The Surgical Tunnel

A company secretary, victim to the vagaries of technology overuse, finds light at the end of the tunnel with medical advancement and ma ka pyaar

“My right hand hurts like hell,” Josephine told me as she settled into her chair, supinating her palm in front of me. She showed me with the finger of the other hand where and how her pain radiated: around the wrist and into the first few fingers. “I have to shake the pain off my hand sometimes, mainly at night,” she demonstrated, replicating the gesture of drying droplets off a wet hand in the air. “It’s a combination of burning and tingling and numbness and heaviness,” she tried to explain, wincing her face. She was a company secretary in her sixties, and wore a red dress that reflected a rose tint in her thick glasses. Her 97-year-old mother sat next to her, upright and vigilant to every word of the discussion. “I can’t do any work around the house and Mummy needs to chip in, as it’s only the two of us living together,” she described her situation. “That’s what keeps me young and fit,” Mummy said. “I’m 97, and the only times I’ve been to the hospital is to accompany people younger than me,” she joked, poking her daughter with her walking stick.

“What’s your secret to a long life?” I asked Mummy. She strained her neck to hear me. “Getting a little deaf,” she replied. I wondered if that was her answer or she wanted me to repeat the question, but she followed it up with, “People talk all sorts of nonsense today, so the less you hear, the longer you’ll live!” Mummy shed a few pearls of wisdom.

“Do you have any pain in the neck or the arm?” I asked Josephine, as sometimes, pain in the hand can arise from a pinched nerve in the neck. But her symptoms were typical of a condition called carpal tunnel syndrome, where the nerve in the wrist gets strained by the overgrowth of the soft tissue around it. “Are you diabetic?” I questioned, as it is more common in people with elevated sugars, thyroid problems, arthritis, and those who are slightly plump. “I find it hard to open bottle caps, turn door knobs, and even cook,” she interjected, remembering how she was incapacitated by her problem.

“The carpal tunnel is a space in your wrist bones. It’s like a shaft cut through the mountainside, but instead of making room in the rock for cars, it’s a passageway in your bones that lets tendons, ligaments, and nerves pass through it to reach your hand. The nerve is getting pinched here,” I said, tapping on her wrist with my fingers, making the pain shoot through the first four fingers of her hand. “This is called Tinel’s sign, which confirms my diagnosis,” I demonstrated, and gave her the full low down of the condition.

She told me her job involved sitting at the computer all day, although she did take breaks and rest her hands as often as she could, following some good advice that she had been given. “Repetitive movements of the wrist is a reason why some people get it,” I affirmed. “Also, women get it three times more than men,” I gave her some trivia. “Chefs, waiters, bartenders, dishwashers, and people who use machine guns often are also prone to it,” I added. Her face registered mild scepticism. “I have operated on a few army men with the problem,” I explained, in case she thought I was joking about the machine gun.

Josephine told me that another doctor, who had suggested a nerve conduction test to confirm the diagnosis, had recommended a splint to ease the repetitive movements on the wrist, but that hadn’t helped. Someone else had asked for an ultrasound of the wrist and tried a steroid injection around the nerve, but after temporary relief, the pain had returned to bite her. “I am your only hope now,” I grandiosely pacified her, as Mummy lent her outstretched hand for me to hold. I had operated on another family member of theirs a year ago for a colossal brain tumour, so they were familiar with my jest. They had come mentally prepared for surgery, which a few others had recommended.

“This is not as big an operation as we had for Francis, correct?” they tried to gain some perspective. “Not as big, but just as important,” I mentioned. “I don’t consider any surgery as simple or small,” I reiterated my stance, “but you’ll be able to do everything from the next day,” I reassured her. “We can ideally discharge you the evening of the operation itself, but as you have insurance, you’ll need to stay the night,” I explained. “Mummy will stay with me,” she told me, to which I said there was no need. “Do mummies ever listen?” she said, smiling at her fondly.

A couple of days later, when they entered the hospital and the nurse intuitively went to Mummy to put the patient wrist band on her, Mummy redirected her to the correct patient. It’s funny how our mind is programmed to believe the cultural stereotype that the older person must be the sicker one. These stereotypes permeate through life – women don’t drive well, thin people are fitter, older people cannot manage technology, or that the French are arrogant – and are especially true in the medical field, where people believe that the younger doctor must be less skilled or that all hospitals are here to fleece patients. And my favourite: All neurosurgeons are dashing.

