In the beginning..

..were two dots, perhaps 3mm apart. But we need to start the story a little before that:

On the 10th of December,after lunch, the boys packed a picnic chocolate cake, and set off to “Cycle Rock”. They left just before 11 o’clock, and were supposed to return before 3 o’clock.
Sonati and I did a bit of e-mailing and had a cup of green tea and were just going off for our afternoon nap, when I noticed Badri Baba come up the slope. “What’s up? Why are you back so soon?”, I asked. He didn’t reply until he came up to the front verandah, and then he said (incredibly calmly),”I think it is a snake bite”.
They had been crossing the verappu (verge) between two sugarcane fields, and so he had not noticed the bite when it had happened and hence had not seen the snake
He had asked Varun to be careful not to get scratched by the sugarcane leaves. Then he felt a pain travel to his shoulder, and a swelling at his thumb. And he saw the two dots.

When he showed me his thumb, I saw the two dots which to me immediately signalled: Fang marks: Don’t panic.

Sonati and I are getting ready: No torniquet, just a sling, call the hospital, and…?, when Badri says, “You have to tell me to be calm”.

Well, almost without thought, within minutes I had called Nikhil at Sittilingi to expect us, and Ramsub to drive us there on his bike. And when we got there after about an hour and a half, his parameters were normal: BP 110/70, Pulse : An “athlete’s pulse” of 60 and a Clotting Time of 5 min. Everything Normal. Phew! What a relief: It must have been a dry bite!
Regi says to wait and watch.

So we went over to Anu’s place, had coffee and dosas, and headed back to the hospital.Evening: Clotting Time is 7 minutes. But CT varies, so maybe this is a normal variation. Regi says to spend the night at the hospital, in the Guest room next to Nikhil’s. We are slated to do another CT at 6 am the next day, and if all is well, we can travel back home with the group going up to the hills.

At Dinner time, Nikhil, who doesn’t care for koozh (salted Ragi balls), asks Badri, ” Hey Badri, do you want to eat koozh (at the hospital mess) or shall we make pasta?” No prizes for guessing the answer. Badri remarks, “This morning, I didn’t know it would turn out to be such a long picnic”. (Varun, when I told him this, said ” And I didn’t know it would be such a short one”). The two of them set off to Ravi and Prema’s kitchen to cook

It was great fun to hear the exclamations and conversation between Badri and Nikhil. I heard snatches of ” OK, I’ll cut an extra onion” and “OK, I’ll search for a couple of tomatoes”. The pasta turned out to be a cheese-and-butter mush with a bit of pasta thrown in. Dinner that night was Ravi, Prema and me (who ate primarily koozh), Nikhil and Badri (who primarily ate pasta; in fact, I don’t think Nikhil ate any koozh whatsoever), and Randall who dropped by after his dinner, to lick the pasta pan clean. Dessert was chocolates.

After dinner,we went out for a walk with Randall, to see the (lovely, bright) night sky, planned on waking up to see the Geminid meteor shower one of these nights (peaks on the night of 12-13 and 13-14). Randall was going to cycle up to Karumandurai on Wednesday, and I told him to come, have dinner with us and go back the next morning…

Then we walked back to the guest room. The swelling had reduced; and there was almost no pain. We went off to sleep.

The 2nd day (11-12-12): The night was peaceful, and Badri and I woke up early and got ready. Randall said he would make me some coffee, and Nikhil took Badri Baba off for the CT.
The CT is 9 minutes.

Regi tells us to stay back; he would carry on with Nikhil to Karumandurai for the Field visits etc. and would stay in touch with us and Ravi through the day. He scheduled another CT at 10 o’clock.
We head to Thulir to meet Anu, pick up some more books and having had coffee and breakfast at Thulir, we head back to the hospital.
The CT is 11 minutes.

Ravi says that he will start administering the Anti Snake Venom (ASV), and Badri is admitted as an inpatient. This is turning out to be a curious incident of the snake in the sugarcane field.

