Platonic Imprint, part 3 by Dr. Ranadhir

PLATONIC IMPRINT

RECAP

While the daughter TIYA is being treated in the University Spine Centre in the USA after a life-threatening accident, we found her Bangalore-based parents Siddhartha and Ahana waiting for an update from the doctor in the hospital lounge. 

 

  Part 3

The web of thoughts of Siddhartha was cut short by the call of the nurse. Doctor Wisconsin was now ready in his chamber to receive Tiya’s parents. 

Siddhartha and Ahana were taken to a modest well-lit room where Dr Wisconsin warmly welcomed them and asked them to take seats. 

‘So you are from Bangalore. It must be decades since I had been to Chennai’ 

‘Bangalore is roughly 350 km west of Chennai’ – Siddhartha replied 

‘Yes, I know.’ Doctor smiled. Taking pause the doctor continued, ‘also I understand what mental agony you are passing through and I have full sympathy for you and your other family members back in India’ – a typical American voice making the visitors comfortable.  

Parents kept quiet with a stretched smile. 

 ‘Since it is all about the spine I shall briefly talk about the spine structure. You might have studied this in schools, but may have forgotten’- Dr Wisconsin was taking the parents into confidence.  

‘I would draw your attention to the figure on the screen of my computer. It shows the entire spine structure. You can see it has four major regions: Cervical (neck area), Thoracic (upper back), Lumbar spine (lower back) and Sacral (bottom of the spine).’ 

‘We focus on the lumbar area, the lowest portion, which makes up the lower end of the spinal column. You can see that the lower end of the spinal column has 5 small but extremely important vertebras. These are numbered 1 through 5 from top to bottom i.e. L1, L2, L3, L4, and L5. The bottom-most L5 vertebra is connected to the top of the sacrum (sacral region, named as S1 segment) through an intervertebral disc. 

Dr Wisconsin continued- ‘Now the video will show you the CT and MRI image of the lumbar and sacral region of your daughter Tiya. See the circled area on both the slides which got damaged by the fall. Tiya’s problem restricts to an area encompassing Lumbar L5 and S1 segments. These two-disc joints (L4-L5 and L5-S1) take the most strain and are the most likely to herniate. At the same time, it is highly flexible, providing for mobility in many different planes including flexion, extension, side bending, and rotation.’  

‘Yesterday we operated the L5-S1 junction of Tiya.’ The doctor paused for a while and then took the parents into real problems of Tiya. ‘She had fracture dislocation at the lumbosacral junction where neurological injury has occurred. Those are very sensitive bones and they were broken and dislocated in three places. This injury is the potential to cause significant damage to the intervertebral disc. This traumatic derangement markedly compromises the load-bearing capacity of the intervertebral disc.

The operation was successful but it might take several months of bed rest for Tiya to brace for bony union and fusion maturation, and to make her walk again. 

 ‘Will she be okay again, doctor?’ – This is the only thing a rapidly sinking Ahana could ask 

‘Sure, we are here ma’am to exactly ensure the same. Yet I must not give you any extra hope than our surgery could offer. The damage was serious and might ask for another round of operation if the patient does not respond to our satisfaction.’    

‘Also I must tell you one more thing. There were some additional problems.’

Siddhartha and Ahana froze further.

But the doctor continued- ‘It is crucial for neurosurgeons to early realize that paralysis of the sphincter and sexual dysfunction are possible in patients from this sort of injury. This could be a side effect of the operation. As such dysfunction is not normally manifested with pain and muscle weakness, but it poses a huge challenge to us during the operation keeping in mind that she is too young.’ 

‘Oh my God, Will she be able to lead a normal life?’ Ahana could only murmur.   

‘I hope so, but nothing could be said at this moment with any finality. Please keep praying’.  

‘Sure doctor, when she is expected to come out of anaesthesia’- Siddhartha said.

‘It normally takes 48 hours, but she might take a little more time because of the complex nature of the operation as I have explained now. And it could take several months before she could be on her feet.’  

‘Sure, thanks. Considering the complexity of the situation, we may need to have your direct input into the case soon.’ 

‘Direct input, what’s that doctor? Siddhartha enquired 

‘Nothing really, except that we will have to conduct some tests of you and your wife. My colleague will collect blood and mouth-swab samples of yours. This is to understand your blood characters and DNA pattern which could be vital information to pre-empt any issue that might crop up while treating her in future.’  

‘Anytime doctor. We are leaving our contact and phone numbers with your office.’  

Siddhartha and Ahana thanked the doctor copiously and came out of his chamber.  

A junior resident doctor came up and asked them to follow to a lab. They donated blood and swab samples.  

Later BC was led to the Hospital office to complete the Guest House application formality. The clerk said that they will be informed over the phone as soon as their application is approved and the room is available. Another officer from the Accounts section in the hospital informed that being a student of the University, Tiya is entitled to receive a medical grant of 75% of the cost of the treatment. The rest 25% has to be borne by the patient and Siddhartha had to sign a few places in agreement to such term. Siddhartha quickly finished the formality. 