We took Josephine to the operating room the next day as the anaesthetist skilfully knocked her out. We infiltrated some local anaesthesia around the wrist and made a 2 cm incision to extend the lifeline on her hand and take it all the way up to the crease of the wrist. “This is the only surgical procedure that can astrologically extend your life,” I joked with my assistant. “Now she’s sure to live as happily as Mummy,” he quipped. We separated the fat until we saw the thick band of tissue we were supposed to cut. We nicked it to slide the instrument under it, and cut along its entire length so that the nerve below could be fully freed from the tension it created. “Such severe compression,” my colleague and me enunciated simultaneously, imagining the plight of the patient.

We closed the skin meticulously and wrapped a comfortable bandage around the wrist. Mummy was delighted to see Josephine when she returned to the room. “My pain is gone,” were the first words she said. “My hand that was asleep and pricking is alive and kicking!” she rhymed. “Amen,” I said to her, as Mummy beamed.

 

20 Comments on “The Surgical Tunnel
  • gurudutt bhat says:

    Super as usual mazda. Thanks for brightening our sunday mornings with your stories.

    Reply
  • Supriya Correa says:

    Between Mummy, Jo, Francis and Jesus, the Macks adore you. Time to buy a house in Bandra and pig out on steaming sorpotel and sannas with your new favourite tribe. With Easter round the corner, there’s place for a second Risen Lord. Amen.

    Reply
  • Eusebio Aranha says:

    And my favourite: All neurosurgeons are dashing.
    👌👌👌😂🤣😅

    Reply
  • Natwar Panchal says:

    Great Dr. Mazda….

    Reply
  • Kersi Naushir Daruvala says:

    Dr Mazda I envi you, your skills as a doctor far outspace then your words you tell your patients. I am more on the mechanical side in my profession but curious to know the fundamental of Neurosurgery.
    AMEN.

    Reply
  • Temitayo says:

    Dear Dr Mazda Turel,

    Its always thrilling reading from you.

    Being a patient myself, I would very much like to express my sincere gratitude for a successful Lumbar Decompression Surgery in May, 2023.

    Your skill and expertise have made a significant positive impact on my well-being.

    Thank you for your dedication and professionalism.

    Reply
  • Temitayo says:

    As always, well-detailed account of a successful Carpal Tunnel Surgery – informative and reassuring.

    Reply
  • Mahashweta Biswas says:

    An eye opener for all of us to not ignore wrist pain, tingling in the fingers. Very well written. Mummy was quite a highlight

    Cheers
    Mahashweta

    Reply
  • Liz says:

    You are indeed dashing Dr. Mazda and I will add loving, caring and warm too. Its great to know you and have you as our Doctor!! God Bless You and your Family abundantly!!

    Reply
  • Dr Upma Jaiswal says:

    Beautifully crafted story around carpel tunnel syndrome and discreet description of the disease.

    Reply
  • Vipul Shah says:

    Dearest Dr Mazda sir ….

    It was wonderful peace as usual on your magical fingers & Tongue of course……..

    I was pleasantly surprised bcos I was under wrong impression that you do only brain & Spine

    Now I realize that you can take care of any nerves 😳

    Good Luck & God bless sir 🌹

    Reply
  • Vipul Shah says:

    Sorry

    Piece ……..

    Typo error

    Reply
  • Setu Ram says:

    A Masterclass on Carpal Tunnel Syndrome
    Now everyone is a desk warrior ..some are malicious spewing nonsense all over the internet

    Reply
  • Rita singh says:

    Loving, able, dashing and caring, human beyond words. We love and appreciate your every move. God bless you.

    Reply
  • Gloria Msampha says:

    She is lucky she will be able to keep her job so that she can look after Mummy.

    Reply
  • Pilloo says:

    You treat yr patients with soo much compassion &operate with such ease…God must be on your side and you must be his superhero on earth!may god continue to bless you to do his work on us mortals!!

    Reply
  • Anjali Patki says:

    Your subtle sense of humour and keen sense of observation makes your articles both interesting and entertaining.

    Reply
  • Dr. Rafat Ansari says:

    Indeed ….All neurophysicians r dashing…u r a favourite amongst all !

    Reply
  • Vineeta says:

    Doc , you are dashing, daring and droll ! Awesome combination.

    Reply
  • Di says:

    As always a well written article… In this one mummy is the best character… Looks like you can skillfully deal with all the nerves of the body… And my favorite: all neurosurgeons are dashing lol… Am sure they had a good previous experience with you hence they trust you and came back to you.

    Reply

Leave a reply

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