So the ASV is given, first a test dose which shows a mild allergic reaction. So an anti-histamine/ anti-allergen/ASV cocktail is intravenously given.

Now what follows are the longest hours for all of us, but I will cut a long story short. 10 vials of ASV are administered from around 10 o’clock of 11-12-12 to around 10 o’clock of 12-12-12. The CT does not fall to normal (5 min to 10 min) values ever. It is at 22 after the last vial is administered. And Regi schedules another CT for 2 pm to give the ASV time to act.

Badri and I head out of the ward to the guest room for a bath. Varun calls Badri to say that it is 12-12-12. When Badri calls him back post-bath to tell him that it is 12:12:12 on 12-12-12, Varun is in his bath, having waited for that moment to start his bath.

I am lying on the khatiya outside Nikhil’s room and wondering; and I think, “Hey if it is not a big4 bite, then the ASV is not going to work. And suppose it is a Bamboo Pit Viper, what would be the symptoms…” When I sounded Badri Baba out on this he said he had thought of it, but he thought that someone else would have also thought of it.
I call Pablo, who gives me Gerrry’s number. Gerry says, Yes that is possible. But don’t assume anything. It may be a delayed effect in a Russell’s viper bite, for instance. In any case don’t give any further ASV because it is of no use. He also gives me the phone number of Dr.Jaideep Menon, who he says is a friend and a snake-bite expert.
But I can’t get through to him. So I text him and wait.
I tell Regi what I have thought, and he says that it is a possibility. Meanwhile we head back for the 2pm CT. The CT is >45 minutes with (as usual) all other parameters normal.

Till now, Regi had held the tension, and I had not had to think at all. Now I felt the dilemma and consequent tension of a doctor who has to treat close friends and family. He said, ” Don’t worry, but it would be better to get to Salem where there are facilities and equipment for (Blood) clotters, dialysis (though at the moment kidney function is absolutely normal)”.

Till now we haven’t told anyone else of the bite, so that we can focus on it. Now I have to break it to Appa that I am coming. He was reeling a bit, but eventually recovered and it was he who met me at Gokulam when we arrived.
I also tell Sonati and Varun to come to Salem. So long as it was Sittilingi, it was fine for Sonati to be at home and get my bulletins; if we were moving to Salem, it was easier that she be on the front line.

Munish drove us to Salem. While in the jeep, I managed to get in touch with Dr. Jaidep Menon. He was the one who reassured me and said “Don’t give any more ASV, This is likely to be a Bamboo Pit Viper bite, and I have known cases where it has taken even 15 days for the CT to normalise” I asked Regi to talk to him also; and Regi texted me back that that was a great relief. (In fact, much later, Regi said that if this sequence had been played out earlier, he would not have inflicted Gokulam on me)

Anyway, this gave me the confidence to be prepared to fight and get Badri out “against medical advice” if necessary if the doctor at Gokulam decided to give more ASV.

Munish was a great help in telling me what to do. Gokulam was as far a contrast as possible from the Sittilingi hospital.It is impossible for me to do justice to the atmosphere at Sittilingi which makes all the difference. People are spoken to like human beings. The nurses are trained to make conversation with the patients. And at the moment, Ravi and Prema and Regi and Lalitha have “enthu” young blood in Randall and Nikhil which really gives the place a nice buzz. But this has to be the subject of a different post.

In Gokulam they just about stop short short of branding patients like cows.

So to get back to our story, we arrive and Badri is admitted to Emergency. I have to pay an advance in cash (Rs. 10000), then go to the lab to order tests, pay for them, go back to the lab so that they will do thr tests. Then buy medicines to be delivered to the ICU. All this money is courtesy Regi’s debit card which he gave me as I was leaving, knowing that I wouldn’t have an idea about the scale of this thing.

