Monday, April 25, 2005

What is best for Preeti?

It’s a question we ask ourselves anew each day. Would Preeti have wanted to go through this or would she have chosen differently? Does the fact that she’s pulled through for 25 days after doctors told us, ‘No hope, call your relatives,’ mean that she wants to fight it out or is that what we want to believe? Do we surrender to whatever has to happen or do we lasso her back with fervent prayers and heartfelt desires?

The days go by but the questions don’t get any easier. We are people of hope and faith. We affirm that whatever happens will be best for Preeti. But several times, we find ourselves having to make a choice on Preeti’s behalf. And that’s when the questions terrorise…

Early last week, Preeti caught an infection, and all the fledgling signs of improvement backed up and vanished. Her temperature started climbing into the alarming 100s, the kidney output decreased and she was back on the ventilator. There was more bad news, this time from two consulting neurologists. Both echoed the gloomy diagnosis of the first neurologist. (One of them used a quaint expression when I asked for chances of improvement – ‘hugely small’. The other said even if she recovered, brain capacity would be ‘greatly reduced’. Are neurologists trained to speak in oxymorons, I wonder?)

Confronted with bad news and worse news, all the doubts – effectively suppressed by hope - came rushing back in. Would we have to make that decision now? Is that what Preeti wants?

‘Make a decision’ is the euphemism that medics use to suggest that a patient has poor chances of recovery. Doctors are understandably cagey when you ask them for their recommendation. What do YOU want to do, they ask? We’ve never had to deal with this before, we say.

Between euphemisms and oxymorons, we deduce the options. One is to stop dialysis or switch off the ventilator. But can we do it knowing fully well that part of her brain still functions, that she can still breathe a little and that some body functions are stable? Another option is to continue the treatment, hoping for some improvement in the brain functioning, which might or might not happen. Neither of these is painless. For Preeti or for us.

Ultimately, each of these options is linked to the monetary factor. As one doctor told us, "The deciding factor in such cases is how long you can sustain the treatment. The day you can’t afford to pay for the dialysis and the expensive injections, the option is clear.” Mercifully, we haven’t reached there yet.

In the midst of these hopeless, confused moments, we’re truly thankful for Dr. Thomas. Three days ago, he told us, “She’s young, her heart is strong. Give her a chance.” That’s all we needed to hear. That’s all we wanted to do, despite the moments of torment and confusion.

Two days ago, the kidneys began responding to treatment. The dour nephrologist actually had a smile when he told us that. The new batch of antibiotics worked away at the infection and yesterday even the ventilator came off.

This morning, the nephrologist said, “The kidney output is extremely good. I may not even need to see her again. My work is done.” Family members and visitors gaze reverentially, even admiringly, at the urine bag hanging over the side of the bed. (Pardon this mention of unmentionables. It is a matter of celebration.)

Now, it’s the turn of the brain. Dr. Thomas warns, “It’s not a rosy picture. Be prepared for a prolonged, sometimes frustrating journey.” The damaged areas might never recover, but perhaps, the brain can find a way around them. We continue to hope.

A big Thank You to each one of you who’s praying and continues to pray for Preeti. I appreciate all of your comments. I’m also grateful to all of you who’ve written in sharing your stories of hope, and for those of you who’ve linked the previous post. I’ve shared all your comments and mails with my family and it has given us a great deal of strength to know that Preeti has so many well wishers. Please continue to keep her in your prayers.

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