The loony goon

I was assisting an appendicectomy in the middle of the night in the operating room, when a senior colleague came up and offered to take my place. ‘There’s a message from the casualty,” he said, “They are sending up a case of stab injury.  We need to post that patient next. So get the workup done quickly.” He took my place, while I walked out to the gates of the operation theatre.

I was expected to quickly take an informed consent and get required forms signed by the patient or the relative accompanying him. Also to compile a quick history and get the basic hematological workup including his blood grouping done. I waited just inside the door, still in my scrubs, expecting a stretcher with a bloodied patient to be wheeled in soon.

And then he walked in. Thin and scrawny with small dark eyes. He wore shorts and a shirt which was completely unbuttoned. He could have been just another patient’s relative.  Until I looked down at his belly. I gasped with disbelief. The man was carrying a whole bundle of his own intestines in his arms on his right side! And he looked perfectly in control.

Now, had anyone written a movie script with this scene I would have called it far-fetched or silly. But what I was seeing was real. A police constable accompanied him. As we quickly put him on a stretcher and wheeled him into the theatre, I noticed that he reeked strongly of alcohol.

I stayed back to get the story from the constable. “Tadipaar,” he murmured, and then said something about him being a “gunda” from a suburb of Nagpur. The story I gathered was that this man had a long criminal record and he had been externed out of the city. But he returned to the city for reasons unknown. He was drinking at a bar with someone, when he was attacked by a rival gang. Since he was completely sozzled, the whole group had stabbed him multiple times, mostly on his back. One stab, probably from a sharp thin khukri-like knife landed in his lower abdomen. It had sliced through the wall of his abdomen neatly. It hadn’t caused much bleeding. But the abdominal pressure had caused his intestines to extrude through that thin slit gradually, and now he was holding almost half of them outside his body.

The medical officer who was filling his medical injury report was so frustrated. I saw him filling at least three long pages of detailed notes about the  size, shape and depth of the 30 odd stab wounds on his back. Medicolegal stuff is rather tedious and you cannot afford to go wrong with the paper work. They had stabbed him like an animal.

He was too drunk to give any consent, so I looked out for his next of kin. A lady in a crumpled white saree accompanied him. His mother. I tried being gentle and explaining the condition, but she glared at me, pulled the papers out of my hand and signed them before I could say much. Not an inch of remorse nor a frown on her face. Not the usual Indian mother. Rakhee in another avatar of ‘Karan-Arjun’- was my first thought. Life with such a son must have left her full of such experiences- she hardly showed any emotion.

As I walked back into the operating theatre I thought about the long list of crimes the constable had mentioned. I couldn’t imagine how this puny man could be a gangster of any sort. ‘Agarbatti pahalwan’ is what the guys would have called him if they hadn’t known this background. But then a man who chose not to be brought in a stretcher, but preferred to walk up one floor with his intestines in his arm must have some unusual qualities.

It took only a few moments to see his strength. Drunk that he was, he kept jumping inches off the operation table. It took no less than six people to hold him down. It was an action scene straight out of any Bollywood movie- complete with his menacing screams filling the air. Twenty minutes later they were finally able to anesthetize him. The abdomen was opened and examined, a thorough peritoneal wash followed, and his intestines were put back in place.

The next morning, this guy, who to me looked like he was going to die the previous night, was awake, hale and hearty. I marvelled at the craft of surgeons. And my respect for them quadrupled. For the first time I thanked my Dean who had forced me to do a Surgery posting instead of giving me a Medicine rotation.  Where else would I have seen such a turnaround in less than 24 hours?

The goon recovered quickly, but his inherent traits wouldn’t go away. In the ward, he would slyly wink at the nurses or misbehave with them. They just didn’t want anything to do with him. He found a way out. He had learnt to pull out his urinary catheter deliberately, and would summon them to insert it back again. His crowd of visitors was rough and caused discomfort to the other patients. And so we were really glad to discharge him as soon as possible.

But all his experiments with removing his urinary catheter took their toll. He returned to the ward again a few weeks later, this time with a stricture in his urethra. Some people never grow up. Some people never learn.

 

(The featured picture is ‘Naked Man with a Knife’ by Jackson Pollock)