A brush with ‘Stroke’.

Voltaire said ‘uncertainty is an uncomfortable position. But certainty is an absurd one’. The most beautiful thing about Life is that it compels you and forces you to embrace uncertainty when something completely unexpected happens that ends up making you richer in spirit and strength. It is true that some of the most beautiful chapters in our lives won’t have titles until much later. This chapter is one such. Having travelled more than two million miles in my business career spanning over 35 years I thought I was so travel savvy that I knew everything that there was to know about flying. As it happens more often than not, I was wrong.

It was 10:45 A.M. on the 26th of February 2015. The ringtone on my cell phone disturbed my moment of savour of my profit from selling eight hundred Infosys shares that I had bought a week earlier. I answered without looking at the display.“Mohan, it seems my father had an attack or or something and has been taken to the hospital at Jaisalmer”said my wife Mamatha with a voice that was pressured as she tried hard not to sob.

“His friends had called. Can you please take down these two numbers?” It took a couple of seconds for me to come to grip with the news. I was already aware that her father had gone to Rajasthan along with his octogenarian friends. I did not ask any question.

“Tell me”, I said, stretching my arm across my big mahogany table for the scribbling pad with my right hand and taking out my pen from my shirt pocket. “Gopal and Krishna are the names of his friends and their numbers are………….” she gave me the numbers.  “There is another close friend of my dad who is from Rajasthan but who lives in Bangalore and is co-ordinating the events with them. His name is Madan and his number is…” I repeated all the three numbers.

“Rajiv is in a state of shock and is hopelessly lost” she said of her younger brother.

I will take care Mamatha. Don’t worry. He will be fine. Let us first find out what exactly has happened”.

I called Gopal first.

“Hello, Mr.Gopal. This is Mohan here, Rangaswamy’s son-in-law”.

 “We are relieved to talk to you, Mr. Mohan. We wanted to take some quick decisions and we called his son Rajiv. He asked us to get in touch with you instead.”

“What exactly happened?” I asked.

 “This morning all of us boarded our bus at around 9 after our temple visit and started for our next tourist attraction from Jaisalmer. I was sitting right next to Rangaswamy. A few minutes after the bus left our hotel, I noticed that he was dozing with his head bent in an awkward way all the way down. I thought he must have not slept well and was catching up on his sleep. An elderly lady from our group got up and started distributing temple Prasad to everyone. Noticing Mr. Rangaswamy dosing she called out to him in a loud voice shaking him by his shoulder. He did not respond”.

Gopal coughed mildly and continued, “I too tried to wake him up by shaking him. I got worried when he did not react at all and looking at his drooling mouth and slouched shoulders, shouted out to everyone that something was wrong with him. We all huddled around him and asked the driver to stop the bus. We discussed and felt that he must have had an attack of some sort and needed to be taken to the hospital.

“Where are you now?” I asked him.

“We are at Jaisalmer. We returned and took him to the only hospital here. It is a primary health centre with no facilities. I am still there with him at this tiny clinic.  They have given some injections and are advising us to take him to Jodhpur, which is a five-hour drive from here. Fortunately, there is an ambulance available. The driver of the ambulance is willing to take us if we pay six thousand rupees. Since the hospital is full of swine flu patients, I feel we should move him out of here but we are in a dilemma if we can transport him or not since if it is a stroke it could be very risky to move him. We wanted his son to tell us what to do but he asked us to contact you” he said excitedly.

 “How is he doing?” I asked. “He regained consciousness a few minutes back. He wants to get up from the bed and walk and keeps saying he is OK. But he is not OK. He cannot even lift his leg. We are in a fix. We do not know what to do” he paused.

I could sense that the decision made to transport or wait could have a life or death consequence and it was this responsibility that was making them extremely shaky.I had to think fast. Between helplessly convalescing in swine flu ridden  tiny clinic with no OT or ICU and going to a big hospital in an ambulance, the latter was the only logical choice.

“Please go ahead and take him in an ambulance to Jodhpur. I will take the next available flight and come to Jodhpur.”

“There are only two hospitals in Jodhpur as per Mr. Baltota. Which hospital do you want us to take him to?”

