Accident
[SATURDAY UPDATE BELOW]
I arrived in India on Sunday afternoon. On Monday evening I used the internet from 7:07 until 8:05 or 8:06. When I was finished I paid my 15 rupees (about US $0.35) and walked out a dirty enclave with children playing, men butchering chickens and peeling potatoes, rank puddles, and the odd motorbike. I stepped out into the street and looked to my right, following my ear to a large red firetruck making obscenely loud and annoying beeping noises heading down the street. I made a face of annoyance to a deaf boy I know in the neighborhood, covering my ears. He looked on, uninterested. The street is narrow to begin with, barely fit for two way traffic when empty, but there is parking "allowed" (because policemen are slipped cash) on one side and taxis keep the lane mostly occupied, making it difficult for the constant flow of cyclists, coolies, pedestrians, motorbikes, rickshaws, cars, trucks, taxis, goats, mobile merchants, etc. On the side where parking was never allowed a large sari/saree shop's small truck was parked. The firetruck had difficulty squeezing through.
Soon after it passed a few people started to gather to look at a boy who I will call Amaan, 14 years old, dressed in jeans and a t-shirt, who was leaning against a metal cage that housed some city electrical or plumbing equipment. He looked like he might be about to vomit, maybe he was drunk. Those were the first things that I thought. But then I saw his leg. His right leg had been pinned between the small truck and the fire truck. It was... open. The laceration must have been at least 2 inches deep. I could see muscle, tendons, maybe bone.There were pools of dark blood around his foot. Some people moved him to the sidewalk and he appeared conscious, but drifting. It seemed like time stood still and no one was doing anything. Someone tied some pieces of fabric around his upper leg. I remained close, did what I could.
Several taxis sped away when we asked for help. Even more taxi drivers pretended not to notice, skulking away. When one driver was willing to help, Amaan was brought into the taxi and I sat on the edge of the back seat between his torso and the front seat. His head lie in the lap of another boy, who I did not see again after the hospital. I held Amaan's hand and stroked his face, looked for the gushing blood that never returned, and tried to make sure he stayed alert and conscious.
I didn't know where we were going. We went to a "government" run free hospital. He was moved haphazardly to a dirty metal gurney, specks of dried blood on the sides and bed. There was no one around, no one that seemed alarmed or concerned. The hospital was dank and dirty, beaten and soiled. He was moved a few times, from gurney to table and back, to an x-ray table in an old room with no shields or vests and equipment out of a Roswell alien investigation photo circa 1947. The two x-rays were paid for when they should have been free.There were not orderlies to push the gurney or rolling racks to hold the saline solution. I helped with these things.
In good time, two of the Amaan's older brothers came. We were told that medicine was unavailable, even though it was supposed to be be free of charge. Behind a closed door someone slipped a doctor money and suddenly the medicine was there. In a room with bloody scraps of cotton littering the floor and walls dirtier than a back alley, a doctor (I hope, I presume) made approximately 25 big black rough stitches on the boy's leg. Seeing the wound before this, I had assumed the flesh had been torn off.
There are no words for the place, for the sadness and desperation, the filth and hopeless hope. The woman who looked drugged, sick, nearly unconscious and in desperate pain, told to leave and carried out because she was not critical. The rows of people lying in filth by the non-emergency admittance door. The crying babies, the sleeping skeletons, the numb and zombie-like staff.
Amaan and several of his family members are here in Calcutta for work, to help those who remain at home. They are from Bihar, one of the poorest and most populous Indian states. He has been in Calcutta less than one year.
It was decided that Amaan would be moved to another hospital where he could be cared for. No hospital vehicle was available so we maneuvered him back into the taxi and he was transported. The new hospital was still atrocious by Western standards but gleams far above the first one. The linens are fairly clean, there is one doctor on duty each day in his unit, 24 hour shifts, once a week. There are a few orderlies and assistants and a nurse.
That night I was relieved Amaan could have a chance at recovery. That people helped him, that he has family here, that I could do something. When I returned to my guesthouse, however, I was numb and shaky. Seeing the conditions of the first hospital made me feel weak and lost, concerned for those there and all that would never even be lucky to be cared for in such a forlorn place of "healing". In a million ways Amaan is lucky. In this country of over a billion, in this crowded metropolis of millions, there must be countless stories of injuries and medical injustices that make his story sound a dream. How many rickshaw pullers, sleeping on the street at night, sending pennies far away home when they can, or sleeping in literal garbage dumps with their families, are injured with no chance? How many car accidents at night leave the poor bloody and dying in the road? Amaan is in school. His leg was not severed. He has family able to borrow the money for the medical bills. The sari shop offered a small sum, but it was refused since one of the family members does some work with them and feared that taking the money would mean he would forever lose their business. Amaan was hurt in a tourist-quarter with many people looking on, determined to help, to be accountable. He is extraordinarily lucky.
