The mysterious story of a disc herniation, a bladder that won’t empty, a get-up that beguiles reality and a handsome reward that tastes better on the plate than in the sea
“There is a 53-year-old fisherman in the ER,” the duty doctor called to inform me. He had been going through severe lower back pain since that morning, but for a few hours now, he had been unable to move his feet as well. “He has no sensation in his legs and is numb in his groin,” I was informed. “Bladder?” I asked to check if he had developed urinary retention, a condition that makes it difficult or impossible to empty one’s bladder. “Up to his nipples!” I was told, which was slang for it being hugely distended. “We’ve put in a catheter and drained over a litre,” the duty doctor announced, happy with the promptness of his actions.
“What does the MRI of his lumbar spine show?” I asked, clearly expecting a surgical emergency. “There is a massive disc herniation at L3-L4 that is squishing the nerve roots completely,” he described. “I’ve never seen such a large disc prolapse in my life!” he almost trembled. Before seeing the patient, I went down to the radiology console where the MRI was done and asked the technician to show me the scan. “Bahut badaa diks hai!” he said with a straight face as I burst out laughing. I requested he show me the badaa diks (on the computer) and indeed it was.
I walked across to the ER to examine the patient. He lay there in tattered shorts and a white shirt that had a few broken buttons and oil stains. His hair was unkempt over his wrinkled forehead, as he lay wincing in agony. He would not allow me to touch him. I asked him to flap his ankles up and down, and there was barely a flicker. He could just about bend his knees. When I ran my fingers over his legs to check for sensation, he shook his head. I tapped a hammer on his knees and ankles to find his reflexes flat. I told him in Hindi that he needed an emergency operation or else he may never recover in function. Looking at his tethered condition, I suggested he do it at the government hospital across the road.
“Don’t worry about the money,” he told me in chaste English. “I want a single room,” he added, ordering his brother who was standing next to him to get Rs. 3 lakhs from the glovebox of his car and pay it as a deposit. I was a little stunned by how quickly the story I had created in my head of another man’s circumstances had been instantly beheaded. Hook, line, and sinker.
“You can go ahead with the operation, but what are the chances I’ll recover?” he asked. “The sooner we do it, the earlier you’ll recover, but to what extent is difficult to predict,” I explained, knowing that it was impossible to determine how much damage was already done.
Oftentimes, even in patients who have ‘badaa diks’ but no neurological dysfunction, we are able to manage the situation without surgery, but that is not an option if a patient has severe motor weakness, sensory impairment, or bladder dysfunction. Within four hours of his arrival, I made a 2 cm incision in his back. Using a series of tubes, we dilated his muscles without cutting any of them, which is the beauty of modern
minimally invasive surgery. A sliver of bone was drilled as the dust coming off it was doused by a sprinkle of water by my assistant. I took off some of the ligament in the way and identified the extruded, humongous disc. It was akin to sighting Mount Everest amidst the Himalays. I held it with a forceps and milked it out, removing it completely. The nerves stretched over it were restored to normalcy, like a crying child soothed by its mother. He was elated to wake up pain free a few hours later. However, the strength in his legs hadn’t improved, nor did his sensations recover. “The sweetheart we have to make our peace with, again and again,” famous writer Pico Iyer wrote, “though she is surely as impossible (and contradictory) as we are, is the one called ‘Reality’.”
I explained to him the next morning that healing takes time. The physiotherapist first got him to sit at the edge of the bed, and over the next few days, he began walking with a walker. He was beginning to feel the ground he walked on as he regained his strength. When he left the hospital a week after, he distributed chocolates to all the staff who looked after him. One month later, he was 80% better; we were able to remove his catheter and he was able to pee normally.
Surgeons rarely remember the patients they have healed; we most often recall the ones we’ve hurt. And so, like in the case of all patients who do well after surgery, I forgot about him. Until one morning, three months later, when he called me at 5 AM. “I want your home address,” he asked, after reminding me of his case and informing me that he had recovered completely. I was obviously a little sceptical and asked why. “You gave me my livelihood back. Today, I went to sea and got such a good catch that I want to give you some,” he sounded genuine. “I was only doing my job,” I said, albeit ‘fishing’ slightly. Most often, when patients get well, they bring along a box of sweets, while some even present handmade cards or small gifts. This was the first time I would be showered with pomfrets and prawn.