I said I would get back to him.

“I will be there within the next 12 hours. Please do not wait to shift him to Jodhpur in an ambulance”. I reiterated.

“But what do we do if something happens during the 5 hour drive?” he sounded shaky.

I raised my voice slightly and said very emphatically “Since he is conscious I do not foresee any problem. Please leave Jaisalmer at once for Jodhpur. I will take the responsibility for the consequences.”

“Ok. We needed someone from his family to confirm that”.He sounded relieved. I hung up wondering if I would also end up as tight assed as him after 20 years.

I gaveMamatha an update and booked two tickets—one for me and one for Rajiv—from Bangalore to Jaipur since there were no direct flights from Bangalore to Jodhpur.

After discussing the various options at Jodhpur with Mr.Madan we finally decided on Sri Krishna Super Speciality Hospital (SKSSH). I called Mr. Gopal to take my father-in-law to Sri Krishna Hospital in Jodhpur. They were relaxed since my father-in- law was sleeping peacefully.

I went home, packed a few clothes and left for Bangalore immediately. I asked Rajiv to take the printed e-tickets that I had mailed from my office and asked him to come directly to the airport.

I kept in touch with Gopal throughout my journey and sought hourly updates on my father-in-law’s condition while on their way to Jodhpur in the Ambulance. Suddenly as I approached the airport they both started giving me confusing and alternating statements about my father-in-law’s condition. I started feeling afraid that my father-in-law was a couple of inches away from Death’s door.

Rajiv joined me at the departure terminal. We exchanged very few words after I consoled him that everything would be OK with his Dad soon. I googled about the hospital where my father-in-law was bring taken while waiting at the gate only to learn that four male nurses had died at the same Hospital the previous week from an attack of a strange and deadly virus. All sites warned all visitors to Jodhpur to wear masks. I started playing Black Jack instead.

The flight was smooth and Rajiv who was completely shocked and speechless in the beginning relaxed midway through the flight. “Where was the need for him to take this trip? He is 78. He should have stayed put at home”, he said airing out his helplessness and trying to cope with his anxiety. We landed in Jaipur at exactly 8:00 P.M. A Toyota Innova that looked surprisingly clean for an automobile from that part of our country waited for us at the arrival gate along with an impeccably clad driver in all white.

I called Gopal and found out that my father-in-law had been admitted to Sri Krishna Hospital. He was conscious and in the I.C.U under the care of Dr.Surana, a neurosurgeon. His speech however was very incoherent. Tests had been ordered out. It was a six-hour drive from Jaipur to Jodhpur and we reached Jodhpur at 2:30 A.M. and went directly to the hospital.

I had to be careful not to step on any of the several people sleeping at the entrance to the ICU before finally standing next to my father-in-law’s bed. He was on an I.V. but had no tubes in his nose or mouth. That was a big relief. I gently nudged his shoulder. He opened his eyes. “Can you tell me who am I and this guy standing next to me?” I asked him gently.

He slurred something totally incomprehensible first but cleared his throat and said again “What do you mean Mohan” barely audibly but like a guy who had a dozen tequila shots and smiled. He recognized both Rajiv and me instantaneously. That was a big relief. “Please go back to sleep. I will see you tomorrow,” I said.

I checked in at Taj Vivanta where my son Rahul had booked a double room.I hit the cosy and wonderful sack at 3:30 A.M.

I got up at eight and headed straight for a quick breakfast with Rajiv, ordering a cab on my way to the restaurant. After a disappointing breakfast of over-spicy Parathas, we left for the hospital.

The hospital appeared more like a motel than a hospital and except the staircase at the main entrance to the hospital every other piece of land around was water logged with slippery and slimy mud.

Both Gopal and Krishna were sitting on plastic barrels in front of Sri Krishna wearing facemasks for swine flu prevention since they did not want to sit inside the hospital waiting room afraid of contracting Chicken Guinea or swine flu. Apparently, hundreds had died from the dreaded disease recently. They looked very comic.

