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Year : 2023  |  Volume : 3  |  Issue : 2  |  Page : 132

The Last Bouquet

Department of Pediatrics, Choithram Hospital and Research Center, Indore, Madhya Pradesh, India

Date of Submission01-Oct-2022
Date of Decision28-Feb-2023
Date of Acceptance06-Apr-2023
Date of Web Publication24-May-2023

Correspondence Address:
Dr. Gouri Rao Passi
No. 139, Indrapuri Colony, Indore, Madhya Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ipcares.ipcares_234_22

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How to cite this article:
Passi GR. The Last Bouquet. Indian Pediatr Case Rep 2023;3:132

How to cite this URL:
Passi GR. The Last Bouquet. Indian Pediatr Case Rep [serial online] 2023 [cited 2023 Jun 3];3:132. Available from: http://www.ipcares.org/text.asp?2023/3/2/132/377512

He peeped up at me sheepishly. Sparkling white teeth flashed in a dimpled smile. “This is for you,” he said giving me a bucket full of water. Sunlight glinted off the silvery scales of shiny fish swimming insouciantly inside. Two weeks ago when he had rushed into my room, with tattooed arms and long flying hair, he had looked positively menacing as he shouted “Doctor! Save my brother.”

My heart thudded uncontrollably as I went to examine the body unceremoniously flung on the examination table of the peripheral clinic where I was interning. The patient, a young boy, had been sleeping on the floor of their hut, when he had cried out in pain. His brother awoke to see a cobra slithering away. Now his foot was swollen and ominously red. I struggled to recall memories of long forgotten classes on the management of snake bite. There was something about the pressure immobilization technique having replaced the deadly, but ubiquitous tourniquet. I snatched up a gauze roll and carefully started binding his foot, starting from his toe.

I had barely completed the task when I noticed my patient's eyelids were drooping and he had begun drooling. I cursed silently as I realized that neuromuscular blockage had set in and there was no laryngoscope, endotracheal tube and of course no anti-snake venom! “Ambu bag,” I yelled. Omar, who oversaw the tiny pharmacy rushed to retrieve it, still intact in its virginal packing. My patient was taking shallow breaths and his lips were mauve. I started bagging him sending up silent blessings to the curmudgeonly registrar in anesthesia who had insisted that we master resuscitation. Is there anything more beautiful than the sight of a steady rise and fall of a human chest?

The district hospital was 4 h away. Time dilated as we settled on a make-shift cot on a bullock cart. Sweat trickled down my back as I focused on ensuring that the mask did not leak. We crept on interminably slowly. Was I in trapped in some Kafkaesque dream or was this scorching sun, erratic bumps, swirling dust, and flies real? My memories of reaching the hospital are hazy. The child was intubated and transferred to the intensive care unit. Anti-snake venom and supportive care did the rest. Back in the village I became an unexpected hero; and continued to be presented with the finest illegally caught fish daily for the rest of my rural posting.

Let me share another poignant story. It was a Sunday afternoon when I opened my door to the unusual sight of two police officers who said brusquely, “You are needed in the hospital immediately.” Enroute, I was provided with the lurid details. A young boy involved in chain snatching had spent the night in custody. In the morning he was found gasping and was admitted to the hospital where I worked. When I saw him, he was covered in bruises. A cursory examination detected shock. The team sprang into action-central lines, intubation, ventilation, fluids, blood….all the mantras that intensivists live by.

An angry crowd had gathered outside, and the local media was quick to smell blood. Injustice is a hard morsel to swallow especially when you are starving. The pressure was on us to work miracles. Every day was a fresh challenge-an unexpected pneumothorax, renal failure, extradural hematoma, even tracheostomy failure. It was a month before I could speak my first truly honest line with confidence, “Your son will be fine.” His mother looked at me intently to gauge the quality of my truth.

When he was discharged, I found a bouquet of the loveliest flowers on my desk. A curious motley of everything-roses, orchids, lilies, gladioli, gerberas. “His mother was a roadside flower seller,” my resident told me softly. “Was?” I questioned, absently. “Her shop was bulldozed yesterday to make way for the new highway. This was her last bouquet.”

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