Sonati and Varun arrive with Amma. Sonati, Varun and I go to the ICU (to which Badri has been moved) and somehow ghiss in to meet Badri.
The head of the ICU met us, and said that all is well; ASV has been given within hours of the bite (which is totally wrong: It was started almost 24 hours after, since there were no symptoms to warrant it till then) and the patient is stable. I said that we think it is a Bamboo Pit Viper to which he says that there are none in India, that he is on some UN panel on toxicology etc. He says that it must be a krait viper. This blows my mind. His arrogance and ignorance is mind-blowing in the extreme; but … Look at our position. Anyway, I said I would send him pictures (which I have since done; and he has thanked me for it and said that it would help the cause of epidemiology in India)

We are shunted out onto this railway platform like area which is all that the ICU “attenders” have to sit on. And it is sloping like a ramp!
I talk to Amma and Appa, a short lecture on Big4, Bamboo Pit Viper; then send Varun off with them and return to wait with Sonati for the physician to come.

When we meet him, he says all is well. When we ask about the clotting time he tells us not to worry. But doesn’t tell me any numbers. Anyway I am relieved that he is not going to shoot more ASV. And he tells us to go home and sleep and come back next morning, Badri will be taken care of. So we give Badri his dinner of Thayir Saadham which Amma had left and go home (Can you believe that?). Badri Baba was incredibly unfazed through all this. And in fact so was Varun, for whom it must have been a more difficult thing since he was a bystander.

So, home to Amma and Appa’s place. Sleep. Next morning, we have breakfast and head for the hospital with Badri’s breakfast. All the monitoring equipment is off, but the IV line is functioning with some antibiotic, whose function is to make sure that the patient cannot run, I think. Badri is reading, and makes a good breakfast. His neighbour is some poor old man with all manner of tubes, a respirator,and what-not who is mumbling to himself.

sketch_gimped

Sonati does a sketch of Badri in the ICU. But soon enough,we are shunted out to wait on the railway platform. When the physician comes, we are told that Badri is discharged and that we can take him home after the formalities are complete.

It is only at 5 in the evening that I get my hands on the lab reports (that after threatening to sit down in the ICU till I get it) and see that the clotting time when we got in was 24 minutes. The drive from Sittilingi to Salem had bucked the rising trend.

So there you are. Places like Gokulam are Hell because the expert claims to have a knowledge which you may not really be in a position to verify. Decisions are made for you which are out of your control. And if you are poor and don’t speak English, then the situation is even worse.

So that was 13-12-12. On the 14th we headed back to Sittilingi, visited the hospital, said our thank-yous to everyone there, and headed to Regi and Lalitha’s house. We spent the night at Regi and Lalitha’s place. Anu in spite of being very much under the weather, came and spent time with us there. We talked of various things: rural India, emu farm scams, the utter and bewildering contrast the tribals face when they have to deal with the big city doctors and nurses, the necessity of having a social basis to medical treatment, and the issue of a dignified death among other things. Those are subjects for other blog posts.

On 15-12-12 we had breakfast at the hospital, and Badri headed off for his CT. 12 minutes. Still not normal, but getting there. Creatinine is 1 which is a bit high but well within limits. His kidneys have been doing a champion’s job. Regi says to come next Friday for a (hopefully) final test. He says that Badri should drink plenty of water, fluids and the juice of vazha thandu (banana stem). He needs to be careful not to over-exert.

We caught the bus outside the hospital to Thumbal, a connection to Karumandurai, visited the shandy where the boys ate popcorn and then caught a “pick-up” back home to Thekambattu. I lit the fire and after a nice hot oil bath each, we had dosas thanks to Rama and Ramsub who delivered the maavu...

Thus endeth the sixth day. And on the seventh day I blogged.(And He, perhaps would have too :-))

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23 Responses to “In the beginning..”

  1. Meena Says:

    Read all the details. Good to know that Badri and Varun are not given to hysterics. Take care.