Mr. Gopal looked like a supporting actor straight out of movies from the fifties with his tight T-shirt and his hanky tied over his neck and did not look like he was 74.Mr. Krishna was a frail but firm old man, bespectacled ,much older than Gopal and appeared kind and soft.

As if a competition was underway, both started out with their adventurous tribulations and their journey from Jaisalmer to Jodhpur in the ambulance, giving me details not only of the timely medical attention given by the duty doctors at Jaisalmer but also of their own negotiating skills and bargaining tactics with the ambulance owner having successfully saved me a thousand Rupees.They also thanked me for the food and lodging arrangements made by my office.

Within minutes I could make out that they were too eager to hand over the ‘Rangaswamy’ mantle to me as if they were handing me the Olympic torch. I expressed my gratitude, which I meant from the bottom of my heart, for here were two elderly gentlemen in their seventies having volunteered and taken on the responsibility of moving my father-in-law from a god-forsaken place like Jaisalmer to a slightly less under developed and less god-forsaken Jodhpur and for admitting him to the hospital.

When the CT scan reports arrived in the afternoon, I was told that there was no major internal haemorrhage in the brain and that my father-in-law had a very minor stroke. I sent the CT scans to Mamatha’s uncle who was also their family physician.

“Mohan I am not happy with the quality of the reports or the diagnosis. The CT scans show a major stroke. Please bring Rangaswamy to Bangalore immediately” he said as though we were talking about a kid with a fracture.

I thought about taking my father-in-law on a plane and the more I tried to figure out the chain of events of transferring him the more nerve wracking it seemed to be on a plane without access to emergency medical services.
It is important to know that transport destination dilemmas like this happen whenever there is a stroke victim. At what point is the extra distance to a much bigger facility too far to justify the extra transport time and the stress?

I asked Rajiv for his opinion. “I can take the bus. You can bring him in the flight” he said. For a minute I thought he was joking. But it turned out that he was seriously worried about the unnecessary flight charges.

“No. We will fly together” I said, “I will buy the tickets”.

I decided to take the next day’s afternoon flight exactly seventy-two hours after his stroke. I made the travel arrangements for the three of us from the hotel’s travel desk. I informed the travel agent to make wheelchair arrangements for an elderly man who was accompanying us.

I sought the advice and opinion of the neurosurgeon about taking Mr.Rangaswamy in a Van instead of an ambulance to the airport. Dr. Surana assured me that Rangaswamy was out of danger and that it was OK for him to be moved around in a wheel chair and taken to the airport in a Van. He assured me that he would give a proper discharge summary that would be required at the time of boarding into the aircraft. He asked me to bring him with me and drop by his house just before proceeding to the airport to take one more look since his residence was on the way to the airport. The flight was at 1 in the afternoon.

I had no idea that to take a passenger who was sick and dependent on an attendant, the ill patient needed a ‘Fit to Fly’ certificate.

We paid up all the hospital bills in cash of course since the Hospital had no swiping machine and asked the ward boy to prepare my father-in-law for discharge. Everything appeared to be going smoothly when suddenly the new duty doctor for the day shift arrived and refused to send my father-in-law with me in Toyota Innova Van insisting on Ambulance for his transfer. He categorically denied the hospital having agreed to send him in any vehicle other than the hospital ambulance.

“It is not even 72 hours since his stroke. I cannot let him go out in a van” he said.

I was sure that an ambulance arriving at the airport to drop off a passenger especially at a small airport like Jodhpur would catch more attention than a SWAT or RAW team and there was no way that the ground staff would let the passenger in. I was determined and confident of carrying him in a wheelchair along with me in a Van.

I called up Dr. Surana, the neurosurgeon. He spoke to the duty doctor and instructed in his capacity as a senior surgeon to let me take my father-in-law in the vehicle. The Duty Doctor glared at me and banged the phone but relented and handed me the discharge summary prepared by Dr.Surana. He warned me that I should first go to Dr. Surana’s residence immediately for a final check up and get clearance on my father-in-law’s condition from him before proceeding to the airport.

