Life of Doctors – Patients, Medicine and Beyond

How blue is my sapphire

My Sapphire was not a cold and precious stone. She was a small hummingbird who sang a high metallic ssooo-ssooo-ssooo. She was blue chinned, with shining blue colors in her plumage, and a short tail. To me she was beautiful, chirpy, happy and kind; she hummed for me in such a way that it lifted my soul and spirit. She lifted my hope and my chances to survive as well. I owe my life to her. She was a bird of the Amazon rain forest .We were companions for a while in the Amazon River basin in north eastern Brazil.

You must be curious to know how we met, an Indian and an exotic bird, in a faraway land.

I and three of my friends had got tired of our hectic and urban lives in hot, dusty and noisy cities and yearned for a holiday in a dark and deep forest that Robert Frost had written poetry about:

The woods are lovely, dark and deep

But I have got promises to keep

And miles to go before I sleep And miles to go before I sleep

My hobby was bird watching and photography. Anil dabbled in Ethnobotany. Akash studied snakes and dreamed of one day encountering an Anaconda in the wild. Amresh’s passion was butterflies! Our Google search for a place that would meet all our interests, and rejuvenate our stale bodies and minds, found this part of the Amazon rainforest and we were soon there.

That fateful day began with me hearing her humming. Looking up, I noticed her very busy inspecting her eggs in a deep cup nest on a horizontal tree branch. Then she sat on them, incubating and very still. She was calm and composed, as though in deep meditation.

I knew that she was a rarity and a photograph, and a record of her hum, would be priceless. I slowly and carefully crawled up, settled on a branch opposite her, took out my Nikon 70, focused, composed and clicked. The click was soft, smooth and quiet but her sharp ears sensed it. She opened her eyes and looked straight at me in the eye, sharply focused and inquiring. I was an intruder.

For a second my world stood still and then it came crashing down. The branch broke and I plummeted 20 feet below.

I distinctly recall both the cracks, that of the branch and seconds later, my spine.

I was dazed, and shocked. The searing pain at the high back flashed for seconds and then all went numb. I lost power in both my hands and legs. I could barely breathe and was frightened as I was finding it difficult to speak or swallow.

As I collapsed and crumpled flat on my back on the ground, I was starkly aware that I was completely alone; my friends had gone on their own itineraries for the day and might be back only by night fall. They might not even know where to look for me. I had nothing to do but wait and hope I would be found.

Then I looked up and saw her watching me. She was quiet but seemed concerned. An impossible thought struck me that she had instantly forgiven me for my intrusion into her privacy. A speck of dust fell into my eye, I blinked and looked again, and she was still there, studying my predicament. I also realized that very moment that blinking of my eyes was the only movement that was left in my body.

She flew down and perched on a stump next to me. She looked around to see if anybody else was around but it was obvious to both of us that we two were the only ones in this quiet corner of the forest.

She was thoughtful for few seconds, which seemed like minutes to me. After that contemplation, she seemed to have made up her mind to do what she could do best, which was to hum. So she went ssooossooo-ssooo.

I did not tell you that I was a doctor, a physician who was developing an interest in ‘remote medicine’. Destiny seemed to have, in wry irony, handed me a dire lesson in do- it –yourself- medicine in the back of the beyond. After delivering that stunning blow it seemed to have mercifully granted me a small compensation. At least for the moment, I was not completely and utterly alone.

She was still beside me.

I decided to call her Maggie. I would have liked to call her Meenakshi or Mallika but they did not seem to suit her. Besides I could not have managed to whisper the hard syllables with my feeble voice.

‘Maggie’ I tried to whisper but it came out as a croak, totally indecipherable, even to me. I was afraid the small amount of saliva accumulating in my throat would choke me.

Unlike her hum, what I emitted was a horribly unpleasant noise. But she turned to me coolly and flapped her beautiful wings as though in acknowledgment. She cemented our association with another hum- ssooo-ssooo-ssooo.

Good, we had established contact. I had to find a way to stay alive till I was found. I had to also think of finding a way to communicate but I thought that could wait till someone found me.

I was ‘locked in’. My mind was crystal clear but my body was unresponsive. Nothing moved except my eye lids. I had become a prisoner inside my own body.

Maggie flew up to her nest to reexamine its contents. The nest was directly above me and I could hear the little sounds that gradually grew into a cackle. I guessed that her babies had arrived and she had urgent and compelling chores to do. She had to go shopping and find food for the young family. But she remembered to come back to me, looked at me and then flapped her wings, ever so slowly, and encouragingly, and I sensed her message ‘Come fly with me’, a message she would soon be delivering to her chicks. I decided to do just that, I had to stay alive and find a reason for it. So I let my mind go shopping with Maggie.

