Archie was assisting me in the actual surgery. Once all was in readiness for the incision, Archie, as was his custom, asked for a moment to say a short prayer. Ordinarily I was impatient with such displays of religiosity, but that day I felt we could use all the help we could get, so I bowed my head, too.
The three of us worked well together. It was the fastest right-upper lobectomy I'd ever performed. We used up the two and a half units of blood we'd just drawn—plus copious quantities of saline and dextrose solution, as temporary blood substitutes—and were surprised and gratified to see how well Dev responded immediately after the operation.
"It's because he's so young," we decided, and of course we were right. However, the first postoperative night in the recovery room was harrowing. I spent it listening to the soft whirr of the chest tube pump, as I watched fluid accumulate in the collection bottle. I was anxiously waiting for its color to turn from bloody to amber, which would indicate the cessation of active bleeding.
I knew that I wouldn't be able to do much more for Dev if the usual postoperative bleeding did not cease, or at least diminish, within 24 to 36 hours. But when it did, I felt sure the boy would recover.
Either his father or Shivaji, or both, came to visit Dev every day, bringing special food from home in stacked metal containers. With this kind of encouragement, Dev's appetite soon returned and within 10 days he was back on the regular ward and beginning to walk a bit.
The family once again dropped from my attention. There were so many other problems—from the financial troubles the sanatorium faced to the lack of a bronchoscope small enough to safely retrieve the foreign objects that infants often inhaled as they crawled about. About a year later, long after Dev had been discharged, my three-year term was almost up and it was time to start packing for our return to the United States. As I began to clean my cluttered office, I uncovered an ugly, six-inch-long iron object—the railroad spike-turned-paperweight that Shivaji had swallowed. When my diminutive secretary came in with another load of books and files, I asked him about that memorable patient.
"Manohar, whatever became of that young man from Ichalkaranji who swallowed this monstrosity. And wasn't that his brother who nearly died of lung
The family once again dropped from my attention. About a year later, long after Dev had been discharged, my three-year term was almost up. As I began to clean my cluttered office, I uncovered an ugly, six-inch-long iron object—the railroad spike that Shivaji had swallowed.
hemorrhage here as well?"
"Yes, Saheb, that is right. The story I am hearing is that after their father discovered that his son Dev was receiving the blood of two Christian Doctor Sahebs, he was removing his objection to his other son marrying the Christian girl Nalini. Saheb-ji, they are already having their first baby. They are giving him a Christian name. They are naming him after you."
"What? No! Really! Why haven't you told me this before?"
"They asked me not to, Saheb. They are not sure you would be giving permission. Also, in India, it is the custom when they name a baby after you that you are the boy's second father and mother. That is a great responsibility, Saheb. They knew you would return soon to America, so they did not want to put the burden on you."
"Well, isn't that something! I'd really like to see them—and the baby, of course."
Word was sent to Ichalkaranji, and the young couple appeared at my office, smiling and embarrassed and bearing a very small baby. It was the day before we were to depart. The mother held the black-haired infant proudly as he flailed his arms and legs about in the bright sun.
I hugged all three of them in one embrace and pressed an envelope into Shivaji's hand. "This is part of my responsibility," I said. "Make sure he goes to a good school. Maybe the one in Sangli." This was a school for mechanics that the Presbyterian Mission had established in a neighboring town. "I'll be thinking of all of you," I added.
"Thank you, Doctor Saheb. We will be remembering you, too. The little one will be here always to remind us."
The image that remains most vivid for me, more than 50 years later, is of the slender vice president, Shri Sarvapalli Radhakrishnan, in his immaculate Nehru jacket. When he swooped down on our little village from the empyrean heights of New Delhi, like a shining white knight, his visit seemed to initiate the dramatic train of events that first plunged us into deepest despair, then offered miraculous release.
How inscrutably, in the words of Omar Khayyám:
The Moving Finger writes; and, having writ,
Moves on: nor all your Piety nor Wit
Shall lure it back to cancel half a Line,
Nor all your Tears wash out a Word of it.
Takaro, a 1942 graduate of Dartmouth Medical School, is a retired thoracic surgeon and former chief of staff at the VA Medical Center in Asheville, N.C. He has written several previous features for Dartmouth Medicine, including "The Man in the Middle" (Fall 2004), about the role played by Dartmouth College alumnus Basil O'Connor in the development of the Salk polio vaccine, and "The Dufek File" (Winter 2005), about his own role in the first pacemaker implantation performed behind the Iron Curtain. All of the photographs accompanying this story are ones that either Takaro or (in the case of photos that include him) a colleague took during his family's time in India in the 1950s.
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