The Surgical Sciatica

Do as the doctor says, always, especially when it involves matters of the back

Benny walked into my room with an obvious limp and a grimace on his face. Taking one look at his visage, I knew he was in excruciating pain. As he sat down, his lips pursed into an O, but what he really wanted to say was ouch. “Would you rather lie down?” I asked, already having made my diagnosis. He agreed and warily made his way from the chair to the examining bed amidst a few more moans.

He was in his 50s. He wore a tight-fitting black polyester shirt whose microfibers were stretched to their limit by his underlying paunch. “Do your friends call you Pot Benny?” I joked, pointing to his belly. He was jovial enough to acknowledge it needed to go, gesturing it with a tap downwards. “I have severe back and right leg pain,” he continued running his hand down the distribution of the pain along his cargo pants as he lay in bed. It had been 2 months now. He had tried the usual medication masala that we doctors prescribe for sciatica, a pain that radiates from the back along the path of the sciatic nerve in the leg. “I need to get back to duty, I can’t take any more leave!” he finished, exhausted.

“What do you do?” I asked. “I work in the army,” he said matter-of-factly. “Really?” I asked, the question emanating from genuine surprise given his physique. “I have a desk job in the army,” he laughed, taking the suspense away. “Don’t worry, I’m not on the battlefield!” he guffawed, putting me at ease.

“If you hadn’t clarified, I would be worried for our country!” I said in jest, but I also apologized for judging him so abruptly. “We are so programmed to make assumptions based on how we must look the part if we are in a certain profession,” I thought aloud. “I wonder what people imagine doctors to look like…” I mused, throwing open the question. “Certainly not like you,” pat was his reply. As he saw my crestfallen expression, he softened the blow by adding, “Because you are still so young!” It seemed like we were already friends.

I was reminded of a ‘sports’ theme party we once had in school. It was a classmate’s birthday and everyone had to come dressed as playing some game. Some children wore cricketing gear, others wore shorts and carried badminton, tennis, or table tennis racquets. A few wore boxing gloves or got along a football or a basketball. One boy came dressed rather formally and all the other kids mocked him for being a party pooper and not taking the trouble to dress the part like everyone else did, until he said, “I’m playing chess.” From then on, he was the hero of the party.

I examined Benny to notice that his right foot was slightly weak compared to his left, and that when I raised the right leg off the bed, he had a jagged pain down his leg from the disc in his spine that had prolapsed and was pinching his nerve. I showed that to him on his MRI film, holding it up against the twilight of Mumbai’s skyline that came in from my window. “So many people in this grungy yet gorgeous city must be having what you have,” I told Benny, “and so many just plod along in their suffering.”

I pronounced that he needed surgery. In his heart, he too knew that there was no other recourse. “A large portion of patients get away without an operation,” I explained, “but your disc is just too big, deeply indenting the nerve, which appears swollen on the MRI,” I said, rationalising my decision. “The fate of the Indian army’s accounts is in your hands,” he said in his self-deprecating humour, poking fun at himself and at the desk job he needed to get back to. I explained to him that it was a minimally invasive surgery and assured him that he would be fine.

The next afternoon, we made a small incision in his back, and, using a set of tubular dilators, which only separate the muscle without cutting it, I got to the bone. I drilled a sliver of the lamina and bit off the ligament covering the dura. The disc had lifted up the nerve root, causing it to look angry and inflamed. I cut into it and with a forceps, grabbed the fleshy piece and wriggled it out. It was like unearthing a pale slug from the soil. The nerve root went instantly lax and retreated to its place, almost as if it were saying ‘thank you’. We made sure there were no free fragments of the disc before we closed.

When he woke up, his pain had dissipated. He tested it by bending his knee and hip and rehearsing the movements that had caused him pain earlier. “You must lose weight before you can try any stunts with your back,” I warned him when he got discharged the next day, giving him permission to resume work in a week. He was eternally grateful.

