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Resilience, Thy Name is God- Dr Deepak Ranade

I had witnessed a peculiar case of a 4-year-old who was referred to me for a medulloblastoma. This is a malignant tumour, that arises in the cerebellum, or the small brain. As neurosurgeons, we deal with many situations, that science can really never explain. If someone asks me, whether I believe in these kinds of prayers, or favours from the Almighty, I refrain from making any comment. These are domains that can never be investigated, verified, replicated or confirmed. We have to very humbly accept the limitations of our perceptive abilities, and possibly the lack of knowledge of the benediction of any divine powers.

This child that I had seen 3 years ago started vomiting and crying with headaches. He was scanned and diagnosed to have a medulloblastoma.

I was overcome with grief as I counselled his parents and particularly his maternal uncle, who was very close to the child.

I went ahead with the surgery, and by the grace of God, excised the tumour completely. The child made a very good recovery, and as per the protocol, was referred to radiotherapy of the entire brain and spinal cord.

He received about 3 cycles and was doing very well. About 4 months down the line, he was brought in the casualty in a very peculiar state. He was just not speaking anything and was completely mute. He would respond to pain, and cry, accept small feeds but was confined to the bed. This is a very unusual complication, called cerebellar mutism, that occurs because of operating on the cerebellar vermis, the central portion of the cerebellum. This part had to be incised to access the tumour during the operation.

All that I could do was reassure the relatives that he will recover with time.

I told him that there was really nothing more that could be done.

Thereafter, the child was bought again after 3 months in a moribund state. A CT scan revealed that he had developed hydrocephalus. That's an accumulation of fluid in the cavities ( ventricles) of the brain, which raises the pressure and causes severe symptoms and even unconsciousness.

I inserted a shunt by doing another surgery. The maternal uncle was entirely in charge of the child as the parents were too feeble, emotionally and financially. The maternal uncle had an incredible amount of dedication and devotion to his nephew. His positivity was infectious. It stirred up some intense optimism in me too. The child was taken back after a mild improvement in his cognitive abilities. He still remained mute, and all I could do was pray for his recovery. Thereafter, he was brought to our hospital three times for revision of the shunt, which was rather inexplicably malfunctioning. On one occasion, I almost gave up and told the uncle, that the case had a rather poor prognosis. However, he remained composed and seeing his love for his nephew almost brought me to tears. Some guys just don't give up. He persisted.

The last time the shunt was revised was about 6 months ago. The uncle called me and told me he was getting the child in an ambulance. They live in a town about 120 km from Pune. The child was brought in almost semi-conscious, and barely moved his fingers, and opened his mouth. He was being fed through a nasogastric tube.

I was feeling very depressed. Nonetheless, I did the job of revising the shunt, and after a week, the child was discharged. There was really no significant improvement in him. I told the uncle, that I did whatever I could. The uncle fell at my feet. I lost my composure and was almost in tears. Here was a man, who refused to give up, and was falling at the feet of a man who had given up. Faith that was unfazed and unflinching. Faith in me, which I knew I didn't deserve. I regained my composure and told him, that my best wishes were always with the patient.

Three days ago, I got a call from the uncle. He was sounding excited. He told me that his nephew had improved quite a bit, and he wanted to bring him for a follow up to meet me. I thought he must be exaggerating and probably imagined that the apple of his eyes was getting better.

I told him to visit me on Monday.

After my surgery was over, I came to my outpatient section and I got the shock of my life. The child was sitting in the chair, smiling, answering questions, and was walking a few steps.

I really wanted to fall at the feet of that uncle. It was incredible. As I ate the sweets that the uncle had so lovingly got for me, I saluted the man and his faith. He refused to give up. I don't know if God exists, but if he did, I am sure, the uncle's devotion and dedication and love for his nephew would have made the Lord rewrite the child's destiny. The sweets that he had given me were probably the most delicious that I had ever eaten.