An unsavoury epiphany

An Unsavoury Epiphany

“Anthony Fauchi is an incompetent moron!” bellowed Dr. Karthikeyan. Once he starts deriding someone, it was not a pleasant sight or hearing. I always cringed inside when Dr Karthikeyan does that. Well Mr. Fauchi can’t hear him now, I thought with a grim satisfaction. Dr. Karthikeyan went on: “He himself funded the Chinese for the research on viruses affecting bats and now he is destroying the economy of the entire planet just to benefit his friends in the vaccine lobby. And there will not be any vaccine for this goddamn virus, I tell you, because there have been no fucking reliable vaccines against RNA viruses so far! What sort of idiots we have running America?”

It felt surreal to hear someone in Hyderabad, India, venting out his vitriol against some American government official. But that’s how Dr. Karthikeyan dealt with any issue. He had a theory about everything and that theory was the unassailable truth in his mind. Anyone speaking contrary to his assumptions was a conspirator or worse. A lot of times he stitched truths with half-truths and arrived at conclusions that baffled even himself. That he had an opinion about everything ever published on the web and felt it his mission to dispense his thoughts to everyone was what bothered me most. 

His opinions about the Covid pandemic were comprehensive: There was no imminent danger and the governments were over-reacting; Sweden was right in not imposing a lockdown; India killed more people with the lockdown than virus itself would have killed; Over-hygiene with a lot of precautions would kill a lot of doctors, and the people that were killed by Covid 19, would have died anyway.

He saw me with contempt. I am an intensivist in the same hospital in which he was the chief surgical gastroenterologist. His problem was that the press loved me. I was interviewed by a lot of media men during the Covid lockdown and my views in public were eviscerated in private by Dr. Karthikeyan. He told me that I was spreading the panic. He disapproved my advice to the fellow doctors asking to take more care. “You celebrity doctors are the worst covidiots!” he would say and I would just feel happy not to be the object of his expletives at least.  I wouldn’t have been surprised if suddenly he came up to me and accused me of being an international conspirator. 

If I gave you the impression that I was the silent sufferer, I was not being fully honest. In fact, I fought with Dr Karthikeyan. I fought bitterly at it. Often I ended up shouting louder than him and would feel guilty later of shouting down an elderly colleague. We often discussed, argued, bullied each other and hated each other’s guts. We needed an adjudicator almost every day to decide who had the stronger reasoning, and our judge was Mr Ranganath.

Mr Ranganath owned a pharmaceutical company in the outskirts of Hyderabad. He lived in the same gated-community in which Dr Karthikeyan and I lived. We worked hard in the mornings, and met for little chats in the evenings. We usually had those meetings in the garden practicing social distancing and hygiene, which despite scoffing at, Dr Karthikeyan thankfully did not object to. As Dr Karthikeyan and I yelled at each other, Mr Ranganath sat calmly and decided which zealot to back on that particular day.

One day, we went too far and personal. In the fit of the moment, Dr Karthikeyan shouted: ‘I wish you have Covid 19’. I immediately countered: ‘I wish you do too’. The instance the words left my masked mouth, I understood the mistake I made. When he wished me that I had Covid 19, he only meant that it would be a simple viral illness and that I would get the immunity for the virus. But when I said the same thing, it was much more ominous, as I always said that the infection could be dangerous and may result in death. 

I hoped that Dr Karthikeyan would let it pass. After all, I practically only said ‘same to you’ when he himself had started it. But Karthikeyan did not let it slide. He had to rub the same thing in. He said ‘but then, I just wished good for you’. He knew that he had me on the ropes in the argument. ‘Did he actually stage my faux pas?’ I wondered bitterly. The subtle gleam in his apparently innocent eyes confirmed my fears. I felt numb. I heard Mr Ranganath, the referee, actually shout: ‘will you two just shut up?’ He said ‘you two’, but he was looking straight at me. I got up and stormed out of the scene, with no face-saving possible. I was not entirely sure that I did not wish Dr Karthikeyan a serious infection. Bloody scoundrel. 

After exactly three days, it so happened that only one of our wishes came true. 

Mr Fucking Murphy from heavens, with his stupid law, made sure which one’s.

********

Dr Karthikeyan had operated on a patient five days ago. He said that he had worn a full PPE, but with his arrogance and crazy ideas about the virus, I could not be too sure. He had fever, body aches, cough and breathing difficulty after five days of that surgery. The patient whom he operated developed fever on the second post-operative day and had got a positive Covid 19 test. I was pretty sure that Dr Karthikeyan himself would have had the Covid 19, while he was quite certain that he would not. He isolated himself at home according to the government guidelines, but refused to get tested for the virus. He was sure that with warm water gargles and paracetamol he would become better.

