Patients under coma are dead for all practical purposes. Most of them cannot talk or walk or move their body parts. It is the huge waste of time keeping patients in coma artificially alive as it only benefits hospitals.
By Rajan Narayan
Indian patients across the country are lying in hospitals in coma. When a patient is in a coma he or she is totally unconscious although a part of the brain may continue to function. But for the functioning of the brain no other part of the body works. People keep their loved ones on a ventilator for years in the hope that they will come out of the coma. This only benefits private hospitals….when there is no hope patient should learn to let go and opt for euthanasia!
VETERAN and popular senior Congress leader Priya Ranjan Dasmunsi died after being maintained in a coma for almost ten years in a hospital in 2017. He had suffered from a massive stroke in 2008 which left him paralysed. He was unable to speak. Blood supply to a part of his brain was cut off causing irreversible damage. His body systems were functional but he breathed through a tracheostomy tube attached to his neck and was fed through a PEG tube attached in his stomach. All basic life functions like breathing, blood pressure, sleep-awake cycle were stable but he was not conscious of his surroundings.
Reportedly after he passed away despite all efforts revive him the 5-star hospital bill in Kolkatta came up to Rs50 crore. It is not known who paid the bill, the BJP government, Congress party, the All India Football Federation which he was heading when the tragic massive stroke took place or his family. Dasmunsi had entered the Indian Parliament in 1971 and was sworn in as Union Minister of State, Commerce in 1985. This is to say there are literally hundreds if not thousands of patients in coma situations in hospitals across the country. The bold and the beautiful and the rich and the powerful are kept in intensive care units for months or years on end. Those who are in coma are virtually dead. Unfortunately, there is no legal provision in India to voluntarily end one’s life or let grieving relatives pull the plug. So much so huge amounts of money are literally wasted on keeping coma patients in the ICU.
QUALITY OVER QUANTITY
IT is not the quantity of life but quality of life which matters surely. We fail to understand why patients in coma or in an advanced state of cancer insist on prolonging their life. I personally with my multiple health problems want to make my exit from the world. I have a rectal prolapse which worsened after several surgeries. Now my rectum hangs out of the anus and I find it very difficult to push it back inside…recently, I discovered that I have severe neurological problems affecting my spine all along the cerebral column to the legs. The consequence is that now I can walk with great difficult, I can barely shuffle.
I don’t see any point in living in so much pain and agony. Unfortunately, the Lord above does not decide the date of one’s exit. So much so even though you may have advanced cancer or a stroke or are an immune-compromised condition, you have no choice but to put up with your life no matter how prohibitively expensive it can become. You may of course minimise your suffering with a lot of very expensive medications. But how many patients can afford the lakh of rupees a month which need to be spent on maintaining a reasonable quality of life of minimizing pain and suffering?
In my case I have to take a range of medicines including expensive injections. My medical bill which includes doses of multivitamins is very pricy. Due to my rectal prolapse I wear diapers 24 hours which on an average cost Rs35 each in a pack of ten diaper underwear for seniors. Plus, now I have been advised to have a high protein and fiber diet and to drink Ensure which is far more expensive than ordinary rice meals or bread or chappati-dal meals.
My life’s biggest disaster happened when I was beaten up on the neck with iron rods and cycle chains while I was editor of the “OHeraldo” on September 16, 1989. I am still enduring the consequences of the severe professional beating by goons instigated Rudolph (today’s Santa Cruz MLA) on the “supari” of minister Dayanand Narvekar. The situation was compounded at the Goa Medical Hospital & College (GMC) where Head of Department of Medicine Dr NGK Sharma started me on steroids. Steroids are a wonder drug but have very serious side effects. Perhaps it was the VIP syndrome of anxiety to please which made Sharma keep increasing the steroids dose exponentially going up to 100 mg a day. Some senior doctor friends of mine told me that I would die if I stayed on at the GMC and advised me shift to Jaslok hospital in Bombay. The most serious blunder Sharma was guilty of was to give me a discharge certificate which said I suffered polyneuritis or polymyositis. In the first one does not require steroids. Without steroids it would be difficult to survive polymyositis. The even more irresponsible act of Sharma was to abruptly stop my stereo doses instead of tapering them of gradually. I went into a coma and courtesy Dattaraj Salgaocar’s was airlifted to the Jaslok hospital in Bombay.
By the time I was in Jaslok the symptoms of what I was suffering from were masked. Dr Ness Wadia did all the conceivable tests both for polyneuritis and polymyocitis. Since an accurate diagnosis could not be made Dr Wadia asked me to continue to take 50mg of steroids and taper it off over time. But it did not work because even at the 50mg threshold the pain was very acute and the dosage had to be increased to between 70 to 80 mg.
SECOND OPINION
I DECIDED to get a second opinion with Dr BS Singhal who was the doyen of neuroscientists in Bombay Hospital. It was a repetition of the same story. In my desperate search for relief I went to every prominent hospital in the country ranging from the Christian Medical Hospital in Vellore to the All India Institute of Medical Sciences in Delhi. It was suggested that I should go to the National Hospital for neurology and neurosurgery in London which is considered the Mecca of the neurosciences. My English filmmaker friend Kenneth Griffith undertook to bear all the expenses. The most touching part was that the general public in Goa contributed towards my air fare to London when an appeal was made by the Editors Guild of Goa (not to be confused with the one today).
At the London hospital they made the situation worse by putting me on very strong sedative called triamcinolone. Steroids are uppers. Triamcinolone is a downer. Between the two drugs I went through wild swings of moods. I came back to Goa thinking there was no cure for me. My weight had gone up to 180 kg, I had virtually lost my eyesight to glaucoma in both eyes. The specialist eye hospital Sankara Nethralaya managed to restore one eye through cataract operation later on. My bones were very brittle and I was unsteady on my feet.
At the Bangalore airport I had a major fall and a broke several ribs. A friend admitted me to the Mallya Hospital owned by notorious liquor baron Vijay Mallya’s family. Here the young endocrinologist Dr S Srikanta who had just come back from Havard Medical School was passing by and took a look at me and said if I continued to take steroids I would not survive for a month. Mine was a doctor-created disease. But if I de-toxed from steroids I had every chance of survival.
So I spent five months in the Mallya Hospital while he completely detoxed me and my weight fell from a 180kg to 36kg. But this led to the collapse of my gastrointestinal system and Dr Srikanta of course claimed that every procedure has side effects, that now I would have to go to a gastroenterologist for treatment. You can imagine the huge amounts of money I spent on my medical treatments which stretched through several hospitals for five months. But at that time I was anxious enough to live as I was at the peak of my career and begged, borrowed the money that I needed for treatment.
POINTLESS LIVING
DO not be obsessed with prolonging life. There is no point in living or really sleeping in a coma. There is no point in being on a catheter for a prostrate problem for three years. There is no point in undergoing invasive surgery for cancer after 70 years. I turned 76 on July 4, 2023 and ready to go wherever people go after they are dead.
When I had turned 75 last year I had taken a decision to end my life. I believed that I had completed my commitment to society. I had fought to make Konkani the official language of Goa. I took on the goons in Goa and this will be testified by senior cops in Goa. I saved Goa from being converted into a concrete jungle by Babush Monserrate and through the Goa Bachao Abhiyan. I have completed my commitments to myself and lived a full life on my terms. Time to say goodbye!