We flew together, mostly under the canopy of trees but occasionally breaking through the gaps in the foliage to rise above and survey what food was to be found below. The steep ascent made me dizzy but the view from the top was breathtaking. A sea of green in which flowers and fruits bobbed up and down like fish. We dived down the way we came and flew skimming over the ground looking for juicy worms and darting insects. Our mind was finally made up on the shopping list and we collected the berries on the trees and the booties crawling on the ground.

It was time to return and give the first feed to the chicks. Maggie was dexterous and meticulous, and playful and parental at the same time. The chicks were chirping and chortling, but also hungry and demanding. She quickly shared the morsels with each of them, in turn. I was thirsty, and hungry too. Like a chick, I lay with my mouth open and the first drops of rain came dripping through the leaves and trickled into my parched throat. It brought along with that the flavor of the leaf, the fruity odor of the wax and the gum on the bark and the crumbs from the orchids that dried on the branches. That was my feast of the day.

It was almost noon by then and my friends were not due to return till late evening.

I was hoping Maggie and I could go for a tour of the jungle. In the forest darkness creeps in by noon and gets thicker as the day goes along. Soon it would be too late and even dangerous to wander. Predators come alive like ghosts in darkness.

Maggie was dutifully back, having fed to the brim her very hungry children. Tomorrow, or one of these days, she would be egging them on to sprout their wings and flee the nest.

She probably felt it was unsafe to go exploring the jungle at that late hour. Instead she decided to give me a magnificent display of the art of flying. She began teasing me by flying around me in dizzying orbits. She probably knew I could not turn my neck but was determined to show me what was possible with flight. She soared high one moment and then dived, pulling out in a graceful arch. She demonstrated steep turns within my limited field of vision and then as a grand finale, gave me a grandstand view of hovering at one spot. The shining blue colors in her wings and body made her a glittering jewel.

When she gave me an encore, my mind soared and dived with her, turned and rolled with her and finally hovered along with her between heaven and earth. I touched down exhausted and descended into a dreamless sleep.

I woke late evening to three faces peering at me, alarmed. Anil, Akash and Amresh had found me. They were about to reach for me and make me sit up. They sounded to me like voices inside a bell ‘Come on, Aswin, let us get you up’.

Alarm bells rang inside my brain. As an Emergency Medicine doctor I knew that I had sustained spinal injury and the last thing that should be done was to move me before immobilizing and stabilizing my spine. My tongue was lead in my mouth and would not move. But my brain screamed ‘Nooooooooooo’.

But no one heard.

‘Maggie, Help’ my brain screamed next.

Maggie flew in, in a flutter and flurry of feathers, She crisscrossed over me, flapping her wings furiously, impeding any action on part of my friends and then alighted on me, and sat still, waving her wings just once every few seconds.

It was Amresh, the butterfly man, who caught on. He was used to seeing wings trying to say something important.

He turned to look at me, and I blinked rapidly just as Maggie had flapped her wings.

‘He means No, don’t move him’ Amresh shouted.

Anil and Akash turned to look at me, I blinked just once.

‘He says that is right, it means- Yes’ they both said in unison.

‘Thanks Maggie’ my mind said. We had established a code of communication, learning from a bird.

It was a long night. Anil, Akash and Amresh dozed off, sitting around me, and keeping me warm with a blanket and a fire.

Up in the tree Maggie kept her vigil. She fed her chicks at regular intervals, but I felt her keeping, all night, an eye on me, who was also like a chick who had lost its wings and had crashed to ground.

When Maggie hummed at the first light of dawn, the world had become different for me. The ‘Spinal Shock’ which sets in immediately after sudden trauma to the spine and cord had passed off and my life and limbs were beginning to return to me. My body was heavy no more. I felt I could move my limbs if I wanted to. I could breathe, swallow and even talk a few syllables, enough to tell my friends to immobilize my body, and thus my spine, and move me ‘en bloc’ to a spinal surgery center for stabilization of the fracture spine.

Maggie, quietly and with great dignity, hovered and presided over my transfer. I could not turn my neck to say goodbye as I was being carried away but the flap of her wings and the finely tuned hum emanating from her throat shall remain with me for the rest of my life.

All of us live with our past. All of us allow it to shape our future. But some of us know how to shrug the past. I think that is who I am…..

I just lived through that past. What happened will no doubt impact my future. I know I can shrug my past off and get on with my life. May be that is who I am, but there is no way I can forget how blue was my Sapphire when my life lost all other colors for those 24 hours.