When a patient takes an alternative route instead a scientific one, a doctor can just hope they are at peace with the consequences
I remember patients more by the geography of their brain tumour than by the topography of their face. Vivek’s tumour was in the left insula – an island of brain nestled between the frontal and temporal lobes, a place that processes emotion, sensation, and awareness. I operated on him in January of 2020. The tumour was excised immaculately, but as it was grade 3, radiation and chemotherapy were mandatory for a decent outcome.
“We’ll skip the radiation and chemotherapy,” the elder brother told me a few weeks after surgery. “He’s absolutely fine and has already gone back to his job,” he reasoned. Vivek was 22 years old at the time, a bright computer engineer with a full crop of hair that we had delicately preserved during the operation. “Why would you do such a thing?” I fumed. “This is our best chance at controlling the tumour; otherwise, it’ll come back for sure,” I warned them, the way you warn someone in Mumbai that the streets are likely to flood on a monsoon day even if the sun is shining at the moment. “The elders in the family have consulted with Babaji and they want him to try some alternative medicine,” he argued. “I’ve spent 6 hours operating on this tumour, removing every visible cell under the microscope and preserving all his functions, and I know for a fact that this tumour will come back,” I tried to explain. “We understand, doctor, and we thank you for doing what you did, but we have instructions from a higher order,” they folded their hands and left.
I understand that science does not have all the answers, but I would respect the ones it does. Thousands of researchers are working on hundreds of drugs that have reshaped the topography of cancer over the past few decades. Their research has not only extended a cancer patient’s survival but improved their quality of life substantially. Yes, there is an alternate world of healing that we are now increasingly exposed to, and I deeply respect it, but it is surely less consistent in its results than science is. Medicine works because of its reproducibility.
A year later, Vivek returned with his family and a fresh MRI of the brain. You couldn’t tell he had ever had surgery for a malignant brain tumour, either on the outside or on the inside. He looked good and so did his scan. “Babaji’s medicines are working,” his father told me. Vivek had been promoted to a senior manager role in his company. His cognition was sharper than ever before and his memory crisp. “If it was a grade 4 tumour, it would have returned by now, but as it’s grade 3, these take longer to recur,” I explained. “Maybe it won’t,” was the argument. “It will,” I said authoritatively, trying to sound less like a prophet of doom and more like a weary meteorologist predicting rain.
The famous Canadian writer Margaret Atwood once said, “Having experienced both, I’m not sure which is worse: intense feeling or the absence of it.” That’s how I felt. Should I rejoice that Vivek was thriving, or mourn the biology I knew too well? Or should I simply shrug it off with a friend’s favourite line: not my circus, not my monkeys.
They kept coming back. Each time I wondered why, because they did exactly what they wanted to anyway. “He’s doing much better than ever before,” the brother said, and strangely, I remembered Margaret Atwood again: “Better never means better for everyone; it always means worse, for some.” I took a look at the scan and informed them that I could see footprints of a tumour crawling back. “Babaji has told us to continue with his medication,” they retorted. “Then I have nothing else to offer except my love,” I said, “but along with that I would still take the radiation and chemotherapy.”
Three years later and two weeks ago on a Saturday afternoon, I got a call from the ER. “There is a 27-year-old boy who was found unconscious at home this morning. The family says you operated on him 5 years ago for an insular glioma.” “Vivek?” I instinctively asked. “That is correct,” said the voice on the other end. “He’s unresponsive and one pupil is blown.” I went down and scrolled through the scan on the monitor. The tumour had grown tenfold with a massive haemorrhage within it. I should have felt sorrow but all I felt was rage.
The family stood there with hands folded. “Do whatever it takes to save him,” the father said. “It’s unlikely he’s going to make it,” I said sternly. The mother collapsed to the ground hearing those words. I contemplated if it was worth operating, because even if he survived the surgery, he would never be himself. The family insisted I operate. In the next hour, as I performed a big craniotomy, brain squished out of the opening. I got into the tumour that was mixed with large clots of blood. “There go emotion, memory, and cognition,” I muttered to my assistant as we cleaned up all the debris from the site of a bomb blast. The damage was done. We wheeled him out from the theatre without a skull bone, allowing space for the swollen brain.
He did not wake on day one. Or on day two. On day three, he opened his eyes. He could breathe without the ventilator. He looked around purposefully. His family was thrilled that he was alive. But he couldn’t speak. I don’t think he knows where he is or what his thoughts are. I’m not sure he can feel either. I am supposed to be filled with joy that I had saved a life. But I am angry. Very angry. Still, patients don’t need to know you’re raging inside. They just want to know you won’t let your scalpel slip, no matter who they thank afterward – you, science, or Babaji.
Because better never means better for everyone; it always means worse, for some.
23 thoughts on “The surgical anger”
Nicely potrayed and Very true Sir. We face such instances often and the anger is real but we can’t vent it out . Even if we try, where to vent , as we can only advice the best but final call has to be taken by them.
Dear Mazda, Every oncosurgeon in India (and elsewhere) would have an anecdote like this to share. Yours is well written as usual. Stupidity is seen even in the most educated people,where they base their treatment on ‘belief’, rather than on evidence. What can most of us do than to expose their folly! Philosophically speaking they stopped his treatment after the first surgery, he lived happily for a few more years with prayers….
