt a lot. And your ears? Oh, it’s much better now. Once the blood clot has completely dissolved, the ENT specialist said he’ll be able to examine and see whether my eardrum has suffered any rupture.
But DMCH has had courageous doctors too. I remembered Dr Shamsul Alam, professor of surgery, who accompanied communist leader Ila Mitra to Calcutta in the mid-50s. She had been imprisoned, tortured and raped by the police after the Tebhaga movement flared up with peasants demanding two-third share of the produce from their landowners. While serving a ten-year prison sentence she had fallen ill, had been hospitalised. Embarassed at street protests at home and outrage abroad, the Pakistan government released a weak, frail and emaciated Ila Mitra on parole, agreeing to let her go to Kolkata for better treatment. `But your khalu had to pay the price,’ his widowed wife reminded me. `They transferred him to Chittagong. They didn’t give him the promotion that was due.’ There are still a few left, I thought, as I remembered the words of gratitude Bidisha (ex-wife of former president Ershad) had written of Dr Afzal of Bangabandhu Sheikh Mujib Medical university where she had been hospitalised. She had been remanded, and allegedly tortured by DGFI officials. Hospitals too, since Dhaka Community Hospital had admitted Masum, and had continued to treat him despite receiving intimidating phone calls.
I am sure there are other instances too. But the rest? Too busy doctoring to be real doctors.
Published in New Age, 9 November 2009