Tuesday, day after the accident I visited Amaan in the hospital in the morning and evening and stayed 2 hours each time. This was only possible because the guard in front of the unit was bribed. Normally, family is allowed a few minutes during lunch and one hour in the evenings. That morning, I did the same things I had been doing- holding his hands, massaging his arms, stroking his hair and face, muttering platitudes he couldn't understand. He had not said anything to me. Only responding with nods and shakes of his head when I tried to make sure he was alert, asking if he wanted water, etc. When I was getting ready to leave, after the guard told me for the third time that I really did have to go, Amaan looked up at me, and said so sweetly, his voice cracking, "Thank you." He speaks A Bihari language and Hindi, maybe Urdu. I speak English.
When I returned Tuesday evening I meant to say goodbye, I had a ticket for a train to New Delhi on Wednesday morning, fully intending on going. I had told him this (through a local friend translating). But on Tuesday evening Amaan said to me, "Are you coming tomorrow? Don't go." I was leaving, I had a ticket. But on the ride back to my guest house, I laughed and cried, Why would I go? How could I go? Because a train ticket that cost $10? There was no way I could go, and on Wednesday I canceled my ticket.
Both Wednesday and Thursday I continued the twice daily visitations. When I extend my hand to him he reaches back. He responds robustly to questions he is asked. He was able to speak with his mother and I held his hand as tears fell down his cheek. He told her that it is just a small cut and he will be fine.
Everyday I see his brothers and I feel like his new Auntie or didi (sister). I am very happy providing the doting care and affection even adults secretly want. As the days go on he has become stronger and more comfortable responding to and returning affection. When I probe him to tell me the special foods and drinks and magazines he likes he asks for nothing. But I know he appreciates the fruit, "cold drinks" (soda) and the little FM radio I brought in. I have been invited to visit his village in the future. I was only able to visit on Friday evening, missing the lunch hour, and he was able to say he noticed and was disappointed (in so many words...). When I first saw him tonight (Friday) he smiled at me- just a little. And later I got a full smile. It was like the sun.
I'm looking for help. I realize that medical advice or consultation 10,000 miles away (or more, or less) is inadequate, but so is his current level of care. I have already briefly spoken with a doctor friend via chat, but I would like as much input as possible. You can post anonymously and everything you say will be taken as suggestion alone. I am not a doctor but I was able to say and suggest things at the hospitals that would not have been done otherwise. All advice and information is appreciated. Here is what I know.
First, here is a link to a photo of his leg that I took 2.5 days after the accident. Click here. I was not able to take a photo of the open wound.
Amaan is injured in his lower right leg only. His leg was stitched at the government hospital, under dire conditions. He has no broken bones. He has received an IV saline drip continuously except for the 4th day when he received 2x250ml of blood (about 1 pint). He never lost consciousness and responds to questions. He has no feeling around or below the wound (right calf, extending behind knee). There is obviously nerve damage, but I have no idea how extensive. His right foot seemed cold the first night but blood flow seems to have returned. He told me he can move/extend his right leg but it is extremely painful. He is very thin and his leg is somewhat swollen. Around the wound his skin is warmer.
From his prescriptions:
Emigo
Enzoflam
Noveran
N.S. 100ml Ing (MM)
N.S. 500ml Ing (Baxter)
Oframax
Pantop
Paracetomal (seen but not prescribed)
Rantae
Revotaz
R.L. - IV (Nirlife)
Tetglob
(+ various needles, syringes, gauze, etc)
The conditions are not good, and I worry most about infection. I asked the staff to bandage the leg yesterday. The same bandages were on today, obviously seeping some blood and pus. The room is large and dirty, the air conditioning does not work well and the windows are often open- open to a busy street in a dirty and polluted city. Gloves are not worn very often and I have not been able to look at his chart. I don't know what questions I can ask, I don't know what more I can do. I am only able to visit for around 1.5 hours a day.
Thank you.
