I was on my way to the airport yesterday to pick up a Volunteer when I received a call from her telling me she hadn’t even left Mumbai yet. So we decided to turn around and head back to the office.
As fate would have it Dr RK Deshwal received a phone call from a gentleman who had been desperately trying to get hold of us in the past weeks. He literally lived about 2 km away from the spot we were.
So we met him at an intersection and followed him down a dirt road, through little villages, past fields of maize and eventually to a little house in the Village of Brahmanon Ka Gurha.
Dr RK was very vague about the patient I was suppose to see. All I got was that this gentleman’s son could not walk and that they had been trying to get an appointment with us for some time.
As I approached the house and took my shoes off I was greeted by extended family and neighbours, all coming to take a look at the “miracle” I was about to perform… “Great” I thought “How am I going to explain this one?”.
In the rural areas of India foreigners are not a commodity, so when an educated white woman who has a reputation as a “muscle healer” comes to a village everyone expects miracles. Sometimes I can live up to this hype, other times I can not.
The sense of urgency from the Father gave me the impression this was not going to be within my scope of practice.
When I walked into the house the family parted to allow us a look at our patient. The first thing that struck me was how emaciated he was, the second thing was how young he looked. My heart sank. He was paralyzed.
Moham* had just turned 25 when he had his accident. November the 23rd 2015, traveling home after work and possibly going a bit too fast. Moham doesn’t recall the accident, he just remembered waking up in hospital surrounded by his loved ones and unable to move. He suffered a break in T1 and T2 and partially severed his spinal cord in the process.
T1 and T2 power the muscles that lie between the ribs, the intercostal muscles. These also help you breathe by drawing the rib cage outwards and upwards, pulling the lungs in the same direction. The lungs expand, helping them fill with air.
He was having trouble breathing and his diaphragm was extremely tight when I examined him, for a moment I thought his diaphragm was paralyzed as well. The diaphragm and the intercostal muscles are your major breathing muscles.
There was another man at the end of the bed and when he saw my confusion he spoke in fluent english, “I know what you are thinking, and no the phrenic nerve hasn’t been damaged”. The phrenic nerve originates at C4 but plays a minor role in C3 and C5 nerves. It controls the function of the diaphragm and thus, breathing.
I was taken aback obviously and extremely relieved. I was trying to think of the nerve but couldn’t for the life of remember the name, but more importantly this guy knew his stuff.
It turns out that it turns out that the gentleman who I was talking to was infact Mohans Physiotherapist, Dr Narendra Tiwari. Unlike Australia or New Zealand, Physiotherapist in India are Doctors, they study for 5 years then do an additional year as an internship before they set the board exam and are allowed to practise.
In addition to being a Physiotherapist Dr Tiwari did his Masters in Physiotherapy specialising in Neurology.
Dr Tiwari took me through the exercises and his treatment plan for Mohan. I added my 10 cents worth when I thought it was appropriate and he appreciated a new perspective on the patient’s condition. I gave the family some dietary advice for Mohan and Dr RK Ji prescribed some herbs that would help support his nervous system and aid in nerve regeneration.
I turned to Dr RK Ji and shook my head, there was absolutely no need for my work here. Mohan was in more than capable hands, and he was making progress, great progress, thanks to Dr Tiwari.
However, with that issue out of the way I wanted to address the bedsores and scabs that were littered across his body. As well as the flies that were using these wounds as a banquet. I explained the concept of wound dressing and they assured me that they had a doctor visit the home twice a week to address the wounds. I noticed a drain in the main bedsore but was still concerned that the others were open to the elements. Dr Tiwari assured me that the wounds on his legs were nothing to worry about as the were not bedsores, they were from “just from a mouse”.
“I’m sorry what?” thinking I had misheard.
But no he actually meant a mouse. Turns out that a mouse (Rat) or two had decided that Mohans incapacitated legs would be a great warm meal during the cold winter nights. The family have tried their best to keep them away and have started taking it in turns to watched over him while he sleeps to keep them away.
No one except myself seem to concerned about the prospect of the wounds becoming afflicted.
So I explained the concept of infection and the repercussions it could have on Mohans progress. They understood and assured me that they would do more to ensure the rats did not eat their sons legs.
I walked away from that situation thinking many things and now I can’t stop thinking.
I can’t stop thinking about Mohan, his family and Dr Tiwari.
I can’t stop thinking about how in the face of adversity the Indians just get on with it.
I can’t stop thinking about how much love Indian families have to give and how if one family member is ill the whole family carries that burden, except it is not a burden. It is a time for everyone to pull their weight and support each other with smile and laughter.
I can’t stop thinking about if we in the western world were in the same position would we have someone watch over us as we slept to protect our numb flesh from the carnivorous vernum.
Finally, I can’t stop thinking about how I have so much to teach these people, but more importantly a great deal further to learn.
*Name has been changed to protect the innocent.