My autobiography - continued

MY AUTOBIOGRAPHY - continued from the earlier post ...

At the UK for FRCS

 

I had to go back to Kannur to sell my car, which fortunately was bought by the son-in-law of Dr Jamaluddin. That night I stayed in the RMO's quarters with Dr Gopala Menon and his wife Dr Sethulaxmi Menon who have a lovely daughter Priya. I had a few friends in Kannur - Dr Abdul Khader (surgeon), Dr Ramachandran (ENT), Dr PMK Nambiar (physician), Dr Gopi Kurup and Mrs Gouri Kurup (Gynaec), and a few others. I bid farewell to all of them. 

First leg of journey to UK was to Bombay first. Then, on to Ahmedabad where I stayed to bid farewell to my little fairy Anju and Rema. Then I went back to Bombay to really leave India for the UK on 1st May 1973 by Air India. The flight had stops in Frankfurt and Paris. Frankfurt airport was a big place, like a city in itself, with elevators all over, a really nice place to see and wonder at. When I arrived at Heathrow, Murali (Chowara) had come to receive me along with Prof Rajkumar and Thara, who took me to their house first in their car. I stayed there for two days and then went to Murali's place near Peterborough, a geriatrics hospital. I was Murali's guest for a few days and I started applying for jobs.

Loughborough

 

I just wanted a locum job, which I got in Loughborough nearby for 3 weeks. I was the only one on-call most of the day as it was a cold hospital with no emergencies. I could spend most of the time in the TV room. That was the time of the Queen's Silver Jubilee (perhaps the Queen's Birthday, since the Jubilee was in 1977). During the day time, I would be busy assisting lots of consultants for surgery and writing case sheets and discharge sheets. There was a Jewish doctor named Cohen. Once, I told him that I will show him my technique of Vasectomy as I had done thousands in India earlier for family planning camps, but this chap thought I was asking for a chance and he said, "I can not sublet like that". Poor chap - I could only pity him. From there, I applied for an accident and emergency posting, which I had to complete as a requirement for the fellowship exam (FRCS), in Medway Hospitals in Gillingham. I got the post.

Gillingham

I worked for 6 months there, at Gillingham. That was where I studied a lot - the hospital had a very good library. Studied and reviewed all that I studied for my MS course back home, a little more deeply. By this, I mean the basic subjects required for the Primary exam. I decided to write the Primary in Glasgow in December 1973. As it happened, I passed it in my first attempt - a rare happening, it seems. The Medway hospital management made a congratulatory letter addressed to me! There was a Pakistani consultant Mr Haqq in the Accident unit and my friends there were Pakistanis - Dr Khan, Dr Ilahi and others. The Medway towns are Rochester, Gillingham and Chatham, on the banks of the Medway river. Our hospital was in Gillingham.

Maidstone

 

When I finished my posting at Gillingham, I applied for a houseman's post in Kent County GH since Rema had already got a post in Kent County Ophthalmic hospital and our allotted house was just opposite the hospital. Life with NHS was a real pleasure - stay was free for us, laundry was free for us. Free milk was available when Rema delivered. If you had a Boots card many items were discounted in chemists' shops. Rema had an excellent consultant Mr Omrod. He and Rema had mutual appreciation, unlike some other consultants. On the other hand, her consultant in a previous hospital at Bishop's Stortford was a miserable lady who hated Indian and coloured people. Our stay at Maidstone was quite comfortable, with lots of friendly Indians. Hari came into this world there! 

Rema had a Greek doctor friend at the hospital who is worth mentioning. Forgot his name. Similarly worth remembering is another doctor friend, Dr Huqq, who was a registrar at Bishop's Stortford. Once, while we were travelling in his car, it snowed, and the car started skidding out of control - but people watching us stopped the car by pushing it back. Two more names we still remember in Maidstone GH are Dr Viswanathan and Dr. Dhanalekshmi. The former in Surgery and the latter Anaesthesia.