Update: Here is a photo after 4.5 days. Click HERE. He has a fever this morning and is in a lot of pain. The leg looks worse to me. He is NOT able to move his foot/toes.
I arrived in India on Sunday afternoon. On Monday evening I used the internet from 7:07 until 8:05 or 8:06. When I was finished I paid my 15 rupees (about US $0.35) and walked out a dirty enclave with children playing, men butchering chickens and peeling potatoes, rank puddles, and the odd motorbike. I stepped out into the street and looked to my right, following my ear to a large red firetruck making obscenely loud and annoying beeping noises heading down the street. I made a face of annoyance to a deaf boy I know in the neighborhood, covering my ears. He looked on, uninterested. The street is narrow to begin with, barely fit for two way traffic when empty, but there is parking "allowed" (because policemen are slipped cash) on one side and taxis keep the lane mostly occupied, making it difficult for the constant flow of cyclists, coolies, pedestrians, motorbikes, rickshaws, cars, trucks, taxis, goats, mobile merchants, etc. On the side where parking was never allowed a large sari/saree shop's small truck was parked. The firetruck had difficulty squeezing through.
Soon after it passed a few people started to gather to look at a boy who I will call Amaan, 14 years old, dressed in jeans and a t-shirt, who was leaning against a metal cage that housed some city electrical or plumbing equipment. He looked like he might be about to vomit, maybe he was drunk. Those were the first things that I thought. But then I saw his leg. His right leg had been pinned between the small truck and the fire truck. It was... open. The laceration must have been at least 2 inches deep. I could see muscle, tendons, maybe bone.There were pools of dark blood around his foot. Some people moved him to the sidewalk and he appeared conscious, but drifting. It seemed like time stood still and no one was doing anything. Someone tied some pieces of fabric around his upper leg. I remained close, did what I could.
Several taxis sped away when we asked for help. Even more taxi drivers pretended not to notice, skulking away. When one driver was willing to help, Amaan was brought into the taxi and I sat on the edge of the back seat between his torso and the front seat. His head lie in the lap of another boy, who I did not see again after the hospital. I held Amaan's hand and stroked his face, looked for the gushing blood that never returned, and tried to make sure he stayed alert and conscious.
I didn't know where we were going. We went to a "government" run free hospital. He was moved haphazardly to a dirty metal gurney, specks of dried blood on the sides and bed. There was no one around, no one that seemed alarmed or concerned. The hospital was dank and dirty, beaten and soiled. He was moved a few times, from gurney to table and back, to an x-ray table in an old room with no shields or vests and equipment out of a Roswell alien investigation photo circa 1947. The two x-rays were paid for when they should have been free.There were not orderlies to push the gurney or rolling racks to hold the saline solution. I helped with these things.
In good time, two of the Amaan's older brothers came. We were told that medicine was unavailable, even though it was supposed to be be free of charge. Behind a closed door someone slipped a doctor money and suddenly the medicine was there. In a room with bloody scraps of cotton littering the floor and walls dirtier than a back alley, a doctor (I hope, I presume) made approximately 25 big black rough stitches on the boy's leg. Seeing the wound before this, I had assumed the flesh had been torn off.
There are no words for the place, for the sadness and desperation, the filth and hopeless hope. The woman who looked drugged, sick, nearly unconscious and in desperate pain, told to leave and carried out because she was not critical. The rows of people lying in filth by the non-emergency admittance door. The crying babies, the sleeping skeletons, the numb and zombie-like staff.
Amaan and several of his family members are here in Calcutta for work, to help those who remain at home. They are from Bihar, one of the poorest and most populous Indian states. He has been in Calcutta less than one year.
It was decided that Amaan would be moved to another hospital where he could be cared for. No hospital vehicle was available so we maneuvered him back into the taxi and he was transported. The new hospital was still atrocious by Western standards but gleams far above the first one. The linens are fairly clean, there is one doctor on duty each day in his unit, 24 hour shifts, once a week. There are a few orderlies and assistants and a nurse.