Sharing Johnnie Walker’s black label with their host at their apartment located close to the Brooklyn Museum, Siddhartha was analysing what Dr Wisconsin had told them in the morning. Manisha had wine, while Ahana preferred juice. Alpesh was sitting in front of his laptop to find out more about the L5-S1 dilemma.  

‘It seems the risk involved in operating that very sensitive area is quite considerable.’ Alpesh sounded tense.  

‘But then why does he have to test our blood and DNA?’ Siddhartha asked 

‘No idea boss.’ Alpesh could not figure out the reason. 

‘But I think the doctor wanted to keep him abreast of parental input to the DNA structure of Tiya.’ Manisha tries to see the reason.  

‘Also this could keep him ready for any eventuality to carry out stem cell operation if such need arises.’ Ahana appeared convinced.     

The discussion of the rest of the evening meandered over several things including the possible shifting of Siddhartha and Ahana to the guest house of the University Hospital. Although Alpesh and Manisha did not wholeheartedly approve of the shifting, they agreed to the point that such shifting would help the parents to be close to their daughter all the time.   

On the fifth day, Alpesh and Manisha dropped Siddhartha and Ahana in the guest house. An hour later Siddhartha received a call from the hospital. Dr Wisconsin would be happy to discuss some new matters with both of you at 4 pm. Two things struck Siddhartha- did the lady over the phone stress the word ‘both of you?’ And what could be that ‘new matter’? 

They finished lunch in the guest house and by 3.30 pm they were in the Visitor’s room of the hospital. And exactly half an hour later they were taken into the chamber of Dr Wisconsin.   

 ‘Good evening, come, come and please be seated’ an excited doctor cordially welcomed the parents.  

 ‘How did you find your daughter?’ Doctor asked.  

‘Yeah! She looks much better, slowly responding to our presence.’ 

‘Responding slowly?’ The doctor was surprised. ‘When did you visit her last? 

‘Last evening. We could not come this morning due to some urgent jobs in India that need to be attended to online. But now we would visit her.’ 

‘Splendid is the least word I could probably use to describe her progress today.’ 

‘Is it? Thank God and thank you, too.’ 

‘No, no, not me. I could not figure out the exact reason for her rapid recovery, but I must say I am ecstatic with the progress.’ 

‘But we always blame mismatch of our blood group with that of my daughter for her ill-health Siddhartha sounded remorseful. 

Waving off that deviation, Dr Wisconsin asked them not to bother much about the mismatch of blood groups. 

‘Let me explain it elaborately.

The human nature and structure are amazing.’  

‘The genetics behind blood grouping helps us identify the possible blood group of the patients. Each biological parent donates one of their two ABO alleles to their child. A mother who is blood type O can only pass an O allele to her son or daughter. A father who has blood type say AB could pass either an A or a B allele to his son or daughter.’ 

‘Tiya’s blood group is O, while her father’s blood group is A, and that of her mother is B. Am I correct? 

‘Yes doctor’ – Siddhartha nodded.  

This has been an issue since the time Tiya was born. After seeing her blood group on the certificate of birth, Siddhartha did enquire a couple of times with some other laboratory, but the result came similar. Yes, her blood group does differ from that of her parents. 

Although both Ahana and Siddhartha were disturbed by this finding, they never put it up for any specialist’s assessment. This topic even did not discuss anytime among them.  

‘But did not you enquire earlier? It appears that both of you were under tremendous mental pressure all these days, thinking mutually about possible infidelity of your partner.’  

Both Siddhartha and Ahana kept quiet. 

‘And you did not dare to even discuss it out among yourselves or with a doctor? The University of Google could have helped you. I am amazed. One could see the darkness on the faces of Ahana and Siddhartha in an otherwise well-lit room. 

‘Let me clear it today with abundant clarity at my command that when a lady with blood group ‘A’ meets with a man having ‘B’ blood group, like yours, they could produce a child having blood groups of all four types ‘A, B, AB, and O’. So it is nothing unnatural or unscientific, but maybe a little unusual and uncommon, that you have a daughter having a blood group completely different from yours.’ 

The doctor stopped for taking a breath. Suddenly he realized that Siddhartha is softly holding his palm in gratitude and Ahana is silently wiping her eyes. 

This gratitude had the weight and intensity of the last twenty-two years since Tiya came to this world.  Was it respect for each other or the fear of losing each other that they could not break this topic among themselves during the last two decades and carried this agony so long?

 

……… To be continued 

Part 1 Part 2

About the Author :

Dr. Ranadhir Mukhopadhyay is a Marine Geoscientist. He had retired from NIO, Goa as a Deputy Director. He now lives at Goa.