Follow the advice of the doctor tells you always, particularly in relation to issues related to the back
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Benny came into my room, with an obvious limp and a frown in his eyes. After a quick glance at his face, I realized that he was suffering from pain. When he was sitting down, his lips swelled into an O, but all was he really wanted to say was a sigh. “Would you prefer to lie in bed?” I asked, already having established my suspicions. He agreed , and cautiously took his place from the chair towards the bed, accompanied by a few moans.
The man was in his late 50s. He wore a snug-fitting black polyester shirt, whose microfibers were stretched to the maximum by his large, slender stomach. “Do your acquaintances call you Pot Benny?” I laughed, pointing at his stomach. He smiled enough to admit that it was time to go, indicating it with a tapping downwards. “I suffer from extreme back and leg pain,”” the man continued to move his hands along the division of pain in his cargo pants while lying in the bed. It was two months since he last complained. He’d been using the typical dosage of medicine that physicians prescribe for sciatica the pain which radiates out from your back in the direction to sciatic nerve in the leg. “I must get back to work and I’m not able to take any more time off!” he finished, exhausted.
“What is your job?” I asked. “I work for the Army,” he said with a smile. “Really?” I asked with real surprise at his body. “I work at a desk,” he laughed, making me feel less anxious. “Don’t worry I’m not fighting out on the battlefield!” he guffawed, making me feel at ease.
“If you hadn’t clarifiedthe issue, I’d be concerned for our nation,” I said in humor, and I apologized for having judged him so abruptly. “We are programmed to form assumptions based on what we should look like to part when we’re in a specific profession,” I thought aloud. “I am curious about what people think doctors should look like? …” I thought and posed the question. “Certainly unlike you” did he response. When he saw my stunned expression He did not hesitate to add, “Because you are still very youthful.” It appeared as if we had already been friends.
I was brought back to the “sports” themed party we used to have in our the school. It was a birthday party for a classmate and everyone had to be dressed in a way that resembled playing a game. Some kids wore cricket equipment, while others wore shorts and carried tennis, badminton as well as table tennis tennis racquets. Some even wore gloves for boxing or wore footballs or basketball. One of the boys was dressed formal, and all the children mocked the boy for being a party-pooper and not bothering to dress up like the rest of them and then he declared, “I’m playing chess.” Then it was his turn to be the star of the celebration.
I inspected Benny to find that the foot on his right was weaker than his leftand when I lifted his right leg off the bed there was a sharp discomfort in his leg due to the disc inside his spine which had prolapsed, and was pressing on his nerve. I explained this to Benny via the MRI film, and held it up against the dark of Mumbai’s skyline , which is visible from my windows. “So many people living in this beautiful, smoky city are probably suffering from the same issues you’re experiencing,” I told Benny, “and so many just sit around in their misery.”
I advised him that he required surgery. With his whole heart, he believed it was the best choice. “A significant portion of patients can be treated without surgery,” I said, “but your disc is insufficiently large, indenting the nerve that appears to be swollen in an MRI,” I said while rationalizing my choice. “The destiny of accounts of the Indian Army is yours to decide,” he said in self-deprecating humor, joking at himself as well as the job he had to return back to. Then I told him it’s a minimally in-depth surgery , and I assured him that he’d be safe.
The next day we made a small cut in his back and, by using the tubular dilators that can only cut the muscle but do not cut it, I reached the bone. I then drilled a tiny bit of the lamina and then cut off the ligament that covered the dura. The disc was lifting up and pushed up the nerve root, which caused it to appear unhappy and inflamed. I cut it open using a forceps. I grasped the fleshy part and then wriggled it away. It was like digging up an unattractive slug from the soil. The nerve root became slack and returned to its home like it was telling “thank for your help”. We checked to make sure there weren’t any fragments of disc before closing.
The next morning and woke up, the pain had gone away. He tried the knee by bending it and hipand practicing the moves that caused the pain earlier. “You must shed some weight before you attempt any tricks with you back,” I warned him after he was discharged the following day. He was given permission to return to work in one week. He was extremely thankful.
A few months later, I got an urgent call telling me that Benny had come back with exactly the same discomfort. My heart was pounding; maybe there was something that was ominous. When I met him, he appeared to be suffering more than when we first were together. “Did you commit an error?” I asked, aware that his disc likely popped out once more. “I felt so great every day, that this morning , I took a bucket full of water and put it over my head after taking a bath. And that’s when I started feeling pain,” he said, shaking his head and rubbing his forehead, this time instead of his stomach. “Courage is knowing it will hurt , but doing it anyway.
It’s the exact same as apathy,” I said, taking the quote from my collection. “And this is why it’s hard to live,” he said, adding the phrase to my own.
In the past there were a handful of times that someone I treated for a slipped disc relapsed with pain in a short period duration, I’d blame myself for the sub-par job, until one of my surgeons, possibly with wit, once advised that to me “Always put the patients first. If you’re unable to identify fault with them you are the one to blame.” I have yet to be able to agree with that until the present day.
We performed an MRI and discovered that he was suffering from a massive disc re-herniation. I advised him that it would be better to take a bite and repeat the procedure. “Do I have an option?” he asked. My usual answer to this question would have been “We can always choose” but this time , I simply stated “No!” I assured that we’d finish in about 30 minutes. I went back to the room and took out that numb little disc that was exploding within his spine. The nerve was once more saying “thank for your” to me for something I was hoping was the final time.
The next day, pain free as if nothing had taken place. “So what do I do?” he asked perplexed. My answer was to keep “Status Quo “… and I proceeded to sing and paraphrase the song of a group that had the same name.
You’ll be able to recall what the doctor told you,
There’s nothing to do but rest in the bed
Your in the military right now
Oh-ooo, you’re part of the military now!
The author is a Neurosurgeon in Wockhardt Hospitals and Honorary Assistant Professor of Neurosurgery at Grant Medical College and Sir JJ Group of Hospitals
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