Sometimes, the only person who has the ability to fix you, is you yourself
She was a young girl in her sixties. (There – I just earned myself some brownie points with the elderly women who read my stories!) They were a family of four: one husband and two sons. “I’ve been having headaches for a few weeks. My GP ordered a MRI of the brain, and they found this,” she said, handing me the films. “I don’t want surgery,” she interjected even before I could say anything. I sighed internally. Whenever a patient’s gut instinct is not to have an operation, and for whatever reason we do go ahead with it, I’ve more often than not had a complication, even if it’s something minor.
I asked her a little more about her pain. She said it was making her miserable. Vomiting was a new symptom over the past three days. Her husband added that she even had a brief bout of unconsciousness yesterday but recovered completely in a minute. “These are all red flags,” I warned and begun to examine her. “Stretch your arms out straight in front of you, palms facing up, and close your eyes,” I instructed. The left arm drifted down considerably, indicating a problem in the right half of her brain.
I planted the black and white films against the incandescent light of the X-ray box and explained to her why she needed surgery. “There is an 8 cm tumour carpeting the entire surface of the right frontal and temporal lobe, pushing the brain to the opposite side. There is also a lot of swelling around the tumour which is causing raised pressure inside the brain,” I detailed with a pointer. “Mom, you have to get this removed,” one of the sons sitting next to her implored. “Are there any risks to this operation?” the other son asked. “There’s always a risk, but the benefits outweigh it in your case,” I stated, adding that there was a tiny possibility of death, paralysis, infection, bleeding, or seizures. This is what I call pulling a Coldplay – making someone experience strong emotions with a serious message. But I ended it with, “And I’ll try to fix you,” which is what Coldplay fans have been consoling each other with after being crushed.
After a lot of deliberation and a few more opinions, they returned to me for surgery because she was getting worse. It was the same week that Coldplay announced their Mumbai concert. I haven’t planned for a complex surgery as much as I witnessed the entire city strategize on how to book their tickets. While people were planning how many devices to simultaneously log onto, I was thinking of the contraptions I would use to get this monstrosity out.
We operated on her the next day. I made a big incision over the scalp and opened the dura, the covering of the brain from which this tumour arose, and disconnected it from its attachment. ‘It was all yellow’ and densely adherent to the brain, indenting the surface unevenly. Attempting to peel if off was an Adventure of a Lifetime because it was bleeding profusely. I dreaded Something Just Like This happening, but there’s always a Higher Power guiding you, and we were able to remove the tumour uneventfully. The brain was soft and pulsating gently after the procedure.
I asked my colleague if we should replace the bone over the brain or place it in the abdomen to replace later. There was a small chance that the brain could swell further, and if it did, it would compress the internal structures. “The brain looks quite soft now… we could put the bone back,” he suggested. “Plus, they are on a tight budget, and replacing the bone later will need a second operation,” he justified. In the wise words of John Kirklin, a famous American surgeon, “At a given instant everything the surgeon knows suddenly becomes important to the solution of the problem. You can’t do it an hour later, or tomorrow. Nor can you go to the library and look it up.” We could either remove the bone and replace it a month later or put it back now and pray she wouldn’t need another surgery. The Scientist in us made us do the latter. You could almost call it Boldplay. We said a Hymn for the Weekend in the ICU, where she started recovering exceptionally well. I was delighted to have made the right choice. She spoke well, ate her food, and moved her limbs, ready to be shifted out. She was doing well.
Until she wasn’t.
At 2 AM the next morning, I get a call saying that she wasn’t responding. Thoughts flashed in my mind faster than the Speed of Sound. I beat myself up in my head until I saw A Sky Full of Stars. My Universe came crashing down. We got an urgent CT scan done to see that the swelling had disproportionately increased. I ordered to rush her to the operation theatre to plan for the removal of the bone. As I drove to the hospital, I wondered how my judgement had failed me this time. After having been in this situation hundreds of times over, how could I have gotten this wrong.
She was prepped and ready in the OT by the time I reached, and we were quick to remove the bone flap. The brain jumped up like the foam of a beer topples over a glass when poured quickly. It seemed to me at that time that Death and All His Friends had come to visit, but we were able to tide over the situation. Over the next few days, she made a steady recovery.
As I drove back from work that evening after 20 hours of being at the hospital, I thought of all the challenges we face as surgeons and how often the decision making is more crucial than the technical expertise. How quickly the pendulum of our outcome swings between beauty and bleakness, transcendence and terror, faith and fear, magic and madness.
How every single thought and action centres around a patient’s well-being, and yet, there are times we falter.
When you try your best, but you don’t succeed
When you get what you want, but not what you need
When you feel so tired, but you can’t sleep
Lights will guide you home
And ignite your bones
But you will have to fix you.
No one will do it for you.
And that is our ticket to Paradise.
P.S. Chris Martin, if you happen to read this, our group of 16 friends were trying for your tickets while I was saving lives. Please do the needful.
33 thoughts on “The Surgical Coldplay”
Dear Dr. Mazda,
This gift you have, the name of which I’m yet to fathom, is definitely going from strength to strength! Surgical and Coldplay seemed worlds apart until I read the article and I’m bowled over by how you bring them together ever so smoothly! Oh what an amazing gift you share with us our dearest Dr. Mazda!