Within the hour, he was outside my building in a dilapidated Maruti van, once again making me question my judgement. Dressed in shabby shorts and a frayed tee, he offered me a big basket of fresh sea food, which I accepted gracefully. But he looked disheartened. “I lost several lakhs of rupees recently,” he told me, as he handed me the ‘catch.’ I offered to pay for the fish in the hope that he wasn’t going to ask me for larger financial help. He politely declined.
“What happened?” I asked, concerned. “Several employees of mine were travelling in a bus in South India that overturned. All of them are in hospital and I have to pay for them. “Why do you have employees down south when your fishing work is in the city?” the detective in me surfaced. “I run a call centre which makes me a lot of money,” he told me. “Don’t ask me how!” he continued, before I could ask him if he was scamming people, which is what Indian call centres are famous for. “I will take care of all my employees,” he told me, while showing me pictures of the new bungalow he had bought in Alibag. Morality is a luxury.
“Okay, I have to go,” he told me. “Let me know how you liked the crabs and lobsters!” he said, waving goodbye. While walking away, he said one last thing, “If you need any help with the underworld, let me know; I have many contacts.” This had to be my most interesting morning of the year.
A few months later, I was craving sea food and randomly thought of buying some fish from him, as the last meal had been so delicious. I dialled him. His phone number was no longer available.
21 thoughts on “The Surgical Fisherman”
Dearest Dr Mazda sir ……..
At the outset it was a novelty change for your readers that you have pen down from Brain to Spine 🌹
New understanding of different aspects of your expertise is very very interesting & story telling movement from OT to Seafood was fascinating sir ❤️
Thanks a million for sharing Mazda Sir 💕
Another great job well done and another soul like me saved by your miraculous work doctor. God bless you for a long long time.
Dear Mazda,
Much as I love your articles because they are informative, emotional, amusing, inspiring and gripping in equal measure, it the last word that always takes my breath away!!
And you’ve done it again!!!
The fisherman perhaps got ‘crabby’ and lob’bstered’ away into ignominity. Thanks to you he recovered! God bless.
Truly loved reading this article. How we judge a book by its cover. Just because his clothes were tattered one was ready to judge that he would not be able to afford this surgery. And he shock you all by telling his brother to get the 3L out of the car as a deposit.
I loved what you said that the nerves were so badly stretched that they were waiting to get soothed by its mother.
He seems a very generous soul and I hope he is well wherever he is..
My mouth is watering reading about the crabs & lobsters. 😉
Avery well written article as usual n very explicit not to miss the humour
What a Dick of story Mazda. You truly are a genius. The fisherman was a character out of fiction novels.
Your surgical finesse has returned him back to normal.
Very good patient and very good treatment. But the gift of basket full of sea delicacies were the best. The end of the story seems like the end of some detective story. After so much of action the fisherman suddenly vanished.
Beautiful said sir, once again my heart is happy as someone has been blessed by you, but the fishy things are you got fishes and not a underworld Don threat. HAPPY DAYS ARE HERE AGAIN.
Excellent write up
Must say that even daddas like u can soothe a crying child with ease!!
Nevertheless…fishermen r braver than v think n the one in ur case seems to b like a Hindi movie flick!
Very well written..as always!
Loved being in the OT with the fisherman!
Now that’s a ‘fishy’ tale! Came in with a badaa diks and left as the underworld’s seafood Don. Who knew treating back pain could land you in such deep water? 🤣
What a lovely story.
Triumphant outcome is the best solace whenever you have a later complication
He gave you some lovely fish then disappeared.
The last line says it all. 👌👌👌
He will definitely reach you in future as and whenever he would have slightest of bachche he would think his disease has resurfaced . Never worry he will be safe .
Interesting story 👍
A masterpiece! It felt like I was reading Guy de Maupassant’s short story. Either his call center hung up or his ‘underworld’ contacts are sleeping with the fishes 😄
awesome
As usual I look forward to your weekly doze of humor and healing.
A fine surgeon and great human being.. Keep up the good work.
Your Botswana 🇧🇼 patients are awaiting your return.
Awesome story Dr Mazda. Enjoyed it thoroughly.
Lovely story..great read
From the medical urgency of the disc herniation to the unexpected complexity of the patient’s life, it’s fascinating how much we can misjudge someone based on appearances.
The way you wove humor into the serious medical situation, and then brought in elements of mystery, generosity, and even a bit of underworld intrigue, made this a truly memorable read. Thank you for sharing such a remarkable and humanizing story!
Take care.