 

Our house in Maidstone was comfortably placed and easily approachable, quite near most super markets and chemists and within walk-able distance from Hospitals. We had two family friends in Maidstone -one Dr Ayyappan Pillai's family and the other Dr John's family. The latter's wife was also was a doctor, I've forgotten her name. John finished MS from Kottayam Medical College. Ayyappan Pillai's wife Vijayalekshmi was an engineer in KSEB Kerala, but was not working in the UK. Ayyappan Pillai was in surgery as houseman. We were to make a 6 countries' Mid-European bus tour by Cosmos along with the Pillais. At the last minute, Pillai contracted jaundice and the two of them had to postpone their trip. They completed the same tour later. The Pillais had two children, a girl and a boy. The latter, after returning to India, finished MBBS. We could not trace Dr John afterwards. Dr Pillai, after getting his FRCS, is now working in Cochin in the private sector. Mrs Pillai retired as Chief Engineer in KSEB. We haven't contacted them recently. We don't travel that way often. Pillai helped us on our return journey, taking us in their car to the Railway station. Although our Maidstone stay was short, we enjoyed our time there. Kent, they say, is the Garden of England. It was indeed very beautiful. During the apple season, the smell of sweet apples used to spread all over.

Returning to India with Hari

 

Next in my narration is our return from UK - with an addition to our family - Hari. Hari was very quiet throughout our return flight and consumed ready to drink sterilised bottled milk during the flight. He didn't give us any trouble on the way. We travelled back in Kuwait Airlines (which was cheaper) and there was only one stop, at Kuwait. At that time, airport there was looking like Calicut bus stand, crowded and dirty, and the people entering the plane were also indisciplined, making a lot of noise. We left Kuwait, reached Bombay and took the next flight to Ahmedabad. I think someone came to receive us at the airport, I don't remember who. At last, we reached A1 Sejal Apartments, where my in-laws stayed. 

At first, Anju was a bit shy and didn't come near us, because Hari was with us. Gradually her suspicions and fear disappeared and she became friendly with me, but was still a bit suspicious of Hari. She would look at him, but only from a distance. It took a long time for her to get adjusted to Hari and Rema. Even after coming to Calicut, she was not very comfortable with Rema. She was missing her grandma very much and one day, while bathing, she said she would walk and go to see her Ammamma.

Maharani and Palms

 

At that time, we were staying in the upstairs portion of Dr AG Nair's house opposite Maharani hotel. No phone, no TV, no vehicle. All travel was by autorickshaw and bus. Later, we shifted to "The Palms" in Wayanad Road opposite the Veterinary hospital. We stayed upstairs and also had access to part of downstairs. Our stay there was comfortable but the sound of traffic was too loud, as the main road was right in front of the house. Rema had very good practice there and I also began a consulting room there in the evenings. I was a freelance travelling surgeon, going and visiting hospitals in Vatakara, Perambra, Balusseri and South Feroke. My work was mainly executing surgery and the follow up was done by others at those hospitals. Occasionally, I had to take an anaethetist along - I had a list of them, Drs Albert, Preman, a Menon from Chalappuram and Dr Krishnadas (Krishnadas and Albert died a few years back). I used to visit Dr Sumathi's NH (Nursing Home), Calicut NH, Dr Abu Backer NH, Koya's NH at Feroke etc. Later I made Rajendra NH my default place to do Surgery before joining Nirmala Hospital in 1977. 

Nirmala Hospital

I was fed up of travelling after 2 years of freelance surgery. Dr Fernanda and one Sr Helen (she was the Nursing superintendent and is now no more) came to ask me whether I can join their hospital. I said I am willing to do surgery there on contract basis and not on salary basis. This was OKed and I started to work there on alternate days first, and do surgery on one day of the week. Their payment was very low and I requested them to raise the remuneration. I started to charge my fees myself. That was better and I continued on, working every day. Still, their payment was very low in comparison with other NHs. Then I raised my OP fees. That was their problem - at every step we have to request for better emoluments. 

