The Surgical Blow

A pillion rider’s accidental fall and nightmarish battle for life, is a reminder for everyone to stay helmeted when on a bike

“There’s a 62-year-old lady in the ER,” I got a call just as I was leaving late in the evening after an exceedingly active day. “She was sitting behind on a two-wheeler at a signal when she lost her balance and fell backwards, the back of her head slamming the road,” the physician in the emergency told me quite casually in contrast to his gruesome description of the fall. In the matter of seconds, I had already imagined in my mind a fractured skull with brain tissue splattered all over the road, had cancelled the dinner I was supposed to go out for, and was wondering – for the umpteenth time – why pillions don’t wear helmets. “How is she?” I asked to verify if my imagination matched the reality in front of him. “She’s absolutely okay!” he said, probably wondering why I sounded so edgy. “She’s fully alert, quickly obeying commands, moving all limbs well, and her pupils are briskly reacting to light,” he described, giving me the low-down on her neurological examination. I promptly uncancelled the dinner in my mind, replacing it with an image of the spare ribs I was so looking forward to.

I lugged my backpack over my shoulder and left my office to swing by the ER before I could call it a day. Apart from a tiny bruise on her occiput, she was immaculate. I was intrigued to see that her hands were covered in ornate mehndi from the tips of her fingers up to her elbows. It was so fresh that I could smell cloves from 2 feet away. I asked her what the occasion was. “My son is getting married tomorrow afternoon,” she said, the longing to be present at the wedding clearly visible in her eyes, “and I need to go home tonight,” she requested. “I would have sent you home, but your CT scan shows a thin sliver of blood in the brain, so it’s better you stay the night and go home tomorrow,” I reasoned. Her overbearing family started loudly concluding that nothing was wrong and that she would be taken care of at home. Just then, she vomited once. “We should not only keep her overnight but also watch her in the ICU,” I cautioned sternly. They found it hard to argue with that and reluctantly agreed. I am certain most patients are of the opinion that doctors and hospitals only want to fleece patients when they suggest an admission for something that is seemingly harmless and where recovery is possible at home.

As I left to feast on burgers and spare ribs with truffle fries, I promised her family that I’d come see her the first thing in the morning and discharge her soon after. At dinner, I asked my friends if they had ever been advised admission by their doctor that they thought they didn’t need, and three of the five raised a finger. They couldn’t elaborate because their mouths were stuffed with chunks of meat. We had the kind of meal that induced a food coma the moment I reached home way past midnight.

At 3 AM, while I was in the deepest stage of sleep, my phone rang. I picked it up with my eyes still fully closed. “Kamlaben has suddenly become unresponsive and she’s not moving her right hand and leg. She’s not able to verbalize,” the intensivist reported. “What does the scan show?” I slurred. “The blood has massively increased, causing severe pressure on the underlying brain. I’ve sent it to you,” he said, raising his voice slightly to awaken me. I scrolled through the video he had sent me and sat up startled. “Get her to the operating room now,” I instructed, putting on my scrubs to go to war. Over a few phone calls, the army was deployed. The OR was prepared, blood was arranged, her head was shaved. She was intubated and shifted for surgery.

Within the hour, I entered the hospital with a heavy heart and an even heavier stomach. I spoke to the son, confirming that we had to operate or else she would not survive. He wished me luck. I wished him back – in case he decided to get married.

“Thank God I insisted on admitting her,” I told my colleague as we made a big skin flap to expose the bone. We drilled a few holes in the bone, the burning dust smelling like the charcoal on the barbeque that was still being digested in my belly. The brain was tense as we lifted the bone off. As I cut open the dura, a large subdural hematoma – brain bleed – delivered itself like an overweight baby way past its due date. There was a large contusion within the lobe that we removed, after which the brain regained some semblance of normalcy.

“Would you get married if your mom was undergoing surgery on the morning of your wedding?” I asked my colleague as we started closing. “I don’t know about my mom, but if my mother-in-law was undergoing surgery, I would,” he joked. As we placed the final stitch to close the skin, we placed bets on whether they would go ahead with the wedding; I said they would, my colleague said they wouldn’t.

As we wheeled her into the ICU from the OR, we saw the son waiting outside, his mehndi-laden hands folded in prayer. I told him that surgery had gone well and that she should recover, but it would all depend on how soon we’d be able to get her off the ventilator. “How is it possible that she was okay for the first 7–8 hours after the fall but became unconscious later?” he asked me, clearly having pondered this while waiting outside. “There is something called as a lucid interval in patients with a head injury,” I explained. “After a transient unconsciousness from the impact of the injury, patients are fully ok. If a CT scan is done emergently, it may not show too much blood. But if active bleeding continues in the head, the pressure builds up and patients then deteriorate after a few hours.” I wanted to tell him that these are patients are often termed ‘talk and die’ in medical parlance, but I didn’t want to burden him with negative thoughts. In cases of a mild head injury, it is sometimes a dilemma even for the doctor to determine which patients should be admitted and which can be sent home.

While it is mandatory in most countries for the driver of a motorcycle to wear a helmet, fewer countries have put laws into place for the well-being of the pillion rider, even though statistics show there is no significant difference between the head injuries sustained by motorized two-wheeler drivers and their pillion riders. In fact, before the Motor Vehicle Act of 1988 came into effect, a study found that only 0.6% of all pillion passengers were helmeted. While Delhi made helmets compulsory for even the pillion rider about 30 years ago, Mumbai brought this rule into effect only a year ago. It is for each one of us to recognise how vulnerable the pillion rider is and insist on a helmet whenever we ride pillion. After all, Kamlaben hadn’t even been in an accident; she simply fell off the bike.