Toyota Innova had an independent passenger seat at the front but the rear seats could not be pulled back.After seating Rangaswamy next to the driver in the front row ( believe me. It was the most physically strenuous thing I have ever done in my life since Rajiv had to hang on to the Catheter)and fastening the seat belt around him, I called Dr. Surana. “Oh, sorry I am not at home. I am in the OT on an emergency. No problem. Just give the airport authorities the discharge summary and there will be no problem,” Dr.surana said in a typicalIndian style. Looking at my father-in-law’s improving condition his slurred speech and frequent dosing off notwithstanding I left for the airport directly with my cavalier courage and my self-confidence without a final check up. Luckily my father-in-law was not only willing but also quite calm and jovial.

I reached the airport and fetched the wheel chair that was fortunately available right next to the arrival hall entrance.  As I arrived at the check-in counter ushering my father-in-law in the wheelchair, he could barely keep himself erect or awake and would doze off and collapse sideways awkwardly. Rajiv and I kept straightening him. There were about a dozen people in front of me. I got the boarding tickets without any issue.

Security clearance posed no problems and as I approached the boarding gate. As we reache dthe check-in counter, my father-in-law almost toppled over once and I had to straighten him by pushing him standing erect with all my might and Rajiv steadied his catheter with as less motion as possible so as not to attract undue attention. After staring at us for quite a while, one of the staff at the Jet Airways check-in gate went inside to alert the flight Superintendent. I approached the check-in counter unfazed and with all my charm looking at the very pretty girl behind the counter. She asked me to wait and left her seat to check with her boss. I turned around to see a few passengers waiting behind me with irritated faces.

The handsome young man wearing an all-white uniform with buttoned flaps on both his shoulders came storming towards me from inside and said, “Sorry, we cannot allow such an unfit passenger to board the plane. You will have to bring a doctor and an attending nurse and take the next flight”.

“There is absolutely nothing is wrong with him, he just had a minor mishap” I said and handed over the reports and his discharge summary. He glanced through all the sheets and said, “This means nothing to me. Look at him; he is not in a condition to fly.”

“I am there with him. He is my responsibility. I will indemnify your airline against any mishap to him” I said straightening my father-in-law with my left bum. Luckily he raised his head and gave the Superintendent a warm smile.

“No. That is not how it works. I cannot permit him” he said.

“You can’t expect me to take him back to Jodhpur hospital. He needs to go to Bangalore immediately” I said trying to sound a bit emotional. He kept quiet for several minutes and acted as if he was no longer interested in my plight.

‘Mr.Sudarshan”, I said having read his name from his name tag, ‘let me assure you, he is perfectly fit’ I said and looked at my father-in-law who was fortunately up and awake but looking hopelessly lost. “Are you not” I asked my father- in-law. He nodded his head, rubbed his nose, raised his eyebrows and fortunately for me very loudly slurred  “I am Perrrffect”. Sudarshan looked at me incredulously.

“I need a fit to fly certificate from the hospital”, he said. I once again gave him the discharge summary though I knew that he couldn’t make out anything from these reports. I realized that he just wanted to save his own skin by covering all his bases so that he wouldn’t get into trouble later on.

“Can you at least speak to Dr. Surana, the neurosurgeon that treated him?” I pleaded.

“It is not going to help. I need the certificate as per our legal procedure, without which I can’t let him board the plane,” he said trying to sound emphatic.

 “Can the doctor send you an email? I have come two thousand kilometres to take him back. Please, don’t let me down. He is my responsibility.” I literally begged him.

His silence meant that he agreed to my promise that he would agree if he got an email from the neurosurgeon. I immediately took out my mobile and called Dr. Surana. Luckily, he answered and I ecstatically handed over the phone to Sudarshan. He spoke to Dr. Surana and said, “Please prepare a declaration certifying that Mr. Rangaswamy is in a physically fit condition to undertake a flight of several hours. Please prepare this on your hospital letterhead, scan it, and email it to me.” Sudarshan handed my phone back to me.

“Hello, Dr. Surana, please scan the certificate and send it to this email.” I said. Dr.Surana replied to my utter horror; “Which scan do you need CT scan or ultrasound?” I could neither shout nor clarify softly that I meant scanning his certificate on his scanner and not his CT scan reports. I would have been ecstatic if Cosmos would somehow conspire and help me out by opening a crater right under my feet.  “Yes. Please send email immediately” I said as if he understood and quickly hung up.

