Dr Viswanathan Iyer, Brain and Spine Surgeon, Qualilife Brain and Spine, Mumbai.
In the year 2011, I started cycling to keep myself fit. I had tried running, but it did not enthuse me. The closed air-conditioned environs of fitness centres were too boring and monotonous for a fidgety person like me. But I took to cycling like a proverbial duck to water. The distances increased, I made new friends and took on new challenges. Like every runner who wants a 10k-15k-half marathon graph, I increased my distances 15k-40k-70 k over 2-3 years. I started visiting hospitals at night and on Sundays by cycle and raised many eyebrows!
Come July 2015, I enrolled for a 200 km cycling event called the BRM 200 km from Borivli to Charotee and back. I cycled 1100 km from July 2015 to November 2015 to prepare myself for the challenge.
On the D-day, 14 th November 2015, the event was flagged off at Borivli. I covered 100 km in 4.5 hours and was cruising comfortably. My ride came to an abrupt end at 149 km as I was victim of a “hit and run” at Manor. According to eyewitnesses, a tanker knocked me off the road and sped away.
Luckily for me, a passing ambulance attended to me within 10 minutes and I was on the way to a nearby hospital. I thank my stars that I was conscious enough to guide my own treatment. My surgical training at the trauma centre of Lokmanya Tilak Hospital kicked in and probably saved my life. The ambulance was just a transport vehicle and no treatment was done. At the local hospital, staff and RMO were ill-prepared to handle acute trauma. No cervical immobilization was done. I had to advise them to start IV fluids through a large bore IV access. Maybe the combination of acute trauma victim who himself is a neurosurgeon flabbergasted the casualty staff. Acute care during the golden hour which we keep talking about is a distant dream. Ambulances should be equipped to give acute treatment and all medical personnel should compulsorily get ATLS training.
Once I was stabilized, I was shifted to a hospital in Thane for further care. Radiology revealed multiple fractures in my pelvis and un-displaced fractures in my cervical and lumbar spine. As a doctor, we have access to the best opinions and advice. After all the initial confusion and panic, we decided to follow the advice of ONE orthopedic surgeon with full faith. Retrospectively, I feel that helped fast recovery. Taking many opinions is a right of the patient, but he must ultimately choose one doctor he trusts and take his advice completely.
Treating physicians tend to underplay the role of allied specialists like physiotherapists etc. I have started respecting their role in patient care much more due to my journey with them. If we emphasize their role, our patients will realize the importance of allied care in recovery. Medicine is not a “one man show”
As a doctor, we are trained to analyze issues and make practical solutions. The check-list system which we use in surgery was put into place during my recovery journey. Each event was recorded and each milestone celebrated. The desperate urge to get back to work and operating room spearheaded my speedy return to full activity. Few patients called and actually said “Doctors have no right to get sick and take leave. We need you”. I owe my recovery to them.
At 45 days, my treating surgeon allowed me to start OPD on wheelchair. It was the news I was waiting for. But I was appalled at the lack of wheelchair access on the roads, buildings and establishments. Simple things like visiting a restaurant, taking a haircut, needed the help of few men who carried my wheelchair on potholed footpaths and across access stairs. Modern buildings had lifts, but reaching the lift from the car was an ordeal. Smooth roads, ramp access are a distant dream for the differently abled of our country. A temporary one month on wheelchair made me more empathic to my patients than so many years of practice.
Did I learn anything? Did I stop cycling? I sat on my saddle on Day 65 post accident and I have cycled 15000 km since. All surgeons face complications during procedures. Do we stop doing that procedure? We learn and we move on. We try to avoid the same complication, but we don’t give up.
I am one of the lucky few who had a road accident and recovered completely to join all professional and sport activities. It is a like a past history with no significance to the present. But I don’t want to erase the journey. It has thought me the value of healthy life. It has made me understand the problems of patients better. The lack of golden hour care, trauma centres increase the morbidity and mortality of trauma. It is time we start demanding equal rights and accessibility for the differently abled. Respect for quality of life should also be our responsibility.
Last but not the least, one aspect which bothered me on Day 1 was the thought of “How will I pay my EMI’s?”As doctors, we do not have medical leave and no one takes care of our medical expenses. We must have financial planning to manage a rainy day.
“Hope for the best, but prepare for the worst” is a dictum we surgeons swear by.