Two weeks later, I got a call from the emergency saying Benny was back with the exact same pain. My heart sank; perhaps it was something ominous. When I saw him, he was in greater agony than the first time we met. “Did you do something silly?” I asked, knowing that his disc had probably popped out again. “I was feeling so good all these days that this morning, I lifted a bucket full of water and poured it over my head while having a bath, and that’s when the pain started,” he said, shaking his head and tapping his forehead this time instead of his belly. “Courage is knowing it might hurt and doing it anyways. Stupidity is exactly the same thing,” I said, pulling out a quote from my armamentarium. “And that’s why life is hard,” he said, completing the saying for me.

In my earlier days, on the few occasions when someone whom I had operated upon for a slipped disc returned with pain within a short span of time, I would always blame myself for possibly a sub-optimal job done, until a surgeon, probably in witticism, once told me, “Always blame the patient first. Only if you can’t find fault with them, blame yourself.” I could never resonate with that until this day.

We did an MRI and saw that he had a large re-herniation of his disc. I told him it was best to bite the bullet and redo the operation. “Do I have a choice?” he asked. My usual philosophical response would have been, “We always have a choice,” but this time I bluntly said “No!” I assured him that we would be done in 30 minutes. I went back in and removed that fleshy little monster of a disc that had exploded in his spine. The nerve once again said ‘thank you’ for what I hoped would be the last time.

We discharged him the next day, completely pain free as if nothing had ever happened. “So, what should I do now?” he asked perplexed. My reply was to maintain ‘Status Quo’… and I then went on to paraphrase and sing a song by a band with the very same name.

 Now you remember what the doctor said,

Nothing to do all day but stay in bed

You’re in the army now

Oh-oo-oh you’re in the army now!

14 Comments on “The Surgical Sciatica
  • Meena Kothari says:

    A compelling read with interesting information disbursed in an engrossing style. I look forward to each new instalment every Sunday!

    Reply
  • Anjali Patki says:

    Tongue in cheek, humorous, educative and interesting narrative. Great job dr mazda. Loved the article .

    Reply
  • Natwar Panchal says:

    Informative, nicely explained Dr. 👌

    Reply
  • Avinash Karnik says:

    Dear Mazda
    Your article as always took me through the operation as if it was shown on a video. Your description is just amazing and laced with some humour makes your articles very special.
    Keep up the good work of making your patients free of the unbearable pain.
    After reading your articles, I’m sure many patients will be seeking you.
    Congratulations is the least I can say.

    Reply
  • Tasneem says:

    Good read!
    Enjoyed it

    Reply
  • Anita says:

    Definitely had me smiling and re-reading the beautiful article. Dr Mazda helpful as always. Bless you and your work 🙏🌹

    Reply
  • Arun Pushkarna says:

    “Laughter”, I have read, “is the best medicine”. But for those who are fortunate to be on your WhatsApp group, “Medicine is the best laugh”.
    You are a gem Mazda!!

    Reply
  • Supriya Correa says:

    And what did YOU wear to the sports themed party….???

    Reply
  • Marzin R Shroff says:

    To paraphrase the same song…
    You’ll be the hero of the neighbourhood,..
    Everybody knows that you’ve operated for good…
    You’re in the army now,
    Oh-oo-oh you’re in the army now

    Reply
  • Porus k Chinoy says:

    Brilliant as usual. A good relaxing read after a heavy bawa lunch.

    Reply
  • Dr atman. Daftary says:

    Enjoyed sir

    Reply
  • Rita singh says:

    What a fantastic story,yet true. Many wonderful reading experience comes under one writing. Thanks for ur fortnightly treat. Hope for many more.

    Reply
  • Dr. Pradip Kumar Tiwari says:

    Waiting for all the stories compiled in a book being released and I will shout out loudly “Hey frenzy, I have already been there ! “.☺️

    Reply
  • Vipul Shah says:

    Dearest Dr Mazda ….
    Read your “ Army Soldier “ piece late bcos was in Udwada where Tragic Death of Cyrus Mistry of SP Group in Car Accident happened…..

    The lifting of Water full of bucket was a cause of redoing of surgery…..

    One must listen to the instructions post surgery very seriously is the moral of the story …

    Your writing Talent of explaining procedure looks so easy that even Non medical person feels that Surgery is very easy 😳🤣

    Please write on Safety of Driving Procedure for your Readers on your operating Accident related surgery in your humorous style please

    Best Of Luck & God bless Sir..

    Reply

Leave a reply

Your email address will not be published. Required fields are marked *