SUNFLOWERS, HELIANTHUS ANNUUS,BELONGS TO COMPOSITAE/ASTERACEAE, THE FAMILY OF DAISY FLOWERS, NEED FULL SUN TO GROW WELL.
LIVING UNDER SHADOW :
Shadow gives us protection or shelter from external danger. In India, women before their marriage live under the shadow of their fathers. After marriage, women are expected to live under the shadow of their husbands. Indian Tradition demands that a married woman should be subjected to live under the influence or domination of her husband. Very often, women love to bask under the glory of the position, the status, and the power wielded by their husbands. But, living under shadow should not endanger the very existence of the individual who is seeking the protection. Sunflowers bloom and thrive only when exposed to full sun. These plants cannot grow well under shade or shadow. Every individual has a fundamental Right to exist. No individual should dominate or influence another individual to an extent that compromises the Right to Life.
A PRESCRIPTION FOR DEATH :
General Krishnaswamy Sundarrajan,PVSM ( popularly known as General Sundarji) was India’s Chief of Army Staff from February 1, 1985 to May 31, 1988. I had spoken about him in my blog post titled ‘WINNING PEACE – THE ART OF PREPARING FOR WAR’. He was married to Padma Sundarji when he was a Major serving with the MAHAR Infantry Regiment in the Army. She spent the best years of her life living with him and had kept his company throughout his various postings. I met Padma Sundarji for the first time in my life in the year 1978. At that time, General Sundarji was serving as General Officer Commanding (GOC) of First Armoured Division. It was a rare distinction of great honor for an Infantry Officer to Command an elite Armoured Division. I was serving as a Medical Officer in the rank of Major under the Command of General Sundarji.
I had met Padma Sundarji at the General’s official residence. I went there to personally administer intramuscular injection of Streptomycin which is exclusively reserved for the treatment of Tuberculosis. Three drugs are concurrently used as first-line drugs in the Initial Phase of treatment of Tuberculosis and the daily injections of Streptomycin are used for about three months. Pulmonary Tuberculosis is a “NOTIFIABLE” Communicable Disease in the Armed Forces. Statutory legislations have been made at various levels for imposing legal obligations on all people to facilitate control actions to prevent the spread of the infection in the community. ‘OPEN’ or infectious cases of Pulmonary Tuberculosis are always treated in an ‘Isolation Ward’ of a Hospital. Padma Sundarji was getting treated at her home and hence would not be considered as an ‘open’ case. It also means that there were no Mycobacterium tuberculosis Bacilli ( Gram Positive, Acid-Fast Bacilli) in her sputum. Apparently, she was diagnosed as a case of Pulmonary Tuberculosis simply based upon an interpretation of her chest X-ray films. There was no conclusive evidence to claim that she was having Tuberculosis infection. Tuberculosis is prevalent in India but it is less common among people serving in the Armed Forces. I had mentioned in my earlier blog post that we routinely medically inspect all personnel to detect illness including infections like Tuberculosis. While she lived at the General’s residence, there was no practical chance that she would come into contact with an ‘open’ case of Tuberculosis who could transmit this infection to her. Apart from that, we routinely vaccinate all individuals to protect them from Tuberculosis. These facts were not used in establishing her medical diagnosis. She was diagnosed as a Pulmonary T.B. case by a Medical Specialist who had no special training in the diagnosis or treatment of Lung Cancer. A Medical Specialist while looking at a chest X-ray film would tend to diagnose T.B. and not Lung cancer. This Medical Specialist had misdiagnosed Padma Sundarji as a case of Pulmonary T.B. as he had no experience in the diagnosis of Lung cancer. She was given the Standard Anti- T. B. treatment and if the treatment was correct and appropriate, she would show improvement day after day. She would have felt a little better after each day of her treatment with those very powerful drugs. She had NOT shown any encouraging response to her therapy and in fact her condition was deteriorating day after day. The Medical Specialist was very convinced with his diagnosis and he had never bothered to check upon her while she was religiously taking these daily doses of intramuscular injections of Streptomycin and other drugs.
