O Negative! Oh No!
Long long ago, some month in 2014, Puteeriah a 45 year old diabetic, came to the hospital with a wet gangrenous foot. The stench was almost fecal. The powers that be decided an amputation was inevitable. But the extent of the wet gangrene left for debate whether it would need to be of a guillotine type to let the pus drain out for a few more days. Irrespective of the type, uncontrolled sugars meant the patient would be a football at the mercy of the anaesthetists. It’s a vicious cycle if there ever was one. The patient’s sugars are uncontrolled. That leads to the wet gangrene. We suggest an amputation. The anesthetist refuses to anaesthetise the patient in view of uncontrolled sugars. We debate that the sugars can’t be controlled until the focus of infection i.e his leg is not amputaated. The sugar rises further. The infection worsens. And so on.
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But this vicious cycle took another vicious turn. The continuous ooze of pus caused the patients haemoglobin to drop at an alarming rate. The low haemoglobin was another reason for the anaesthetist to refuse surgery. ‘Haemoglobin needs to be corrected for surgery’. But correction into an open tap was not going to bring his haemoglobin up. Which also meant his wound suffered poor oxygenation and poor healing, a warm invitation for invading anaerobic organisms to pitch a tent. Within 3 days the hemoglobin had fallen to 5 g% from 8g% at admission. Little did I know this man’s fate was sealed since his admission into a system that doesn’t care. Puteeriah happened to be an ‘O negative’ blood group, a precious blood group. Something the blood bank would not part with for almost any circumstance. The Queen of England wouldn’t get a drop from this blood bank even if she returned the Kohinoor. And to procure blood from another blood bank you needed in writing from ours that there wasn’t any available. Oh another vicious cycle indeed! It’s poetic. Whirlpool after whirlpool. Puteeriah was bound to drown.
And most of the time when you try to save a person who’s drowning in a whirlpool, chances are you’re gonna drown with him. This is what happened to me when I decided to take matters into my own hands. I made a call to the blood bank officer and informed him about the patient’s condition, that his haemoglobin was at 5g% and he would die if we din’t transfuse blood. Oh the lambasting I received, the open threats. How could any patient die with a hemoglobin of 5g%. What he refused to acknowledge was the patient’s sepsis and alarming rate of fall in hemoglobin. I asked at least for a letter to document unavailability, so as to procure blood from another blood bank. The BBO (blood bank officer aka big bad oaf) had heard enough. He made it evident he knew my boss on a first name basis and was going to speak to him regarding my insolent behaviour.
Shaken by the threat I called my boss to confess what I did. My naive self was expecting a pat on the back for going beyond for the patient. A kick on the butt I got instead. ‘ How dare you try things without informing me. If we transfuse blood from another institution and the patient develops a reaction, I will have to go to court.’ What worried me was who’d have to go to court if this guy died? Well no one. Maybe the court doesn’t care as long as he didn’t die of a transfusion reaction.
It was the 7th day of his admission. I was carrying out the evening rounds in the male ward. Puteeriah was breathless. I propped him up and asked the sister to start nebulisation. The oxygen cylinder was empty as is customary in state run govt hospitals. I watched as the gasps began. The crackles from his septic chest were audible from a few feet away. He breathed his last a few moments later. I always thought that such things happened only in movies. But the glass window opposite his bed shattered with a gust of wind a second later. Also did my heart, at the apathy for the life of a poor man. The mechanical process of declaring death and handing over the body followed suite.
