Hindu Narrative

[Guest]

SaiK - I am not for one millisecond arguing against medical facilities everywhere. Age and experience taught me that the cynical ward-assistants in that 1983 Casualty in Pondicherry were not against saving life - they had just seen too many Casualty officers like me inflicting fruitless injury and indignity on a human who had already suffered a great deal and who was bound to die given the pathetic facilities available in those days. As a young enthusiastic surgeon I did not realise that - I had knowledge, but no judgement or perspective. In 2007 I can see their point.

We are dealing in some serious "life-philosophy" issues here and life and death and events at the point of death are very emotive issues that civilizations have reached their own conclusions about over centuries.

The way death and life saving treatment are viewed are greatly dependent on how people view things, and at the risk of digression I will describe some insights I have gained.

When a man's heart stops his brain will die in about 3 minutes, after which reviving his heart will leave him a brain damaged vegetable and potential organ donor. What is done to a human being when his heart stops is that people start giving cardiac massage - a desperate if life preserving act that appears like you are trying to kill the person you are trying to save. A tube is stuck down his windpipe and this act occurs in an environment in whichone person is jerking up and down giving massage. The dying persons face may be covered with vomit, saliva or other secretions, and his neck has to be extended backwards to push a tube in the windpipe and this looks like you are trying to break his neck. Another desperate measure would be to stick a long needle straight through the chest into the heart, suck blood out to confirm you are in the heart and then inject heart stimulating drugs. Alternatively you give a high voltage electric shock that makes the victim jump and convulse like he is being kicked by an artillery shell. All this has to be done in full public view in some instances.

Not surprisingly - if you fail to save a life, people will think that you actually killed him with all those horrible things you did. If you save him then people ignore the horrible things as a bad memory.

It requires some judgement to decide who merits such inhuman treatment to save his life. If you have a person who is dying of cancer who is in pain and has suffered for months, there may be no merit in trying to restart his heart if it should stop and a decision not to do that is reached in consultation with relevant all round consultation.

In India I have found time and again that there have been instances where well meaning doctors have immediately started all the heart restarting drama and failed to save the life. They then get blamed and a police case is made out against them for murder and relatives break up hospital furniture. On the other hand, a more worldly wise doctor - seeing that a man's heart has stopped can spend crucial life-saving minutes explaining that the person is about to die (while the man's brain dies in those few minutes). After that the doctor does what he can, but the patient dies and everyone is "deeply grateful to the doctor who did everything and knew that the person would die". The doctor in this case has done more public relations than medical therapy. But he gets credit and does not get arrested or bashed up.

There are some crucial cultural differences here. Religious attitudes do play a role, but nobody has defined these exactly and there is work ahead for psychologists and sociologists.

But you can see how well evangelism can work in this scenario.

You have a padre waiting near the emergency room. A patient with a stopped heart is brought in with distraught relatives. The patient is pulled away into a private area for doctors to jump on him. The relatives are pulled away to a convenient area/chapel to where the padre says a prayer.

You can judge what happens next.