Sir You perfectly described the rage we all go through when we try to explain them the consequences of if not followed the protocols of treatment, still the belief in alternative medicine is ruining lives .Who is to be blamed ?? God save them 🙏 🙌
Dearest Dr Mazda sir ……..
Eye opining Marvelous piece by your good selves Sir …….
The over smart patient particularly his or her Relatives has a very bad habit of spreading unwanted knowledge & so called expert opinion confusing patient……….
Unfortunately even if you as a Surgeon thinks the RIGHT course of action for patients, they think otherwise resulting in their own LOSS……….
The correct belief & conviction should be always let Expert & Professional decides in their respective field what is best for the patients……
Sorry for your Vivek but the Quotes you referred in your Article were little heavy for us common janta 🤣🤣🤣
Dear Mazda,
That was poignant!!
There comes a time when optimism overcomes reason. Worse when faith casts its long shadow on knowledge.
You have captured the emotions beautifully!!
Even though hopeless, my prayers for Vivek (whatever his real name)!
So very sad to hear this story about Vivek..you have written it so well..most times I’ve encountered Babas / Gurus who advise that one continues with the treatment recommended by the doctor BUT in addition take their pudis..they are the smart ones !!
It’s not your rage bro
Its your undiluted frustration, at people genuflecting before faith and charlatans( aren’t they the same ) and refuse to accept science and reason.
This ain’t just a medical problem.
Its now increasingly , a social, indeed ,geopolitical problem.
Cannot escape it.
Thankfully our Indian bretheren haven’t rejected vaccines yet,as elsewhere in the ” developed ” world.
Writing is our only catharsis I guess
OMG!!
Doc. You are the Good Samaritan ..Always hoping and wanting the BESTfor your patients. You pen down all experiences so beautifully .we actually n factually relive your full experience.In Viveks case Did his family ever ask Vivek what he even wanted? Treatment or Babaji?
You have expressed the anguish of a conscientious doctor.
We have the same anger and frustration when a stroke patient who would not otherwise recover is denied treatment for spurious and inexplicable reasons
Your rage in this case is absolutely right sir, even though the parents are much more sufferer in this case throughout their life just because incorrect decision
Thank you, Mazda, for sharing this moving, restrained, and deeply human experience.
The quiet fury behind the compassion, and the heartbreak behind the frustration, must be incredibly painful for someone as caring as you.
Sometimes science can save, sometimes it can only watch… and that helplessness must be the hardest part of being a doctor. It’s almost as though saving a life can still feel like a loss.
I would like to extend my sincere thanks and deep appreciation to Dr. Mazda for the valuable and insightful information you have provided, and for your remarkable explanations distinguished by clarity and scientific accuracy.
Your lectures and clarifications have been a true source of enrichment for us, greatly contributing to deepening our understanding of medicine and broadening our scientific perspectives.
I can only affirm the truth of what you have mentioned — no matter how much science advances and work develops, there will always be those who still believe in superstitions and unscientific practices. This often makes the task of persuasion challenging, despite the clarity of facts and the weight of professional experience.
May God bless you and your efforts, and may you continue to be a beacon of knowledge and wisdom, and a role model of dedication in both scientific and professional service to society and humanity.
With sincere respect and appreciation,
Sulaiman
Understand your Rage completely Doc. You knew it was coming, it could have a better outcome but couldn’t do anything.
Sometimes things are not in our hand….
Thank you, Doc Mazda, for such an insightful article.
Personally, I too, have faced such situations where shamans/charlatans have won, much to the detriment of the person in the long run. But such is life. However, I love your message to us all: “ never stop practicing good medical advice, irrespective of the challenges…..”
I look forward to seeing your awesome articles on the weekends. Thank you 🙏
This was one edge-of-the-seat thriller, and although I thoroughly enjoyed reading it, I also felt the same helplessness, disappointment and frustration that you felt despite all your knowledge and good intentions. Your anger is totally justified and just goes to show how deeply you care.
Like they say “You can lead a horse to water, but you can’t make it drink” 🤷🏻♀️
The best thing is you relying on your doctor then prediction to your future life ways to live.
Fully agree with your, science does not have all the answers but should be respected for what it has. Similarly, the alternative science of healing are as promising….and both need to be respected for what they offer, but I’m definitely skeptic of babaji’s as there are professionals in the second stream too.
Well written Dr Mazda
I certainly believe in Prayer Care and Medicine and not just rely on some Godman
God bless the work of your hands.
A very stupid action taken by family. The sufferer is the young man. We all respect our saints and babaji where it is there place.This should not go in matters of scientific expertise. Reading ur article has filled ur readers too with rage for the waste of a young life.
An extremely difficult situation well described. It’s great that you make this effort of sharing your experiences and spread awareness. Impactful and engaging write up
Kudos to all ur efforts and concern but can’t help with the superstitious believes that has imbibed in human race since ages.
Again a beautiful piece of writing…impactful n alarming.
Very well described and narrate the truth
We often see the line in a doctor’s chamber…..” I treat..but he cures ” faith to that extent in doctors or patients is understandable.
But what happened as you described is really sad doctor.
Thanks for sharing, it helps us believe more in science and God