Friday, August 15, 2014

MotiBindu, Phacoemulsification and other stories......


The first time she heard about cataracts in the eye, was way back in her  childhood,  when someone referred to it, exotically as "Motibindu" in Marathi, or literally, the Pearly Point. It was supposed to ripen like a fruit, and was then harvested  as such in a complicated surgery. 

A cool  Mumbai morning in August 1977. (Yes, that was before global warming set in.)

A lady in her late sixties,  in crisp white saree, and a knitted saree cardigan (to guard against AC) , got ready to be driven to an eye clinic in a Western Mumbai suburb. Her entire extended family, including her doctor daughter in law had arrived, and they would shortly reach the clinic where the cataract surgery was  scheduled. Assorted sisters in law  from within  and outside Mumbai had also arrived. Strangely there were no parking problems on one of Mumbai's most crowded roads.  Everyone watched the comings and goings in the OT, and a hush descended as the doctor went in. The old lady, wished everyone and entered the OT , with her elder doctor daughter-in-law, who had been kindly allowed to be present.

Sometime later, she was wheeled out into the room, with a big bandage over her eye, and gently lifted on to the bed by expert attendants. A whole gaggle of relatives who had gathered , and spent time talking to each other about so and so's cataract, how it was messed up, how so and so corrected it, suddenly hushed up, peeped in to see the patient and left, promising to come again.

Then started 10 days of what can only be called a cataract festival.

Literally hundreds of blood relatives, and relatives by marriage descended into the suburb, and the younger daughter-in-law, was allocated the chauffeuring job, of transporting elderly types from home to clinic and back, along with assorted lunch dabbas, dinners and tiffins for the patient. The patient, despite a traumatised lens area,  was in her absolute element , instructing people about how cooking oil at home needed to be replenished, how you couldn't buy it on a Saturday , and how someone needed to rush in the middle of everything to someplace to order and have it delivered.  The younger daughter-in-law would often wear jeans and kurtas to the complete consternation of some disapproving elder ladies , who had no clue about clutches, accelerators, and the possibility of entangling your feet in saree pleats , while driving a bunch of loudly talkative folks back and forth on one of Mumbai's arterial high traffic roads.

There were suggestions about how a sneeze  would shake the eye stitches and nullify the surgery, and how no pickles with mustard and hing were to be brought in the lunch. There were folks who visited the patient and mentioned horror stories of failed cataracts. There were indirect and direct discussions about other relatives who visited.

And there was one visit, where  a grandma type sat next to the patient, and whispered to her, asking, how she tolerated her younger daughter-in-law wearing, "these jeans". The patient lady, "patient " in more than one way, a new dressing over her eyes, and looking straight ahead and up, explained, that girls then, did many more activities than before, her daughter-in-law was fulfilling a crying need of transporting elderly people in comfort by driving them and food back and forth, and in any case , the daughter-in-law always dressed appropriately in traditional clothes for other occasions as required, and so the old lady had nothing to complain. The grandma type, suitably admonished, was heard mentioning to others , how lucky the driving daughter-in-law was.

By and by, ten days passed, stitches were examined, decisions taken, and the suspense finally ended as the stitches , bandages et al were removed,  black no-nonsense mafia style sunglasses , totally out of character with the patient in question, were worn, and everyone, patient, extended family and all, returned home, via a visit to the local deity at the temple. The entire family except for diabetic types (including the patient) enjoyed some celebratory sweet stuff specially made by the patient's sister.   And so ended the saga of the cataract.

Cut to 2014.

Another cataract surgery. Hospitals, lobbys, computers spewing out paper after paper, bills after bills, medical records and so on. Special hospital clothes to be worn by the patient. One relative allowed with the patient, and made to sit in a waiting area much away from the sterile spaces.  Patient spaces populated with all kinds of infrastructure like oxygen supply, ECG machines, bells, tables that slide, etc.

There were seven cataracts scheduled that morning. No relatives supplying advice, no waving to them by the patient, just one bed after another, trundled into the OT.  One bed after another, trundled out of the OT after 25 minutes, the operated eye covered by a specially shaped cup type thing using tape. The aforesaid driver daughter-in-law , this time,  automobile-disabled due to potholes,  was called in to see the patient, and stay for some time in the recovery area.  Patients were given a choice of snacks. Unlike in 1977, sneezing (which did not happen) was clearly not an issue, as a sambaar with red chilly tadka proved.

Patients were instructed, NOT to turn to the side of the operated eye, when they slept, as they waited. Relatives were strictly told they could wait outside. The daughter-in-law has a habit of listening to such instructions, and on her way out ,  was aghast to see a young patient , in a bed near the doorway, sleeping exactly on the side of the operated eye. She rushed back  to the recovery room junior doctors still in their surgical greens and shower caps, to tell them about this.  They came urgently, to advise that patient, and straighten her out , literally.  And the aforesaid daughter-in-law returned to the waiting area, having done her good deed for the day .

Three hours and few checkups of reddened , occasionally watering eyes, the patient returned home, wearing mafia style dark glasses, uncannily like those of the old lady in 1977.

Phone calls and emails happening, several types of drops to be put in the eyes every so many hours, useful instructions, all written down in a discharge summary, and a followup appointment in the following week.

Thanks to the modern Phacoemulsification technique, there are no stitches to be removed, no eureka moments after ten bandaged days, the patient goes home and spends some bored times checking emails on the PC, and watching TV even on the first day, observing MP's fighting in Parliament.  Immediate relatives, drop by at home , and return , pleased about the progress.

And life goes on. 
....

....

I am just wondering, if a time will come when they will have drive-in cataract operations by robots.

And like, the mother-in-law worried about cooking oil reaching reorder levels , instructing folks to avoid Saturdays while ordering it,   I wonder if the robots, will also alert you if your car is running low of gas or oil ?.........        

:-)


2 comments:

  1. This surgery was experienced
    by this one last year at age 77.
    Done quickly, no problem except did not like all the eye drops
    that I had to use, had a chart sitting on my table so none would be missed.

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  2. I had my first experience of a Cataract Surgery when Mom got both of them removed in the space of a few months last year... but it was good to hear the old experience at the same time! :)

    How times have changed... for the better I guess... atleast you get sambhar with red chilly now instantly! :D :D

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