A CITY SNAKE!

It was a dark rainy night when my staff called me to inform about an admission in my hospital, I was groggy and reluctantly reached the place. A patient named Hari had cut his hand with a knife and came,bleeding profusely in an agitated state.He was an Oriya migrant working in Mumbai since last month. He did not understand any local language, hence communication was very difficult.I tried to ask him the chain of events leading to this but it agitated him further.He was brought to the hospital by an equally confused employer.Maybe he had a fight with someone was his possible conclusion. Hari was mentioning something about a bite but was not sure and the wound examination did not reveal any bite marks.Something was amiss and my intuition prevailed, forcing me to stay back in the hospital. I called up Mansi telling her to sleep off as I would be pretty late. We gave him all the first aid measures and put him on saline. By this time Hari had become relatively calm and settled. After an hour, the lull before the storm ended. My staff told me that Hari had started frothing at the mouth and was becoming breathless! I was expecting some catastrophic event and all my fears came true. I immediately intubated him and put him on a ventilator and ordered for Anti Snake Venin vials. My hunch was right, the poor Hari was a victim of a snake bite and had cut his hand to let the bad blood flow! It is rare to see snake bite cases in our concrete jungle city.Most commonly we encounter banana traders and handlers with snake bite where the snakes camouflage in the stacks of the yellow green ones. Hari was a building labourer and probably bitten while asleep in his slum.Strangely nobody including Hari had seen the snake which had made matters difficult for us.Any way now I heaved a sigh of relief as the diagnosis was established. Now the headache started as his employer started grumbling about the cost of treatment and pleading that I transfer him to a municipal hospital to facilitate free treatment. I was livid with rage! We were fighting a battle to save the patient in these odd hours of night and all he could think was about the money part. How insensitive of him ? I told him that it was not possible to transfer Hari in such a condition anywhere without endangering his life. I took a stand that if he was not able to afford the cost,I would spend from my pocket to save Hari. This embarrassed him further and he pledged his full cooperation for the treatment. I was happy to hear that. It took four days of aggressive treatment to get Hari out of the woods. On fifth day, he was hale and hearty,off the ventilator and started having juices and soft diet.But, he was confused and clueless as on the first day! He had no spatial orientation.Later we explained him the sequence of events, yet he could not remember seeing any snake in his vicinity. A day later, he went home walking with a twinkle in his eyes and a big smile on his face.

He had decided to stay back in Mumbai. After all, survival was possible only in this city.Had he been bitten in his native town, Death would have been the only outcome!

I decided to share this story with you all for the fact that sometimes,Intuition leads the way in diagnosis.If I had decided to go home that day,Hari's resuscitation would have been delayed.I must also thank his employer for full support. He could have left Hari alone and walked off home shrugging his shoulders, avoiding any responsibility.It was great of him to stand by him in his bad times.He had been a good Samaritan indeed!