When I first met Padma Sundarji, I had immediately diagnosed that she was not in Good Health. Her face lacked the expression that is typically associated with the vigor and bloom of Good Health. I had instinctively known that she was not responding to her Anti-T.B. treatment. I spoke to her mother Smt. Indira Rao. This elderly lady had openly expressed her disbelief in the diagnosis. She was utterly unhappy with the Anti-T.B. treatment that was being given to her daughter. She was already feeling helpless and anxious about her daughter’s life. If Padma Sundarji had been the wife of any other person, I would have immediately sent her to the Hospital and would have obtained an opinion from a different Specialist. In my previous blog post I had narrated as to how I had intervened at Military Hospital, ROORKEE and had publicly exposed the incompetence of the Medical Specialist there during 1973. Padma Sundarji was living under the shadow of her husband. If you are in someone’s shadow, you receive less attention and seem less important. I was less qualified than the Medical Specialist, and I was not in a position to convince General Sundarji to disregard the opinion and the treatment recommended by this Medical Specialist. Padma Sundarji needed urgent re-evaluation. I had asked Smt. Indira Rao to take her daughter to the All India Institute of Medical Sciences at New Delhi and obtain a second opinion. Indian Traditions stood in the way of this battle for life. Women are not expected to act on their own even if their own life is at a great risk. She could not act upon my sincere suggestion and my desire to protect the health of a person to whom I was asked to give an injection. I had administered the injections for only a short period of time and the duty was resumed by another Medical Officer. I had no further contact with her or her mother. Eventually, Padma Sundarji was transferred to Army Hospital, Delhi Cantonment. She died of Lung cancer in 1978. She was cremated in New Delhi. She never had a chance to return alive to the First Armoured Division and to her existence under the shadow of her husband, the General who later became the top Military Commander of Indian Armed Forces.
THE BATTLE OF LIFE vs DEATH :
In 1978, the medical community and the general public were not aware of the dangers of ‘SECOND-HAND’ tobacco smoke. People who inhale ‘second-hand’ smoke are exposed to the same cancer-causing agents as smokers. Second-hand tobacco smoke also causes Lung Cancer. By the time symptoms appear, Cancer may have begun to spread. Hence, early diagnosis of Lung Cancer is very important to improve the chances of survival of Cancer victims. I am not claiming that Padma Sundarji would have lived forever if I had admitted her to a Hospital promptly. I could have definitely helped to prolong her life by a few hours or even a few more months. General Sundarji who had repeatedly inspected and tested the Medical Unit under his Command in the First Armoured Division clearly knew that his Medical Officers at their very best could only protect and prolong the lives of his men for a few precious hours. During those precious moments, we evacuate our casualties to the nearest Hospital. If we succeed in doing so, we most certainly save some lives. In the battle of Life vs Death, a few hours makes a huge difference. Padma Sundarji who had lived under the shadow of a General did not receive the benefit that I was trained to give to the men under his Command. She was excluded and I did not evacuate her to the nearest Hospital which could have added a few more hours to her life.
BHAJA GOVINDAM – PART – II :
At First Armoured Division, we took pride in our training and preparedness to defend our country from the threats of external aggression. Apart from the threats posed by external enemies, human existence faces several challenges. Many times, we are not aware of the threats faced by our loved ones who live under our shelter. The Art of Diagnosis interests me,but there may be no escape from the threat and hence the ultimate refuge still remains the same, the sweet name of GOVINDA.
Bhaja Govindam, Bhaja Govindam,
Govindam Bhaja muudha matey,
Sampraapte Sannihitey kaaley,
Nahi Nahi rakshati Du krun karaney.
Dr. R. Rudra Narasimham,
Kurnool Medical College, Kurnool, A.P., India,
M.B.B.S., Class of April, 1970.