  2. srilata Says:

    Hospitals make you feel so helpless! Just the opposite of what you’d expect from them. Anyway, good that you had your Sittilingi friends.
    Srilu

  3. Swapnal Says:

    Waited to enquire of badri’s health till I read this blog, so as not to bombard u with questions. Badri’s calm in the situation is awesome.
    In New zealand the blood reports reach from the lab to the doctor directly and everything is uploaded on a common system,so that even if u go to a different doctor, te doctor still gets ur history. India can sure take a lesson here.
    However all well that ends well and badri baba managed to charm the snake😊

  4. nagini Says:

    What an experience. And you all seemed so calm through it all! So glad to hear all is now well.

  5. Chandrakesh Says:

    Good to know that things are alright… Doctors can take things to nowhere and there is not countability of what they are doing, they create a sense of urgency in which we, as patient have no control over.

  6. HIppo Says:

    All iS Vell

  7. Piyush Manush Says:

    unfortunate that regi and co, do not enjoy the company of humane hospitals for reference in the city .. Gokulam, R.K.Hospital, Shanmuga, P.P etc are all known hell holes.

  8. Pinky Brahama Choudhury Says:

    All is well – wow Badri, quite an epic story and so good to read that line! All of you amazingly calm – really awesome and that sketch by Sonati tells it all! Love you guys! Will call soon!

  9. HIppo Says:

    By the way, did you notice the acronym in my comment “All iS Vell”? S’na didn’t.

  10. Ravi Says:

    It is amazing that Badri (and Varun too) kept their cool in a situation like this! A lesson for all of us. Kudos to you for depicting the whole story poetically:) And a nice sketch of Badri by Sonati:)
    -Ravi

  11. kapil Says:

    Glad all is ok folks. Badri, you are incredible. Best to all of you – kapil

  12. gaurav1729 Says:

    Thinking of you guys. Glad it all worked out. I guess we’ll never know what kind of snake it actually was?

  13. randall Says:

    damn we missed the meteor shower no?… lovely sketch sonati…shud b eeing u guys this wednesday wit my bro

  14. Milind Says:

    Glad all turned out well. Badri’s calm is remarkable.

  15. manju Says:

    Glad to know that Badri is doing fine.

  16. Anoop Says:

    Reminds me of an old hindi proverb….Jaako raakhe saiaya, maar sakhe na koi.

  17. Kala Seetharam Sridhar Says:

    Wow, Madhu and Sonati, thanks for the detailed update! It does seem that was a miraculous escape. All is well that ends well. Best to Badri as he recovers, our memories to Varun. Take care and will talk to you soon. Kala-Sridhar-Vindhya

  18. Alok and Chandrika Says:

    Thanks for sending this to us, Sundar, Sonati….we are all admiration for the way you guys handled this whole thing, and for all the wonderful community support that your place and its people have developed with each other. What a blessing too…to be able to get the right advice at the right time. Our very best wishes to Badri baba and Varun, who we remember well from their visit to Rishi Valley. With love, Alok and Chandrika

  19. Susan Thomas (@Susan_09) Says:

    Good to know that Badri is well now… and this is indeed a very useful account of what happened. Not only for info on snake bites but for those who often feel like questioning the ethics of plush hospitals but don’t feel confident in questioning the docs in spotless white jackets…

  20. Ani Says:

    Woah!Hopefully,hopefully amma turns out to be like Badri after she’s 50…Take care!

  21. Pinky Brahama Choudhury Says:

    I did, but ignored it as some new generation style of syntax – Anti snake venom !!! Slow reflex – aging I guess!!! Take care – lots of love to you and Varun!!!

  22. Detsung the Deng Xian Sung Says:

    WoW!!??!! What an experience there!! Wonder what it will be like back here in Assam!!!!!!!!!??????????? Brrrrrrrrr……..Don’t dare to think about it. Lucky You Badri!!! Anyways everthing went off with nothing too serious. Hoping to see you/Sonati and talk in person and hear out the stories.

  23. Sanjay Maharishi Says:

    badri looks like the buddha in sonati’s drawing 🙂
    love this post and love your blog

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