He was admitted in my ICU after three days. He had severe breathing difficulty and a chest CT scan done showed severe infection of his lungs. He was adamant that he did not have a covid 19 infection. He said he had just a urinary tract infection with lung infection and I better treat him for the same. However, once admitted in the ICU, it was mandatory to test for the Covid virus, and I was sure that his test would be positive, because of his highly suggestive symptoms. I sent two of his samples for testing on consecutive days, but both the times, the tests came as negative for Covid 19. I wasn’t surprised despite the negative results, because false negative results were quite common with Covid 19 infection. In fact, one of my previous patients had to be tested 11 times, before a positive result came. 

They say that guilt is the most painful of human emotions, and I then knew why. I was fairly certain that I did not cause his infection, but was mad at myself for verbally wishing that he got a Covid infection. He was less careful than many doctors and possibly had the infection on his own and without the benefit of my wishes, but that didn’t quell the gnawing pain inside my bones. Scientifically, I felt vindicated but emotionally, I felt utterly responsible for his disease and could see that if he died, I would never be able to live with myself. My god! Guilt was indeed painful.

I treated him with utmost diligence. I sat with him for hours together and used my entire clinical acumen to make him better. I tried all the medications available, which weren’t many at that time. None of the medicines that showed promise had the necessary approvals nor were available in India at that time. I had to rely on Chloroquin and supportive treatment. Dr Karthikeyan continued to deteriorate despite the care and his breathing became more laboured by the day, and after three more days, I had to put him on a ventilator. I knew that only 10% of Covid 19 patients survived after needing a ventilator, and I was staring at a very bad outcome. Dr Karthikeyan was quite vocal and healthy a week ago. Now he looked frail and emaciated. I wished that I never knew this man in my entire life, my sworn friend and enemy whose well being was the only thing on my mind at that time. I was very angry with him too, for putting me in that untenable situation. In fact, I felt like stabbing the idiot once he came home from the Covid 19 ordeal. I was losing the battle and was struggling to accept that fact. I couldn’t eat or sleep and was losing weight myself. 

Dr Karthikeyan deteriorated further over the next few days and his death looked imminent. His blood pressure started falling and it looked certain that he might not survive one particular night. Sitting at his bedside, I cried inside my mask and realised that inside our facades, we both loved each other and that we always had been true friends. I did not go home that night and I was sitting in my room in the hospital holding my head in my hands with tears in my eyes when my phone suddenly rang. It was Mr Ranganath, my neighbour with a suggestion in hand. But what he suggested was both a miracle and a felony. 

Mr Ranganath had some experimental doses of one of the anti viral drugs Favipiravir, in his factory. He was trying to get the government approval for testing the medication. It was criminal to use an experimental medication for a patient without proper approval that too without his consent. Yet when Mr Ranganath proposed to use that medication, I felt that it was the most moral, ethical and noble deed to use the treatment for Dr Karthikeyan. 

The next few days went off in a blur, but what happened indeed was a miracle. I administered Mr Ranganath’s medicine to the unsuspecting and unconscious Karthikeyan and took care of him with renewed vigour. Over time, his health started improving, I took out his ventilatory support and within the next few days, he was out of the ICU. Over the next week, he was back home and started recovering. He was weak in the beginning, but was regaining his charm pretty quickly. 

********

After a few weeks, Dr Karthikeyan recovered enough to start arguing again. However, this time I was not ready to quarrel with him. He started noticing the change in me after a few days. ‘What is the problem? Are you patronizing me?’ he asked me. ‘Do you think that treating me has proved what all rubbish you were saying? Don’t you remember that my Covid tests were negative twice?’ I did not want to point out that the test could be wrong. I was just happy that he was alive. I was happy that Mr Ranganath helped when no one could. I did not mind that Karthikeyan did not know what happened. It proved my point that Covid 19 was dangerous, strict precautions helped and medicines, when properly used could save lives. It also proved Dr Karthikeyan wrong. He was a fool not to take the virus seriously and could only be saved from a near certain death by the use of anti viral medications. I was happy.

My happiness did not last long.

Mr Ranganath who perhaps noticed my smug look, caught me one evening and delivered the sucker punch: He never gave me the actual Covid 19 medication, he revealed. He just gave me a placebo that looked like the original medicine. His idea was simple: I had given up on Dr Karthikeyan that fateful night and sometimes the doctors need a placebo more than their patients. With the placebo, I believed in the miracle and took better care of Karthikeyan.  May be Karthikeyan was better in his understanding of Covid 19, he said. I felt as if a wrecking ball slammed into my chest. I was left speechless. 

At some distance, Dr Karthikeyan was enlightening someone: ‘Dr Anthony Fauchi is an imbecile of the worst kind’..