That night I was relieved Amaan could have a chance at recovery. That people helped him, that he has family here, that I could do something. When I returned to my guesthouse, however, I was numb and shaky. Seeing the conditions of the first hospital made me feel weak and lost, concerned for those there and all that would never even be lucky to be cared for in such a forlorn place of "healing". In a million ways Amaan is lucky. In this country of over a billion, in this crowded metropolis of millions, there must be countless stories of injuries and medical injustices that make his story sound a dream. How many rickshaw pullers, sleeping on the street at night, sending pennies far away home when they can, or sleeping in literal garbage dumps with their families, are injured with no chance? How many car accidents at night leave the poor bloody and dying in the road? Amaan is in school. His leg was not severed. He has family able to borrow the money for the medical bills. The sari shop offered a small sum, but it was refused since one of the family members does some work with them and feared that taking the money would mean he would forever lose their business. Amaan was hurt in a tourist-quarter with many people looking on, determined to help, to be accountable. He is extraordinarily lucky.
Tuesday, day after the accident I visited Amaan in the hospital in the morning and evening and stayed 2 hours each time. This was only possible because the guard in front of the unit was bribed. Normally, family is allowed a few minutes during lunch and one hour in the evenings. That morning, I did the same things I had been doing- holding his hands, massaging his arms, stroking his hair and face, muttering platitudes he couldn't understand. He had not said anything to me. Only responding with nods and shakes of his head when I tried to make sure he was alert, asking if he wanted water, etc. When I was getting ready to leave, after the guard told me for the third time that I really did have to go, Amaan looked up at me, and said so sweetly, his voice cracking, "Thank you." He speaks A Bihari language and Hindi, maybe Urdu. I speak English.
When I returned Tuesday evening I meant to say goodbye, I had a ticket for a train to New Delhi on Wednesday morning, fully intending on going. I had told him this (through a local friend translating). But on Tuesday evening Amaan said to me, "Are you coming tomorrow? Don't go." I was leaving, I had a ticket. But on the ride back to my guest house, I laughed and cried, Why would I go? How could I go? Because a train ticket that cost $10? There was no way I could go, and on Wednesday I canceled my ticket.
Both Wednesday and Thursday I continued the twice daily visitations. When I extend my hand to him he reaches back. He responds robustly to questions he is asked. He was able to speak with his mother and I held his hand as tears fell down his cheek. He told her that it is just a small cut and he will be fine.
Everyday I see his brothers and I feel like his new Auntie or didi (sister). I am very happy providing the doting care and affection even adults secretly want. As the days go on he has become stronger and more comfortable responding to and returning affection. When I probe him to tell me the special foods and drinks and magazines he likes he asks for nothing. But I know he appreciates the fruit, "cold drinks" (soda) and the little FM radio I brought in. I have been invited to visit his village in the future. I was only able to visit on Friday evening, missing the lunch hour, and he was able to say he noticed and was disappointed (in so many words...). When I first saw him tonight (Friday) he smiled at me- just a little. And later I got a full smile. It was like the sun.
I'm looking for help. I realize that medical advice or consultation 10,000 miles away (or more, or less) is inadequate, but so is his current level of care. I have already briefly spoken with a doctor friend via chat, but I would like as much input as possible. You can post anonymously and everything you say will be taken as suggestion alone. I am not a doctor but I was able to say and suggest things at the hospitals that would not have been done otherwise. All advice and information is appreciated. Here is what I know.
First, here is a link to a photo of his leg that I took 2.5 days after the accident. Click here. I was not able to take a photo of the open wound.
Amaan is injured in his lower right leg only. His leg was stitched at the government hospital, under dire conditions. He has no broken bones. He has received an IV saline drip continuously except for the 4th day when he received 2x250ml of blood (about 1 pint). He never lost consciousness and responds to questions. He has no feeling around or below the wound (right calf, extending behind knee). There is obviously nerve damage, but I have no idea how extensive. His right foot seemed cold the first night but blood flow seems to have returned. He told me he can move/extend his right leg but it is extremely painful. He is very thin and his leg is somewhat swollen. Around the wound his skin is warmer.
From his prescriptions:
Emigo
Enzoflam
Noveran
N.S. 100ml Ing (MM)
N.S. 500ml Ing (Baxter)
Oframax
Pantop
Paracetomal (seen but not prescribed)
Rantae
Revotaz
R.L. - IV (Nirlife)
Tetglob
(+ various needles, syringes, gauze, etc)
The conditions are not good, and I worry most about infection. I asked the staff to bandage the leg yesterday. The same bandages were on today, obviously seeping some blood and pus. The room is large and dirty, the air conditioning does not work well and the windows are often open- open to a busy street in a dirty and polluted city. Gloves are not worn very often and I have not been able to look at his chart. I don't know what questions I can ask, I don't know what more I can do. I am only able to visit for around 1.5 hours a day.
