Round Three: Tricks My Mind Plays

A friend said something the other day that made a tremendous impact. She said despite the remarkable progress made by medical science and the precision of cutting-edge diagnostic tools, doctors are unable to accurately predict the exact timing of the birth of a child.

Isn’t my case a little similar?

But first, let me explain the gap in my blog series, when I have loads of information to share with organ transplant recipients. What a treacherous path is it, strewn with unmarked bolsters that often spring up seemingly out of nowhere, despite my valiant attempts at maintaining a modicum of sanity, as I hang on for dear life to the fine threads of life that hold me to the planet and everything I value here.

Truth be told – I had a lapse last week that took me to Kokilaben Hospital and back. 

Back from Chennai, I had not recovered fully from the physical and mental exhaustion of the past month's assessments and pre-screenings --- "work up" -- as an organ recipient, when brushing aside my family's counsel, I launched myself fully into a career overdrive again, determined to check off a long list of pending tasks and pick up the chords of my life, where I'd left off.

Fact is it’s easy to say "take it easy" or "maintain what you have; look no further” when you don't have huge medical bills to pay for life that you take for granted; when you have nothing but the most difficult of choices staring you in the face, at the halfway point of your life.  

In the line of my unfinished agenda, of what, in retrospect appears to be an inanity, I convinced myself that a short haul to Ahmedabad was something I couldn't possible miss out on, should anything happen to me in the OT. That I had to be physically present to monetize an agreement with a business partner, in whose Road Travel Assistance mobile app, I’d picked up 15% stake; so off I went, accompanied by my assistant on an early morning flight to Gujarat’s capital. As the day wore off, my batteries, that had already been hovering at their lowest ebb, after the preceding few months’ ins and outs of the various hospitals, also started wearing thin,

I started to give in and found myself dosing off at the security check, on board Jet Airways, waiting to get my bag checked in, waiting in the queue at Cafe Coffee Day for a steaming cup of coffee; while taking down copious notes of points I needed to draw my business partner's attention to, so on and so forth.  So was it any surprise when I reached home that night around 11 pm, I was tottering on my feet, after a day’s whirlwind trip?

I vaguely remember 'what'sapping' my daughter's new medical prescription for infantile eczema, that didn't make much sense to my sister on phone (Because I was mailing her a wrong set of pix), so we decided to do the exchange the next day and I crashed on my bed. I must have slept for close to 15-16 hours, at a stretch, on the minimum.

The next day was business as usual, and by night fall, I remember feeling hugely pissed off at my father for insisting that we fix his TV remote first so he could watch the ongoing cricket series, when I could only think of my two days of sleep deprivation.

When I was unable to fix the remote, I went to seek my neighbor’s help; the help of my daughter's tutor, who was about winding up her session with Arzoo to finally realize that I hadn't charged my Tata Sky's second TV ID. I did that and the series came crackling back to life on the dead screen. My dad was pleased as a punch and back at his favorite perch on the couch.

My last memory of that night is of falling sleep with my daughter circled up beside me.

Then there is an absolute abyss. No memory of what happened over the next 24 hours, except that there was a stream of familiar and unfamiliar faces swimming above and before me - gloved hands, white over alls and menacing faces donning surgeons’ masks.  

Was it really happening or was it a figment of my delirious mind? 

I thought I was arguing with my sister, attempting to brush aside my bro-in-law’s gentle protests, shove away unfamiliar hands and fob off, with every ounce of strength I could muster attempts to pin me down and hold me to my bed, finally overcome and handcuffed. 

Apparently, what hurt me most was that I was unable to reason with my sister; as she appeared to be siding with those masked bunch of hoodlums in restraining me against my will to my bed. My caustic mimicry of her concern cut no ice. "Hush! Easy....Is that required?" she inquired as I made nasty faces at her. There was no reasoning with those burly men and that made me so mad at all of them, including my sister. 

When I came round to my senses about 16 hours later, I was calmer and stable but with no memory of the chronology of events that preceded. 

“What happened?” my doctor Gaurav Mehta’s reassuring face came into focus and all I could do in response was sob bitterly, my body wracked by waves of misery, as I pulled out my bandaged limbs – “See what they have done?” I also felt, for the first time the prick of my feeding pipe, through which doctors had tried to give me fluids during those 16 hours of deep sedation. 

"She is so offended. Please remove the handcuffs," my doc told the paramedic staff," and in that one sentence I found some of my dignity restored. 

My two days stay in that white space - where you have no moorings of the past or the present; where speech doesn't match thought; where memories melt away into a fuzzy head; where your drug-addled mind and semi-delirious state loses all context caused by a malfunctioning liver - I discovered during those 16 hours, the scariest place on earth. 

Gradually, over the next couple of days, with my medical team's and family's help, I was able to re-construct the chronology of my 16-hours' stay in that no mans' land.