We saw the son return in the evening, straight from his wedding; I had won the bet. He had on his vibrant wedding head gear. He also wore a nose ring and multiple earrings in both ears. Chains adorned his bare chest, and he wore a piece of golden cloth that looked like a combination of a dhoti and kilt. Without asking, he applied the ritualistic haldi and kumkum on his mother’s forehead and left a box of sweets by her bedside, holding her hand for a while.

The next morning, Kamlaben woke up with a smile on her face, surrounded by her loved ones. She heard in great detail about the wedding she’d missed while her new daughter-in-law fussed over her and pressed her feet. A gentle-mannered woman, she thanked me profusely for saving her life and asked when she’d be able to have a bite of the celebratory mithai her visitors had brought her. “One tiny bite, right away. The rest of it, once you’re out of here!” I joked, patting her hand.


20 Comments on “The Surgical Blow
  • Bipin mehta says:

    Very nicely written experience, every doctor faces, and good job done by insisting on pt’s for admission. Very well timed emergency performed surgery has saved her life. Keep up good work.

  • Avinash Karnik says:

    Dear Mazda
    Your decision making at the right time must have saved so many lives of patients who were fortunate to choose you as a neurosurgeon.
    Time and again you have always dedicated your life first to your profession rather than your personal commitments. I’m proud to know you.
    God bless

  • Shweta S says:

    You are a blessing to mankind Dr Mazda
    Thank you for sharing 🌻

  • Chanda says:

    Hi Dr. Turel,
    You are getting to be a bit infectious – in a good way.
    Can’t wait for your next article attack. You certainly have a kill of many of your admirers.
    Thank you for such pleasurable reading.
    Bless you!

  • Anjali Patki says:

    Excellent narrative, gripping and intriguing. Hats off to a perfect decision by you , made each time. Looking forward to many more such interesting experiences

  • Dr.CAUVERY. N says:

    I am anOGcian,…now at 60 turned Diabetologist, last 23 years not touched my scalpel, due to hovt posting in the peripheral area,…but admire your devoted service, …was touched to read,the smell is of barbecue as the surgery proceeded…..,true , time to chew, or close our lids in slumber….My salutations to you dear Sir.

    On this World BRAIN 🧠 Day,…a befitting write up,I relished every line of it,…I am an essayist myself.
    Bonjour….from Dr.CAUVERY.NATARAJAN, Pondicherry.

  • Brian Sutherland-Macleod says:

    Dr Mazda,

    God has blessed you with a gift and through your hands he does his work. We are all truly blessed to have a Neurosurgeon like you. Thank you!!

    God bless.

  • Mina says:

    I have been one of those who implicitly trust the doctors as believe them to be experts in their friend who would know better than me medically.

    Your article infact exonerates me as many of relatives are always second guessing the doctors and secretly accuse me of not choosing alternative therapies.

  • Temitayo says:

    In this gripping narrative, Dr. Mazda K. Turel, a neurosurgeon, recounts a life-threatening case of a pillion rider’s accidental fall and subsequent battle for life. The story serves as a potent reminder for everyone to wear helmets while riding bikes. The doctor’s dedication and swift actions save the patient’s life, but not without challenges and critical decisions.
    The narrative powerfully captures the emotions, uncertainties, and complexities faced by medical professionals, as they balance life-saving interventions with personal sacrifices.
    The gripping account keeps readers engaged, highlighting the importance of timely medical attention and the profound impact of accidents on individuals and their families.

  • Ajit Sawant says:

    Another great captivating story of a difficult unexpected situation arising out of a accident and how you handled it skillfully !! Keep writing dr …

  • Anuradha says:

    This article serves as an eye opener to the perls faced by pillion riders and bikers in general. Also the manner in which you with your presence of mind, saved this lady’s life, is truly laudable. Ver good doctor. God bless.

  • Kersi Naushir Daruvala says:

    Excellent diagnosis, Wishing all the best in all your surgeries. May Ahura Mazda bless you and your family, friends and hope for quick recovery for all your patient too.

  • Dr Indu Bansal says:

    Another gripping narrative as always from your pen. U are blessed with both the qualities of pen as well as scalpel. Keep on writing, keep on operating and keep on saving lives.

  • Chandan Sanjana says:

    All is well that ends well. Your patient allowed you to have your lip smacking burgers and ribs with your truffle fries, your sleep got messed up, but you did your surgery so well. God always guide your hands to make every surgery successful. The man got married brought Nighat for his mum. Wow. Thankyou Gid for saving this woman with your timely intervention.

  • Rita singh says:

    Dear doctor, wish we all had a doctor Mazda in our city .God has blessed u with all the best qualities he has in his store. A compasionate heart and a genius mind. Keep up ur good work and keep writing please.

  • Germaine Boatwala says:

    That was a hard read, considering the injury and the age of the patient. India is very tardy on rules, even more careless about enforcing them. Then, there’s corruption. But it is for the two wheel riders to assess the pros and drastic cons of not wearing a helmet. It’s not an accessory, nor a petty inconvenience on the head. Until life is valued in our land, these cases will continue unabated, I’m afraid!
    Great write up as usual, doc! I come from abroad, where not wearing a helmet is rare.

  • Sameer says:

    Love the way you keep up the humor amidst such serious situations… wishing him luck in case he decides to get married is still having me in splits.

  • Sunita says:

    We drilled a few holes in the bone, the burning dust smelling like the charcoal on the barbeque that was still being digested in my belly..
    Remaining immune from such like food associations .. ?
    I guess it might be tough to eat, if it was the other way around.. ?
    As in the barbq reminding you about the burning dust after drilling a few skull holes

  • Tasneem says:

    Well written. Fun informative read . I like Dr Mazdas sense of humour

  • Setu Ram says:

    Total disregard for basic safety as a pillion rider.


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