The caterwauling could be
heard in the corridor long before the
young adult male was carried in on a plank of wood. His head was lolling
from side to side, a red trickle of blood oozed from the corner of his mouth.
His checked shirt was discolored and stained.
Evaluation was difficult.
I had to push past an old
woman beating her chest and a young one (wife?) throwing herself at his feet
and hanging on for dear life.
Haemetemisis perhaps?
Anyway, emergency treatment had to be
given. Perhaps if I started an IV line, pushed in a stomach tube and washed out the stomach
with ice water, the bleeding would stop long enough for me to send him to the
nearest hospital. The sooner the better I thought. I did not like the look of
the accompanying crowd. They were muttering in nasty undertones and one seemed
to be drunk. The accompanying crowd can
get very nasty if there is a death. I did not really want one on my premises (I
only have an outpatient clinic) or have it destroyed or the adverse publicity.
(Death on the premises drives away patients).
He was conscious, oriented
and passive when I inserted the needle. He actually seemed to enjoy the poke.
The wife wailed louder. Another lady joined in (I think she was his sister.)
The stomach tube was another
story altogether. He gagged, fought and sat up. Determined to succeed (I am a great
admirer of the Robert Bruce spider story if you fail once try and try again) I held
him down and tried harder.
Suddenly, he pulled out the
IV line. (This made blood drip on the floor as well). He pushed me to one side,
fell to the floor and clutched my feet. I almost fell on top of him. My nurse
and watchman attempted to get him back on the bed. My office manager started to
yell and clear the room.
“Save me!” He shouted.
“ I am trying to, but, unless you cooperate what can I do?”
“I want to be saved from you,”
he shouted, “but you are killing me instead!”
“Nonsense! I am trying to
save your life.”
“What is that stick you are
pushing down my throat? I can’t breathe.”
I explained patiently, “It is
not a stick, it is a rubber tube. I am trying to stop the bleeding long enough
to get you to a hospital.”
“What will they do?”
“Probably put in another tube
to see where the bleeding is from and then try to stop it. They might give you
a bottle or two of blood.”
I could not make sense of his
behavior. For one thing his vital signs (pulse rate 86/min regular as a ticking
clock, BP 120/80, was not really consistent with vomiting that amount of
blood.) Also he leapt off the treatment table with enthusiastic alacrity.
” Are you alright ?” I asked, “If so, I will send you now itself to the
hospital with the drip and the tube.”
He looked a little ludicrous.
His hair was tousled and stuck with matted blood. His clothes were stained red.
The IV was attached to one arm and the tube was hanging out of his mouth
clenched in his teeth. He spoke with it in place like an old western movie.
“Ayoo!” he said, “I am not vomiting blood. I just swallowed a
brick dissolved in water to frighten my family. I got tired of their nagging
about my drinking. I was hoping they would leave me alone. Let me go. If I stay
here any longer, you WILL kill me.”
Gathering his clothes, he
flung the tube down and pulled out the IV line. He went to the wash basin and
cleaned himself up. My nurse and I watched aghast. Then he ran out of the room
followed closely by disbelieving relatives.
“ A miracle!” shouted one of
them, “I told you this doctor has lucky hands. She just has to touch you and
you will recover.”
Well, a little community
goodwill doesn’t hurt , And, in the final analysis, “All’s well that end’s
well!”
Dr. Gita Mathai
The
writer is a paediatrician with a family practice at Vellore.
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have any questions on health issues please write to
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