Two surgeons who used to be there changed hospitals - Dr Ramakrishnan and Dr KM Aniyan - but I still continued on. I started Endoscopies and cystoscopies (before Aniyan). Most of the major surgeries there were being done by me. The problem was that there was no assistant to cover for follow-up except the temporary RMOs. For all emergencies, I had to go there, and I was staying 8 KMs away. One pleasure of working in Nirmala Hospital is that there was no handicap in working and no intervention (by management) like other Private hospitals. Their management takes a long time to implement changes. For eg. I wanted them to have a Dental department; they haven't done that so far, in spite of availability of a good Dentist. 

In 2015, my spondylitis had started giving me trouble. I could not stand for long periods of time but I managed surgery by sitting down. It gradually worsened and I thought it was time to put a stop to my beloved profession before any unpleasant development comes along. I declared my retirement, giving one month notice, and it finally happened on 15th May(?) 2015. They conducted an unprecedented get-together party with talks by many staff members including some students. It was a memorable day for me when I really saw how they all liked me. They gave me a cheque for Rs one lakh as a gift of love. (A similar day to remember was when the Desamangalam public gave me a send-off in Feb 1963).

Retired life

 

It took a long time for me to adjust to post-retirement life, but I had my computer hobby and so I could spend time usefully that way, as I still do. For some time I went and sat in Sarada NH in the evenings to spend time and see patients. The I realised that there is no point to see and examine patients if I am not doing surgery - I am not a physician. So I stopped that too. Since we stayed in a flat, and that too on the 3rd floor, it was not easy for arranging consultation at home. So, gradually, I got accustomed to retired life in due course.

Rema's illness

 

Our life was sailing along smoothly when Rema started having difficulty in walking. Before my retirement itself, after one of our Puttaparthi trips by train, she had considerable pain around hip and pelvis. I took her to Nirmala Hospital for some physiotherapy and they took an X-ray which showed two accidental fractures in the two pubic rami. The ortho doc then saw her and suggested some investigations to rule out neoplastc secondaries. We were greatly relieved when the pathological fractures were ruled out and it was ruled to be only osteoporosis due to vitamin D deficiency and hypocalcaemia. It could be arrested but the skeletal changes it made could not be stopped. She developed kyphosis and a double scoliosis along with other changes to the spine. But we carried on with heavy doses of vitamin D and calcium. In time she developed knock knee, lost parallelism of lower limbs and had difficulty in walking. We imagined it will gradually improve. Then her movements became more slow and the winding up of kitchen every night became more and more slow, with more frequent toilet visits. A commode was utilised but her sleep became less and less and even her personality started changing. Then it struck me that putting in an indwelling catheter will reduce the number of toilet visits. Dr Sindhu, our neighbour downstairs, promptly came for helping to catheterise and her husband Dr Jinesh brought a catheter from MIMS since it was late in the evening. 

The next day - 13th September 2020 - was a Sunday. Rema had good, sound sleep due to the catheter. When Rema woke up, she found she could not do anything alone. I helped by trying to lift her up, but she slipped and fell to the ground. I was not aware then that this was the beginning of her paraplegia. Immediately an Ambulance was requested from Nirmala Hospital and they acted promptly (probably because I had worked there for many decades). I was helped to put Rema on to the bed by Ajithkumar and Sunitha's nephew. Lifting her out of the bed to the ambulance was easily accomplished by the driver and his colleague because of their training. I thought bringing her down would be a big problem. But God helped.

 

We directly went to the new Emergency block OP and every step was smooth, except when Rema became a little boisterous while taken for ECG. A mild sedation was given and she became quiet. The Casualty MO in charge of ICU was Dr Varsha. She was very efficient and knowledgeable and did everything promptly and intelligently. I liked her interaction with patients. I was given a room which Rema was to occupy the next day and I slept there though sleep was much disturbed. The next day when I went to see her, I was shocked to hear from Dr Ajithkumar, neurologist, that Rema had developed quadriplegia. He said he would go to see her regularly and consoled me. She was shifted to the private room that evening from ICU and continued to be there till 2nd December when we shifted to Puttaparthi. 