Thank you.
Update: Here is a photo after 4.5 days. Click HERE. He has a fever this morning and is in a lot of pain. The leg looks worse to me. He is NOT able to move his foot/toes.
posted by Maya at 9:13 PM
5 Comments:
Maya,
I followed you here from metafilter. I am unfortunately no sort of doctor and have no advice to give. Is there a way some extra money could help bump your friend up into a nicer hospital (if there is one around), or get him some real medical advice, or help with medication? I don't have much to give but I'm sure I'm not the only one who would like to help out.
Let me know.
Kelsey
Maya, I have something to say that may sound extremely callous to you, but please give this a thought:
I am an Indian. Life in India is tough. It is easy for you people (from developed nations) to feel sorry for the poor unfortunate Indians.
But when you offer money and affection, you are offering something that Amaan can only get from you, and not from anyone else in the society he belongs to. You are putting yourself in a position of power. He will become dependent on you. When you go away, as you must, eventually, what will his position be ?
I can't quite get the right words to get my point across, and I am *not* suggesting that you don't help at all, but I would ask that you don't overdo it.
Everything in life is relative. An Indian used to the tough life doesn't feel sorry for himself. Thats normality. Until someone like you comes along and shows him how miserable his lot in life is.
Which it isn't. Compared to the life in Ethiopia (just picking a target, I don't mean to denigrate that fine nation), life in India is positively heavenly !
Help him a little, and then walk away. He will survive.
Anonymous Indian,
Thank you for the input. These are precisely the reasons why I have not been paying for everything. Although I know it is a struggle for his family, it is not my place. The best thing I can do, the only thing that can not be bought or replaced is time. I am trying to give as much time as I can. Yes, life in India is hard, and it is difficult seeing him in a place where medical assisants must be bribed/tipped to change his sheets. What I am truly looking for and looking to do is bring attention, if possible, to small things that may affect his care and further treatment. All of the preventable disabilities and diseases here ARE miserable... There is nothing in his chart about nerve damage, about the loss of sensation, no one is talking about infection, and I want to, for example, make sure he has enough antibiotics when he leaves the hospital, that someone tells him he must complete the course, etc. I have visted his family in the city and there are plans to visit the home village in Bihar. I was there at the accident and this is how things played out. This is not my first time in the country, and I do plan on returning and keeping in touch. Time will tell, but I am sincere and the relationship does mean something to me. Thank you for your comments.
And thank you, Kelsey.
@Anonymous: I appreciate that your comment here was well-intentioned, but as a fellow Indian who has seen first hand what a little care and concern for a human life, if administered at the right time, can do, I don't think that your advice to Maya is correct. It is not the worst thing in the world for a poor Indian to become dissatisfied with his lot in life. Frankly, your comment seems a little condescending to me. The poor Indian who is lucky to receive a little help when needed understands as well as you and me that such help is unlikely to be forever and can deal with the withdrawal of that help better than you and I ever could, I'm sure.
I came here from Metafilter, Maya, and am sorry that I can't be of more help regarding treatment options but I just had to offer a dissenting opinion from Anonymous.
Hi,
I am not a medical professional, but have accompanied patients with bad leg injuries, and have seen infections. Looking at the photo, what I wonder is if the darkened area is getting bigger or smaller. If he has a fever and is in a lot of pain, he most likely has an infection. That has to be dealt with right away. If you can get the people around him to consider giving him more, or a different antibiotic, that could be worth it. If you can get him food made with a LOT of garlic and onion that may very well help because those are both antibiotics. Honey can be used topically on the leg. There have been many tests using honey to treat even leprosy. I'm suggesting this on top of high power internal antibiotics because infection is not something to mess around with. Continue to touch the non-open skin in order to provide healing energy and to help the nerves continue to re-build. Healing energy is real and can really help. Turmeric (bright orangy yellow spice) is widely available in india and has many curative properties. I do not know them well, but I have a strong feeling you should incorporate turmeric into his treatment- maybe mixing turmeric and honey and applying it to the wound? I am NOT a doctor. I do not know this from books. I have a strong sense that I should tell you these things, is all. I hope they can be helpful. You are a human being. If you did not follow your heart on this you would become less of a human being. You are doing the right thing. Be well. I'll be praying for Amaan and asking my circle to do the same.
Love,
Susan
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