You may think that when a doctor suggests an urgent surgery, he is out to dupe you, but sometimes, it’s just to make sure you don’t fall off the edge.
“There is a 16-year-old girl admitted with vomiting,” the ward doctor called to inform. “She also had some stomach cramps, and the medicine guys worked her up for a gastro bug, food poisoning, and typhoid but found nothing,” he added. “Could she be pregnant?” the curious cat in me inquired. “They ruled that out too with a test,” he confirmed. “Since yesterday, she also started complaining of a severe headache and was unsteady on her feet, so the consultant in charge ordered a brain MRI and found a large tumour in her head. Hence, we are calling you,” he gave me the gist.
When I went to see her, she was sitting with her hand in her head. This is not a good sign, I thought to myself. I peered into her eyes with a fundoscope, a device that allows you to see the optic nerve head. It was fuzzy and red as opposed to sharp and white, suggesting raised pressure inside the brain. She spoke coherently with a gentle smile even though she was in pain, respectfully doing her best to answer all my questions. I was pleasantly surprised; I don’t expect anything civil or gracious from today’s teenagers, even if they are unwell. “There is something wrong with the world today, I don’t know what it is,” a song that Aerosmith sang 30 years ago often plays in my head on loop when I see the kids of today.
The MRI showed a large heart-shaped tumour at the back of her head in the area called the cerebellum. I circled the tumour out to her father, a short bald guy, who stood there with hands folded but slightly apart as if to catch every word that came out of my mouth. “It’s filling up the entire fourth ventricle and blocking the normal fluid outflow pathways,” I explained the reason for the headache, showing him how the normal slit-like ventricles had ballooned up. “It is also pressing against the upper part of the spinal cord, which is why the imbalance,” I gave a clear explanation.
“We’ll have to remove this with an operation,” I explained, detailing the need to do this at the earliest. “Can’t we try some medication to see if it melts,” he asked; understandably, like most people, he wanted to avoid surgery for his daughter. “Not only do we need to do it, but we need to do it tomorrow,” I pushed. When doctors press for surgery, relatives often have their antenna going up. They are only here to make money… they are scaring us… someone else we know got better without the operation that two other doctors insisted on… we must take another opinion… are all the thoughts I’ve heard screaming from inside heads without actually being articulated. “There is something wrong with our eyes, we’re seeing things in a different way, and God knows it ain’t his,” the Aerosmith song continued to play in my head.
“At least shave her head to be on the safe side in case we need to do something urgently,” I instructed the ward doctor before I left for the evening to go for a friend’s wedding anniversary dinner. “We’ll get back to you in a day or two about our decision,” the father told me. As I drove away, I didn’t blame him because this is a pathology that could remain stable for a few days or even weeks or it could get worse anytime. As surgeons, we tend to act before the situation deteriorates because then we have a better chance at recovery. It’s going to be a while before patients can universally trust a doctor’s intuition. “There’s something wrong with the world today, the light bulb’s getting dim,” Steven Tyler crooned in my ears.
I had a fabulous dinner. Walloped succulent lamb chops. Picked on peppered prawns. Munched on mutton. Nibbled on noodles. Hugged friends I hadn’t seen in ages. Danced a lot, sweated a little. I drove back home with my windows down, a cool late December breeze blowing in my face. As I parked my car, I got a call from the hospital. “The barber came to shave her head, and she’s not waking up,” the ward doctor paused, not saying anything after. Neither did I, waiting for him to continue. “There is no response even to deep pain,” he added, waiting for me to say something. I remained silent. “Her pulse and BP are okay,” he added, to tell me she wasn’t dead, but still waiting for me to respond.
“Living on the edge (You can’t help yourself from falling),
Living on the edge (You can’t help yourself at all),
Living on the edge…” blasted at full volume inside my head – the electric guitar, keyboard, percussion, everything. If you grew up in the ’90s or are an Aerosmith fan or even a fan of Tyler’s daughter, you’ll know what that would sound like on full volume at 1 AM.
“Activate the entire team and shift her to the operation room now!” I commanded. “Don’t wait for consent or clearance from the billing department,” I warned, softly but very sternly. “If we don’t do this now, she will die.”
“Hey, Siri, play ‘Living on the Edge’ by Aerosmith,” I instructed, as I turned right back out of my lane and reached the hospital in the six-and-a-half minutes that the song lasted. To my surprise, the patient was already on the operating table. I changed and scrubbed, and cleaned, draped, and bore a hole into the skull as bone dust swivelled into thin air. I took a tube and inserted it into the ventricle to drain some CSF, cerebrospinal fluid, releasing the pressure in the brain. Fluid gushed out at such high pressure that it sprayed my mask wet. She instantly opened her eyes. I connected the tube to a system to let it drain at a constant slow rate.
I told the anaesthetist to keep her ventilated overnight and told the father we would operate early morning to remove the tumour if he was willing. “I don’t have a choice, do I?” I asked. “Not really,” I replied. Eight hours later, we took her back to the OT, flipped her prone, and opened the back of her head. Pearly white tumour slurped into my suction, begging to be removed. We cleanly separated it from the cerebellum, and as the last bit came out, it unplugged the fourth ventricle with a clear egress of CSF, restoring balance in the brain. We closed in the usual fashion, and she woke up bright and crisp the next morning. All the tubes and pipes from her body were removed as she was discharged in perfect health a few days later – the MRI showing a complete removal.
“I don’t even remember what happened to me,” she confessed. “Just think of it as having taken a good night’s sleep,” I told her. “Thank you for saving my daughter’s life,” the father acknowledged with reverence, “And Happy New year.”
I couldn’t help but think of the song of the moment again. “There’s something right with the world today, and everybody knows it’s wrong!”
34 thoughts on “The Surgical Edge”
great decision
You are a good Doctor !!!
