Where one’s pain is another’s gain :

The Hindu
08.06.2013
CITIES » KOCHI

Where one’s pain is another’s gain :
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NIDHI SURENDRANATH


The myth of the Kerala model of development was built largely around the promises of universal education and health care. Now, teaching and treatment shops dominate these two sectors creating billionaires in every city. Still, the horror story of a Kochi photographer is unparalleled.

R. Vijayakumar, a former journalist and the proud father of a medical practitioner, walked into a city hospital with fever early in February this year. When he left the hospital in April, he was taken out on a stretcher, his muscles wasted, his voice silenced and the family poorer by Rs.15 lakh.

Things started going wrong on January 31, the day his son Rahul had a freak accident at home. Rahul had bumped his head on the bed while jumping out after a nap. He was admitted to a prominent city hospital, known for its emergency care, with a minor internal injury to his head. The doctors said Rahul was critically injured. “Steel your mind to face any eventuality,” a doctor told a distraught Vijayakumar. Though, Rahul got out of the hospital and went home healthy a week later, Vijayakumar didn’t expect to be a victim of the health care business actually tying him down to a hospital bed for close to three months.
Vijayakumar got fever while staying at his son’s bedside. He was worried that Rahul, an MBBS graduate, would miss his entrance examinations for a postgraduate seat. Rahul was also scheduled to start working at the same hospital in February. The stress of his son’s injury, coupled with the responsibility of managing his photography studio and household chores took a toll on Vijayakumar and his fever grew worse.

He was admitted to the same hospital four days after his son was, after he bit his tongue at night during a severe bout of chills. Vijayakumar was driven over to the casualty department around midnight. The doctors administered preliminary care and Vijayakumar felt better right away. Around 3 a.m., the doctors said that he would have to be admitted. Vijayakumar resisted, saying he did not want to get admitted and that he had to take care of his son. “When he said he wanted to leave, the hospital staff pinned him down and gave him a sedative injection,” said Libu, Vijayakumar’s friend, who had taken him to the hospital.

Rahul later found that his father had been sedated with Serenace, a trade name for Haloperidol, an antipsychotic drug usually used to treat patients suffering from acute delirium and psychosis. Vijayakumar says the hospital staff would put him under sedation every time he regained consciousness. “He was always sleeping whenever I went to visit him at the ICU. We were really worried,” says Bindu, Vijayakumar’s wife. The drug was administered without consulting the hospital psychiatrist, who was on leave at the time. Vijayakumar was at the hospital for 11 days, during which he developed Neuroleptic Malignant Syndrome (NMS), a potentially fatal condition known to be a side effect of Haloperidol.

“NMS is a prominent side-effect of Haloperidol. A patient who was delirious due to fever would be extremely sensitive to the effects of the drug. Ideally, a psychiatrist should be consulted before administering such drugs,” said a city psychiatrist, who did not want to be named.

The family did not inform Rahul, a trained doctor, of his father’s condition as he was still recuperating from his head injury earlier. “If they had told me, I may have been able to prevent what happened,” says 26-year-old Rahul.

Doctors at the hospital said his father was mentally ill. The family took Vijayakumar to a psychiatric hospital where the doctors completely ruled out mental illness. Vijayakumar’s psychosis was temporary and induced by his fever, which the earlier hospital had done nothing to cure. The psychiatrist stopped Vijayakumar from taking a bunch of anti-psychotic drugs that the first hospital had prescribed. The family then took Vijayakumar to a third hospital for treatment. While the psychiatrist there confirmed that Vijayakumar’s psychosis was fever-induced, the neurosurgeon had other ideas. He said the 51-year-old was suffering from a rare disease called Paraneoplastic Limbic Encephalitis, a topic of special interest and research for the neurosurgeon. From there, things went steadily downhill. Vijayakumar was treated for the disease without any evidence to prove the illness. The doctor administered IV steroids, and withdrew them suddenly when the tests came back negative. Vijayakumar almost lost his life at this point and the family saw no option but to take him back to the first hospital, this time critically ill and near death.
His trials did not end there. He was confined to the ICU for 32 days. This time, he had severe pneumonia and had picked up several bacterial infections due to his prolonged stay at the hospital. The doctors prescribed several high-end drugs to which the bacteria causing his illness were resistant. He had been put under the ventilator for three weeks. The negligence of hospital staff was the only constant. Bindu had the shock of her life when she went to the ICU to see her husband one evening. “Everything looked fine from the outside. His sheets had just been changed and they were tucked in neatly. But all the monitors displaying vital signs showed question marks. I called the nurse and when she pulled back the sheets, he was lying in a pool of his own blood,” says Bindu. Blood from the open cannula (a tube that is inserted into the body, often for the delivery of medicine) on his veins was dripping out onto the hospital sheets. In a few more hours, Vijayakumar would have bled to death in the critical care unit of one of the city’s top hospitals.
Vijayakumar’s family was furious. When they questioned the careless attitude of the hospital staff, they were threatened by the management. As soon as his condition stabilised, they took Vijayakumar out of the hospital.

“We got him back alive. That’s all we were hoping for at the time,” says Bindu. After spending around Rs.15 lakh for treatment, Vijayakumar’s muscles had atrophied and his body was nothing but skin and bones. He could not walk.

It is now a month and a half since Vijayakumar got out of the hospital. He has been undergoing Ayurvedic treatment and can now manage to walk a few steps without support. Rahul, the young doctor in the family, is prepared to fight against the rot that has entered his chosen profession. “These doctors and hospital managements are cheating poor people. That cannot be allowed to happen,” he says. Vijayakumar is resigned to his fate. “It’s all business,” he says, his voice hardly rising above a whisper.