Thank you and be thou blessed “always and in all ways”!
What a bold decision and honest efforts with the Faith in the Almighty. The guts and still the flutter in the heart to save the patient is admirable. That’s why we, doctors are compared with the God.
Excellent narration
Soooperb, you’re really with it. Cool play on words… thoroughly enjoyed it…good fun😊
Again a.super write up.
Made me tense too.
But you are a miracle man dear Doc Mazda.
Coldplay it is, but you fix others!!!
I was on edge reading this article. But you pulled off another miracle. Bless those hands of yours that are the source of miracles you pull one after the other. Wonderful.
“Sometimes, the only person who has the ability to fix you, is you yourself”
Very true Dr. Mazda and thank you for the excellent write up. 🙏🙏🙏
I too agree… sometimes the only person who can fix u is U urself!!! …all cases r unique in their own way..what a roller coaster ride for the girl hesitant fr surgery…she was in safe hands! The entire family must have blessed u twice!
Stay blessed doc!
It’s just complex Surgery this which common lay people could not able to understand technical work But in simple language it can only make in story teller hat on to you Dr Mazda
*You treat pts like your family member only* Great 👍
Sir, you r expertise in the brain and spine . Your patient case stories looks interesting, horrible and create sympathy towards the patient and the treating doctor during the short journey of read out completely.
Such complex surgery does not need brain visions but guts to move forward. YOU DID IT AGAIN SIR.
Hey, I think your site might be having browser compatibility issues.
When I look at your blog site in Firefox, it looks fine but when opening in Internet
Explorer, it has some overlapping. I just wanted to give
you a quick heads up! Other then that, superb blog!
U r a genius doctor. So oo,cool and competent. We thought the case almost gone out of hand yet u managed a timely, rescue. Truely my seniors used to say “doctor bhagwan ka roop hota hai.”God bless, hope u enjoyed the concert.
Your work is amazing excellent but what puts you on the top of the list is your humbleness it earns you major brownie points with your karma you are really talented and a blessing to humanity.
Gifted Neurosurgeon always helped patient and become victorious brought back life from jaw of death
“Doctor bhagwan hota hai”.I. often times heard my parents say. Which in ur case seems so true. Hope we had many more like u.But now many times we hear about shaitan docs too. Anyway God bless u .
Description is awesome. Often happens in our surgical career when we think it would have been better if we had removed the bone flap. Seen in quite a few chronic SDH cases.
Sir,
The decision making situation you faced is very difficult. But I am sure you always treat your patient as family member.
You are great sir.
Excellent Mazda
Keep on writing
Enjoyed
It is a heartfelt treat everytime to read your experiences and the way you pen down your mercurial talent…so clear as if the scene is happening in front of us and we are also a part of the happenings… Really its tough for us as Drs but the way you pen…just super…
Thoroughly enjoyed reading this article.
Excellent article Mazda! Wit, humour, tongue in cheek et al!
👌 Superb Dr.You are great.
Love the emotional narrative doc. But you will have to fix you is the real fact
Very Great ..Nice write up…..first time came to know that there are people like Shashi Tharoor in Medical field ( with regards to Vocabulary)…. Sir…you are going to get blessings for such devoted great…..God less you
Ur really a gift of God to people in distress. So intelligent and so dedicated. “Doctor bhagwan ka room hot hai ” saying rightly goes with you. God bless u.
Dear Dr. Turel
What a great narrator you are! I am simply impressed with your story, your selection of words, and the way you bring everything to life. It resonated deeply with me, especially since I recently had a similar experience during a craniotomy for ICH on a patient on anticoagulation.
The decision to replace the bone was taken based on the soft, pulsatile, and sunken nature of the brain, despite knowing the risk of bleeding recurrence and swelling. The patient’s financial situation influenced the decision, and she was a distant relative of a colleague. Unfortunately, despite initial improvement, the patient deteriorated due to reaccumulation of the hematoma, and I had to re-explore and remove the bone flap.
Your narrative about balancing surgical judgment with unpredictability, and the emotional weight surgeons carry, truly captures the essence of our profession. Like you, I’ve learned that sometimes, despite our best efforts and technical skills, outcomes can swing in unexpected directions. But we keep pushing forward, driven by the hope that “we’ll try to fix them.”
Because we know that only we will have fix for ourselves.
Warm regards
Super Write Up Sir !
Time is Brain…!
Dear Dr Mazda
Amazing narrative. Getting the patient out of the jaws of death. God bless you
You made some decent points there. I looked on the internet for the subject and found most persons will go along with with your blog.
Superb article. I love your sense of humour, your humility and descriptive ability. To be self depreciating is an art and you do it brilliantly. All the best.
I relish, lead to I discovered just what I used to be having a look for. You have ended my four day lengthy hunt! God Bless you man. Have a nice day. Bye
Usually I don’t learn article on blogs, but I wish to say that this write-up very pressured me to try and do it! Your writing style has been amazed me. Thanks, very great article.