It was a routine summer night and what I was going through was the most hectic part in any doctor’s career, that is the first year residency and that too in the Department of Pediatrics where your sweat is the only perfume. Early in the morning at around 4:45. A.M, a middle-aged man came running into the Pediatric casualty holding his eight-year-old daughter in his arms. His face had a worry. He too was sweating and I can say it wasn’t just because of Summer. His eyes were filled with tears that were fighting to come out but his manliness stopped them from rushing out. All he could say was – Doctor, my daughter is having severe abdominal pain and has also vomited ones. His voice had a mixture of worry, panic and whatnot emotion.
My co-resident, Dr. Ami, was about to examine the patient when the patient shouted at the highest pitch of her voice and all of a sudden her eyelids fell off, respiratory rate decreased, heart rate fell down from 120 to 40. Immediately, the patient was shifted to PICU intubated and put on ventilator. Her name was Rani – the beloved daughter of her parents – who had almost no clue what had happened to their daughter overnight. Till yesterday, she was their sole entertainment; playing and wandering around the entire day. They even had to scold her to slow down her enthusiasm and today she could not even breathe on her own and needed the support of the ventilator. Both her hands were pierced with IV cannula, her mouth from which she would say jingles was now just a passage for endotracheal tube.
She underwent all the investigation but to our great surprise every report came out to be normal. All relatives were inquired strictly to find out if anybody has intoxicated her. 24 hours had passed by. All possible investigations were done and we were still clueless about the diagnosis and her condition was deteriorating with every passing second. That evening when we were about to finish our work in the ward, Rani’s 4-5 relatives surrounded us and angrily asked that if the reports are normal then what has happened to their dearest Rani. We had no answer to the question. They decided to shift Rani to a private hospital, but their thought of shifting her could not turn into success because any Private Hospital will think a thousand times before taking such a serious patient under their Shades. At last, they decided to keep Rani in our government setup only.
The only major investigation that wasn’t done yet to find out the reason for her unconsciousness was an MRI. Though doing the MRI of an intubated patient is very risky, we had no other option. Oxygen cylinder and stretcher were made ready. And finally, I and my senior Doctor Jayant headed towards the MRI room while providing respiratory help to Rani by bag and mask ventilation.
During that short Journey from PICU to MRI room, I constantly kept on looking at Rani’s face and all I was repeating in my head was no matter what this patient must survive. During the 15 minutes in MRI room, my one hand was constantly giving her ventilation by bag and mask and the other hand was kept on her chest to feel her heartbeat. Amidst, all these thoughts MRI was done and Rani was again shifted to PICU and kept on ventilator. Now, everyone was eagerly waiting for the MRI report to come to a diagnosis.
Everyone was shocked when it came out to be normal. Again, we were at the same place from where we started, we were clueless, but we could definitely not just sit like that or else what is the meaning of all these qualifications? Dr. Jayant and we all had one doubt since the time we admitted Rani and just to clarify that we did a neuro-physician reference. Our neuro-physician, Dr. Harsh sir examined Rani and within no time he said that it’s a case of a snakebite that too a viper snake. We had this doubt from the beginning but there weren’t any bite marks. Dr. Harsh sir showed us a bite mark just above her right knee that became apparent due to blood deposition in the last 24 hours and was not visible at the time of admission. Dr. Harsh sir has shown us the path but to run ahead on this path was our duty now. Immediately, Dr. Jayant sir gave an ASV injection that is anti-snake venom injection to Rani followed by two-hourly injections of ATROPINE and PHYSOSTIGMINE.
The response was shocking. Within eight hours Rani started doing movements of her limbs. After 24 hours, we were able to wean her off the ventilator. Her relatives and we all who had saddened faces since last two days were now filled with hope. After three days, Rani opened her eyes and the first word that she uttered from her mouth was
“mummy”. For her mother, it was like Rani has taken birth again. Her eyes were filled with tears. But this time they were the tears of joy, the tears of happiness.
When Rani was recovering, I slowly went to her and asked her that dear, did you have a snake bite?
She innocently answered that yes, Dr. Herat while I was in school, two days before, I was bitten by a lizard. I laughed inside at her innocence that this little girl does not even know the difference between a lizard and a viper snake. But thanks to God, she was recovering and we shifted her ward. Every time I would go to take my routine Ward rounds and come to Rani’s cot, she would say that Herat Bhai, I want to eat Samosa and then all of a sudden she would burst into laughter.
Her laughter was all that I needed to toss off the tiredness of my entire day of emergency Duty. She was discharged after two days. We all were very happy, her parents seem to be satisfied with the treatment that we gave to their daughter. After around 15 days while I was sitting, filling up my routine file work in the Pediatric Ward, I heard a sweet little voice from behind – “Herat-Bhai Meine samosey khaa liye hain”. I turned around. It was a sweet little girl of around eight years wearing a red dress with earrings and matching bangles and that immense smile on her face. I knew she was my fighter, my own fighter – Rani. I must say that that was the moment, I realized that my pediatric residency is worth everything.
