Reflections on my illness

To the Editor:

Tuesday, November 19 was supposed to be my usual maniacal day in my office when I see more than 300 patients; God had intended otherwise.
I got up out of bed, but I was extremely dizzy. I staggered to the bathroom and called my wife on my cell phone as she was downstairs. I was retching and nauseous and threw up about 20 times. Thank God there was no blood in the vomitus. In my mind I thought it was possibly gastroenteritis possibly evolving and that rest would take care of it.
My condition worsened by the afternoon. I went to my office and Deepak (my associate) started me on IV fluids, and I reached out to my friend, Anaka Prakash, who as usual was my guardian angel. Both he and I were worried about my unsteady gait and decided that I needed to be admitted for observation at the least and I needed a CT scan of the brain.
I was on the third floor of Bayonne Medical Center and after the CT scan was done and then all pandemonium broke out. I had an acute bleed on the cerebellum (vermis) and I was being transferred to ICU. In about 15 minutes, my friends, OR Staff and Dr. Prakash called Ramesh Babu, neurosurgeon, who reviewed the films and recommended a conservative approach. Dr. Litinski, the intensivist, started an A-line to monitor my blood pressure and I was told about the scenarios of possibilities: 1) Bleed could stabilize, 2) Bleed could progress and I could stop breathing. I would be intubated – did I have a living will. My life was flashing in front of my eyes. I told him to do his best, 3) The bleed could be related to an underlying aneurysm which would be determined later if I became stable by doing an MRI, MRA and MRV.
I spent the next 72 hours in the ICU hoping for the best. Dr. Condo, Anaka and all my friends were by my side twice a day. Three CT scans done 12 hours apart showed my bleed had stabilized. I had an MRI/MRA/MRV confirming that it was a localized bleed and not and AVM or an aneurysm. It was surreal, but I felt truly blessed that God had given me a second chance. They are watching my blood sugar and blood pressure for now. I have very little residual side effects from this life threatening event. I am walking with a walker and I have residual truncal atoxia. I am told it should resolve 100 percentover the next two weeks.
As I am sitting in my chair gazing outside at the beautiful city of Bayonne on this sunny day, a myriad of thoughts come fleeting past my eyes. How lucky I am to have such great physicians in the town I practice and call my second home for over the past 31 years. I was deeply hurt by the scathing article in the New York Times about Bayonne Medical Center being the costliest hospital on earth and that people were being gauged by a careless hospital. A hospital is not four walls or a building. It is the people inside who make up this institution. Bigger is not better. Look at Wall Street – the debacle, the debauchery with AIG and all the institutions including Goldman Sachs. What is the price of life – ask a person who has been at the brink of life and death. Don’t put a cost on an illness or prorate a diagnosis – that is Nazi medicine. In this Jurassic Park of health care, Bayonne Medical Center is a victim of high-powered HMOs and insurance companies whose bottom line is dollars without addressing quality of care issues. A measure of a good MD is and should be number of days spent in the hospital greater than or equal to the number of days out of the hospital with quality of life. From that perspective, I salute the doctors in Bayonne Medical Center along with all the unnamed nurses and personnel who are the base of the pyramid of well care that this small hospital provides its community. BMC is the “Cheers” of medical care, where everyone knows your name and you are not a number. From quality of care and timeliness in this acute setting, mass general standards were kept by all involved in my care.

A very grateful patient.

D. IYENGAR
Medical oncologist

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