Doctor Diaries : Part 1

He looked at me intently, wide eyed. No, I wasn't going to touch him if he didn't want me to. It wasn't fright or anger, mere curiosity. I didn't know what to make of it. I was trying to comprehend his mood. Suddenly, I was going back in time to the day when I first met him..... 

..... He came to us with a subconjunctival hemorrhage and a few blue patches on his back. His blood was brimming with leucocytes, cells that fight infection. Only, in his case, they were bad cells growing uncontrollably and not performing their function. In addition, they were even spilling out, fragmenting and would potentially start blocking his kidneys which could be life threatening. His hemoglobin and platelets were dwindling in the meanwhile, causing him to bleed into his skin and eyes. Under the microscope were seen blast cells, a dreaded finding for haemat-oncologists. He was suffering from a form of Acute Leukemia. The parents were shattered on learning the diagnosis. The castles they'd built in air for their family came crashing down in a few seconds. Given his age, the kind of leukemia he was suffering from was expected to be aggressive. 

He underwent his first lumbar puncture. My consultant likes to do the first lumbar puncture himself. As he says, it is extremely important to not puncture any blood vessels in the process. That would mean we have introduced the bad white cells from the blood into the CSF which cushions the brain. The procedure not only requires immense experience, but also profound faith in your own abilities.

We started immediate basic therapy for him. By evening, he had progressed from bad to worse. His cancer cells were already starting to choke his kidneys, a term we doctors like to call 'tumor lysis syndrome'. We used a drug called Rasburicase to antagonize the effect of it. Each shot of that drug costs about 15,000/- as it is a relatively new drug in the field. So much so that my consultant confessed that this was his first time as well.....

All of 8 months, he kicked and gurgled, spitting some fresh saliva into the air, and went back to sucking his thumb, completely oblivious to his disease, poor prognosis and the pain written all over his parents' faces.