What had happened was that the day after I returned from Ahmedabad, my daughter found me completely zapped; almost knocked off - on my bedroom floor, sitting with my head in my lap, curled into a ball. 

She tried to shake me out of that temporary amnesia, sensing, even as a 13-year-old that "something was amiss" but when she couldn't revive me, she hurried to call my sister, who came rushing with her husband and two children.  

Half an hour later, an ambulance wheeled me away to Kokilaben, where I continued to kick and fight the paramedics' attempts to conduct me to the waiting van.  

"I am fine. Nothing is wrong with me," I vainly, patiently and elaborately tried to string together a coherent sentence, but what came out were a few garbled sounds that made no meaning. My daughter burst out in tears. My dad and other members felt scared. They had always known me as a logic-driven, rational person. They did not recognize this new entity.

"It's normal in a liver-compromised patient," the paramedics, and much later, my doc tried to calm my family. They sounded indifferent, although the connection between delirium and liver malfunctioning is so tenuous; it’s difficult to explain it to a lay mind. 

What happens is that liver is the main de-toxifier in the body. That is the official portfolio assigned to this organ holds in the hierarchy of other organ functions. And when this organ with its tentacles of bile ducts becomes lax at its main responsibility, there is an alarming amount of toxin built-up in the body, leading to a state of mindless delirium. 

With a heavy doze of antibiotics, tranquilizers and sedatives, my doctors were finally able to de-toxify my stomach. 

"What can a patient do in such a state?" I asked my doctor, reminded of recent sporadic episodes of selective amnesia; the abrupt mood swings; the desire to sob my heart out; punctuated by sudden bursts of superhuman energy, ability and desire for activity....memory lapses, I'd been too shamed and confused about to admit, even to myself. They finally began to fall in place. 

In vivid detail, I recalled another, recent terrifying episode. We were at my sister's place for dinner and I "accidentally" managed to lock myself inside the washroom. Unable to turn the latch, I grew anxious and confused by the second, until my equally anxious family on the other side had to call in a locksmith to have the door break open. 

When I stepped out, their mouths fell open. "What's the big fuss about?" I said. "Why did you need a carpenter?" I quizzed. "Nothing. You just got locked in," said my bro-in-law, throwing a protective arm around me and no one discussed the incident, thereafter.  On another occasion, I casually threw my daughter's prescription away after sending out of focus pix of it to my sister.

Never a fussy eater, the day before, I pointedly refused to have chick pea salad that I am otherwise very fond of, insisting with a poker face that I'll have everything except "that" knowing very well the trouble my sister had taken in preparing it. 

"Is there no way to prevent such incidents in future?" I've asked my liver specialist.  

"Sure, there is. Don't let toxins build-up to such an acute level. As a liver patient, you must empty your bowels at least three to four times a day. I am going to write a laxative for you."

I gaped.

Was he kidding?  

"That's it?" - A laxative?

"Yes," he said. "I prescribe it to all my patients on the organ list. It's very effective. With time, you will be able to self-monitor and recognize the signs of toxin pile-up and regulate your life, accordingly."

"If it has such a simple fix, why didn't you try telling me before-hand?" I wanted to scream. But thought against it, as the realization sank-in that the protocol is still in the works. Perhaps it’s still being developed as I write about liver transplant - at the cusp of medical science; at the cross-juncture of what is known and not known.

I take my laxative every night now. I shudder at the thought of slipping into that non-defined space before surgeons can give me an intricate patchwork of bile ducts woven into a quilt pattern with a cadaver liver. Will the cobwebs in my head, altogether clear out then?

Already, there is an obsessive-compulsive response to my bowel movements at home. My family has coined a new code-phrase for it - "Did you go to London, today?" My bro-in-law thinks it’s more discreet than a direct line of questioning about my motions.  

It's been slightly more difficult to explain the episode to my daughter, whom I now catch looking at me rather oddly, at times. "Missing you Mama. .....I hope....you won't do those things again..." she said on phone, on the day I was getting discharged from the hospital. "What things?..." I taunt...

"Well....you know..." she hesitates.

Having been there and back, I understand her fears. 

On my discharge day, while my nephew, who had come to fetch me, went down to settle the bill at the counter, my doc came to see me on his morning round. "It's so confusing. Every time, I see you, you are surrounded by new people. Who are they? Family, friends...?"

"Both," I respond smugly, amused, that even the know-all doctor can feel confused. 

I throw a final look at my Spartan hospital room - huge and spacious, with drips and tubes still tied to the bed, and last evenings' neon lights filtering in.

It was the World Organ Donation Day, the night before - the day I lay in my bed handcuffed, waiting for life to feel normal again.

"But of course, the cadaver doesn't know the significance of the Day," my doc took a weak crack at the macabre situation that wasn't lost on anyone.