Treatment was mainly Physiotherapy and some supportive and  nutritional items. Physio was being done mainly by Mr Rahul. He did it very well, and he was very practical. With his way of doing things softly and effectively, improvement was definitely visible. He had been giving physio to Rema by coming home even before this quadriplegia set in. Both of us have an excellent rapport with Rahul.

 

Rema's CT scan and X-rays all showed considerable degenerative changes. There was nothing to suggest surgical interference. So we were to follow only conservative management. Hari was with his Amma right from the next day onwards at the Hospital. He continued to be at the hospital itself doing everything needed for Amma - one can't see such a dedicated person anywhere else. He was helping Rahul in physio also, changing positions etc. Anju also came for a short stay as it was Covid season and had to undergo quarantine etc. Moreover she was lacking leave, too. Poor girl. With much unwillingness she went back to Aberdeen promising to come back again. Anju kept on coming with me to the hospital and back, morning and noon in the car, and boosted my morale frequently. She used to console me too, and for that duration, I forgot my loneliness. Finally she left by British Airways from Bangalore. Her presence in the house, at least for a few days, was a great relief to me.

Shifting to Puttaparthi

 

Hari was silently making arrangements in Puttaparthi, like getting the house (two bedrooms, both A/C, in S3 block ) ready for us to shift. Hari said he will inform me when things are ready. That day came very soon. We decided to go to Puttaparthi on 2nd Dec 2020. I made arrangements for the best available Ambulance from Calicut City Service Coop Bank through Mr Saju James, the General Manager. He arranged the best driver also. 

Mr Saju needs a special mention. He came all the way to my house in Arcade Apts early in the morning in his motorbike to pick me up and come to Hospital, where the Ambulance was waiting. He helped us to pack and load the essentials into the ambulance and my car. You see, he didn't have to do these things - I asked him just to arrange the ambulance, that's all. He is a wonderful person. 

After everything was packed, I got into my car and Hari into the ambulance to be with his Amma. Driver Koya was driving my car and ambulance was being driven by Sheffin Chacko whom Saju suggested. Both are excellent drivers, Sheffin a faster one, but safe. The car came behind keeping the ambulance in view. We didn't stop at too many places as usual, except in one place at Ramnagaram and then after Bangalore at Nandi Upachar. Afterwards, we drove straight to Puttaparthi. 

When nearing Prasanthi Nilayam, Hari guided us to Mandir through a back entry. We finally reached by about 6.30 pm, after starting from Calicut at 5.30 am. There was a big party to welcome us - all Hari's friends and wellwishers. In no time, Rema was taken straight to our flat. I followed, with Nagaraju, Hari's closest friend. It seems everything was perfectly arranged and planned by our Bhagawan.

 

The next day onwards, food started coming from a Dabbawala (that's what we called him) who brings breakfast, lunch and dinner to our place, whatever we order the day before , quite tasty and clean. We got a young lady as a helper for looking after Rema and her needs like sponge bath, diaper change, etc. Later, her mother started to do her work. A house cleaner Lakshmi would come in the mornings for sweeping, mopping and washing dishes.

 

Hari - typically - was looking after everything we needed, planning ahead all that was necessary - a washing machine, a powerful inverter and many such needed items. As soon as we had a need in our mind, Hari would get it in a jiffy. For eg. I just mentioned broadband, and he installed it the next day. After coming here, our needs also have diminished. We have very few essential vessels in use now and only one induction cooker; no gas stove. Hari gets most things online in bulk. Hari does his duties also online, due to Covid restrictions. His own room is downstairs, C4 (ours is D9) and goes there only once or twice a day. Though we have a lady (Rathnamma) for looking after Rema's needs, most duties like diaper changing are done by Hari - in her absence even at night, keeping an alarm. Rema and I often lament about Hari's tough duties, but he tells us not to bother. We then thought that Hari is a "Sthithaprajnan". Now, Rema has just started to stand with support (even this was unthinkable earlier). Recovery of upper part of body is almost complete. All this unimaginable recovery is due to one man's - Hari's - dedicated care. We are proud of you, our son. What else can we say.