Wowwwww bravo Dr Mazda you are a real life hero god bless you.
Mazda Doc “The Good Samaritan!” You are amazing. I love your temperament. God Bless !! You have walked into your Fathers shoes Keki “The Masterblaster”
Excellent job!!
Dearest Dr Mazda sir …….
Extremely extremely happy to read you back in OT to make us dive inside the brain of your patient……..
Although 87% of your readers may not know anything about Aerosmith bcos they have grown up with Latadidi & Kishore da & Rafi Saheb with whom majority can relate unlike your sophisticated English guys 😳
We non vegetarian also enjoyed your mouth watering dishes in your writing only 😎
The efficiently handled Surgery by your quick timely decision made you more lovable surgeon sir ❤️
Lastly the word Curious Cat with pregnancy was best humorous phrase coming out of your vocabulary 🌹
Thoroughly enjoyed your outstanding amazing piece…..God bless & keep on writing for your Fans …🥰
This story is a tremendous combination of good judgment, skill and a calm and patient centric surgeon. Mazda you are a hero !!
Perfect miracle doc. Only I wonder why you made me go through all that trauma of Physiotherapy and medines for a month when you knew you had to operate and fix it like you did. Anytime you want to operate, I’m always ready.
Kudos 👏 to you Mazda. Feeling a sense of pride not simply on your achievements but more so on your approach and your ability to confront a threatening situation.
Fantastic work doc. Always, always can rely on you, without a doubt or any second opinions. So happy that I know not only you but have had the pleasure of meeting your father too. 👏🏻👏🏻👏🏻
Amazing. Trust in you will always be there. 👏🏻👏🏻👏🏻
Great 👍
As usual by the grace of God she survive by U Sir.
Congratulations 🙌
U r The “ PILOT “ with full Confidence & command on SURGERY
“ Tusi great ho sirji “ 🙌
Great Fantastic job at right time
Very well written!
Excellent written looks like watching movie… good case and perfectly handled..hats off to you …
Very interesting
Mazda, you don’t just operate on the edge—you write from it, live on it, and save lives from tipping over it.
Your words are as sharp as your scalpel, blending urgency, empathy, and a touch of rock ‘n’ roll.
The world may be ‘living on the edge,’ but stories like this remind us there’s still so much to hold onto. Brilliantly told!
Great Sir! Not simply most of people refer doctor as God.
Wishing all the success in your endeavours.
A brilliantly written piece once again Mazda. The uniqueness is that you have entwined the article with various verses of songs so relevant to the article.
Waoooooh 🔥, outstanding job Dr
Wow Mazda you put Wilbur Smith to shame. With the emotion of choking you created you should hire a ghost writer and head for a Pulitzer
Dr. Mazda
Highly appreciate your quick response and doing the job just in time.
Right decision at right time.
Best Wishes to you for even more outstanding work in your hands.🌷
Our friend, your father Keki must be very proud and very happy to read this.
Please convey my Regard to him too.
Dr Arvind Vartak
There is indeed a mistrust on the patient and family’s side when surgery is put on the table. Negative remarks a from family and friends don’t help the situation at all. I waited 6 and a half years for back surgery because of just such mistrust and comments. My health deteriorated and surgery became imperative. Looking back I wish I had listened to the doctors who knew best and saved myself six and a half years of pain and trauma.
Your rock Dr Mazda! Rock on!
Dear Dr Mazda,
Greetings of the day!
Your decision are always correct, I have immense trust and faith in you after what ordeal I hsd undergone. You do your duty with the intention of Saving life, relieving pain and giving right advice.
I remember 10 years back I use to get severe headaches with no relief. You operated upon me and removed a very small hard cyst on my head. You said the cyst was on and off pressing the nerve which caused pressure hence i got headache after my MRI screened by you. Once I got operated and the small hard cyst was removed, miracle took place, my headache had gone and I had a sigh of relief from the 5 years agony which I had undergone. This small hard cyst was rather unnoticeable and I just couldn’t imagine the agony I had undergone with splitting headaches. I learnt never to ignore the smallest change that happens in any part of the body. Approach your Doctor with faith and trust in his decision. I did just that and got treated by you.
Thankyou so much.
Hi Docta, I have a lot of respect for two worldwide professions: medical doctors and teachers. One saves lives, and the other shapes them. Or used to, since it all comes down to money now.
Your piece is a wonderful testament that these professions so profoundly revered in the yore are still being practiced aptly.
Thank you for sharing, and please continue mending lives with your qualifications and experience.
God bless.
Dear Mazda
I love this article. Also understand the dilemma a doctor faces when he has to take split second decisions in spite of doubts raised by patients’ relatives. I also like the confidence you have in yourself and your penmanship is adorable. Well done and God bless!
Right action at the right rime is the key to survival.
Yet,again we witness ur miraculous healing talent by ur gifted hands.Thanks to the God almighty for creating doctors like u even in these materialistic times .
As always, a wonderful piece!
I know that you are an excellent surgeon like your father.A good surgeon knows when to go ahead in an emergency and when to stop.I am also an anaesthesiologist with 42 yrs of practice.Your steps of your story is going through my eyes just as I anticipate steps of Anaesthesia before a difficult Intubation and consequences thereafter.Too good an outcome doc Congratulations.
Wonderful description of a medical emergency. Relatives are often suspicious of the motives of doctors.
I am really surprised. In all the emergency and all the risk taken, how can music plus fabulous songs 🎵 get into your head it’s amazing.
Keep up the good work 👏.
Doc… needless to say, your presence of mind, preparedness in anticipation and proactive energies are at play at all times !
These are the traits of ‘The Good Doctor’ !
Please stay the way you are, always !!!!
Lovely Mazda..great prose and great descriptions..thank God and thank you she survived…