After a few minutes, Sudarshan came to me waving a sheet of paper. “Look what your friend has sent. He has sent an email from his personal email ID mentioning two sentences. There is no Hospital letterhead, no mention of any hospital or his credentials. How do you expect me to accept this?”

“Sudarshan,” I addressed him all the pain in my face that I could muster up  “trust me. Nothing will happen. You are the sole decision maker. Please allow me to take him with me. He is my responsibility. Nothing will happen to him” He gave me a long hard look and said, “Do you know how to empty his catheter?” he asked me looking at my father-in-law’s half urine filled plastic bag. “Of course,” I lied. Though I had seen many, I had never touched one of those in my life. “OK. I will check him in based on your words.” I felt like the earth which had stopped spinning had started again.

The next challenge was to find a wheelchair that would fit into the aisle of the aircraft to transport and seat my father-in-law in that tiny airport. Luckily a bribe of 1,000 rupees miraculously presented an aeroplane-friendly wheel chairalong with a guy to take him to his seat.

Airlines have the right to refuse to transport persons demonstrating conditions that may worsen or have grave consequences during the flight — and they do not hesitate to act on that right.  As a Savvy passenger concerned about an uncomfortable incident at the gate  I should have known what clearances to obtain and what to expect at the airport. Well I did not.

The flight from Jodhpur to Mumbai was an hour and fifteen minutes with my father-in-law mumbling to me every five minutes that he wanted to go to the toilet by himself. We had wrapped his private parts with two sets of diapers. The catheter was full. I unscrewed it,put, capped it and emptied the content in the toilet. That was a first time for me. We reached Mumbai at around 5:00 P.M.

To my horror, I saw all three flight attendants with whom I had grown quite friendly remove their baggage from the overhead bins. “Where are you going?” I asked them horrified. “We change here. We are going to Ahmedabad. New flight attendants will arrive to accompany you to Bangalore.” I literally collapsed at the thought of explaining and defending to a set of new attendants.

My father-in-law, on whom I had kept a close watch, had dozed off and slouched all the way over to his right blocking the aisle during a small respite that I had taken from him. “Who allowed this passenger inside?” the new and apparently senior most attendant thundered as soon as she entered the aircraft with her team. I then noticed the sorry state of my father-in-law’s posture. I wiped his drooling mouth with my hanky and pulled him straight back in his chair. “How was he allowed to board?” she continued. With her immaculate uniform and her tight hair bun, she looked like Hitler’s assistant. “Where is his accompanying doctor?”

 “Are you a doctor?” I said “No. But I will mange him”.

 “How? What will you do if he suddenly gets worse?

‘No. He just had a minor stroke. Nothing serious” I said

“Are you sure?” she asked.

I responded, “Why else do you think that they boarded him in at Jodhpur?” Realizing that it was a connecting flight, she kept quiet and huffed away.

The flight landed at Bangalore at 6:45 P.M. and by the time I arrived at the gate I had aged by a couple of decades in terms of ‘travel savvy-ness’.

A year after this, I happened to meet one of the members of the team that had gone to Rajasthan with my father-in-law. He said “but for you Rangaswamy would not have been alive; the decisions you took that day right since the moment you asked us to take him in an ambulance all the way to Jodhpur and bringing him back to Bangalore made that possible”.

The words he said made me feel weirdly about the undue credit that the world gives for carrying out one’s duties. If someone is thirsty and you give him a glass of water, have you done a great and noble deed? No indeed. While I had felt happy that I had been able to safely bring my father-in-law back to Bangalore straight out of the ICU over two thousand miles in two different flights, I never felt that I had saved a life. Honestly speaking, it was my father-in-law that was the true hero.

The True Hero after reaching Bangalore Hospital

4 thoughts on “A brush with ‘Stroke’.

  1. Blessings to my Son in Law who gave me a rebirth like a mother and looked after like a father..
    added exactly after FOUR YEARS on 28 2019
    Emmarar

    Like

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