We’ve always read stories of hope, faith, bravery, the indomitable human spirit and the impossible urge to live. But how many do we read about science and the conviction that keeps the doctors going? Sheela Devi’s journey is one such, of doctors battling with her through 30 days at the ICU of PGI, Chandigarh, and walking out of the neurology ward with her.
THE DAY OF THE ACCIDENT
It was a normal work day for 40-year-old Sheila, a bus attendant at the all-girls Carmel Convent School in Sector 9, Chandigarh. The morning of July 8 started early, about 4 am to be precise, for the single mother of two teenagers, who finished her household chores to board the school bus at 6 am. Sheela, who has been working at Carmel for the last eight years, was on her way to the auditorium of the school when she saw a 250-year-old peepul tree on campus topple over under its own weight, trapping students having lunch under its shade. Hearing cries of anguish, Sheela rushed to rescue the trapped girls when a stray branch of the 70-feet tall tree fell on her, causing serious head injuries. As many as 18 children were seriously injured, and one even lost her life in the tragedy.
THE TRAUMA MANAGEMENT
Sheela was rushed to the Advanced Trauma Centre of PGI on July 8 in a critical condition and was in an altered sensorium with multiple grievous injuries and fractures, including that of the spine. She was immediately intubated and her airways were secured. She was shifted to the Trauma ICU and underwent radio imaging of the head and spine. The imaging showed left extradural hemorrhage with cerebral edema, multiple facio-maxillary fractures and wedge compression fractures of the spine area. She was mechanically ventilated and tracheotomised on July 12. Gradually, her sensorium improved, and she was weaned off the ventilator on day 18, July 26.
Subsequently, Sheela was shifted to the ward under Neurology Care for further management and she responded well to all treatment interventions, was hemodynamically stabilised and discharged exactly after a month-long hospitalisation at PGI on August 8. Prof Kajal Jain from the Department of Anaesthesia and Intensive Care, Dr Aastha Takkar from the Department of Neurology, Dr Apinder Preet Singh from the Department of Neuro Surgery, Dr Ranjana Singh and Dr Raman Sharma from the Department of Hospital Administration, along with senior residents, nursing staff and attendants comprised the core team who treated Sheela. “To be honest, our effort is always to save lives, but we don’t know what clicks. Sheela arrived early at the hospital and am proud to say that the PGI has a robust trauma system,” says Prof Jain.
‘YOU HAVE TO ADAPT TO SITUATIONS. WHAT MATTERS IS TEAMWORK’
Trauma claims the lives of the young and old alike and hence there is a need for the medical fraternity to give a structured programme conducive to our settings in India, rather than follow a programme from the West. The internationally acclaimed Advanced Trauma Life Support (ATLS) programme at the PGI is the only one of its kind in the country to create a team that understands the nuances of accidents and emergencies in the triage area.
“Our regular mock drills, tests, and simulation scenes in case of natural disasters and accidents have trained our senior residents and the emergency team to take immediate action. The logistics and systems are in place, residents are absolutely thorough with the steps and no one has to be told what to do. From rushing down with the right team when the ambulance arrives with the patient to the entire treatment, it is a seamless flow of steps, and this I feel helped Sheila to get immediate and the best treatment,” reflects Prof Jain. The first 10-minute interval after the trauma – the Platinum Ten – adds Prof. Jain is vital before the golden hour and saves lives.
Prof Jain says Sheila’s recovery was possible because of the teamwork of doctors and health professionals from various departments working together closely to take care of each aspect of her medical treatment. “We were all very moved. It was emotionally very trying to see her children crying in the corridors, for their mother is all that they have. We, at that time, had 11 other patients in the ICU and also two children who had suffered serious injuries. So yes, we were hard-pressed. But Sheila is young, has no co-morbidities and we had a strong support system. It was wonderful to see her recover and walk on her own after her discharge,” says a satisfied Prof Jain.
On August 8, Sheela received a grand send-off back home from PGI, with the brave woman receiving thunderous applause from the students and staff of Carmel Convent School, her two children, family and friends, and the team of PGI, responsible for her miraculous recovery. Prof. Vipin Koushal, Medical Superintendent, PGI, recalls how Sheela’s daughter, had full faith in the almighty and the team of PGI. “Every time I would meet her, she would tell me that her mother would speak and open her eyes, and this has been possible because of the tremendous teamwork of the doctors of various departments, the nursing staff, and her well-wishers. Our Director, Prof. Vivek Lal, a neurologist himself, was personally involved in each aspect of this case,” shares Prof Koushal. The only earning member of her family, with Covid taking a further toll on Sheela’s monetary health, financial and emotional support poured in for Sheela from various sections of society, including the Chandigarh Administration and the school staff.
‘THE PGI TEAM GAVE ME A SECOND LEASE OF LIFE’
Sheela is now back home and is being taken care of by her children. She hopes to return to school after she fully recovers in another eight to nine months and completes her follow-up treatment at PGI. “In this one month of struggles and tough times, there were a thousand moments of fear and anxiety about the unknown, hopelessness, and despair. But the PGI team, with their constant medical and psychological support, helped me to be victorious and come out of this near-death-like situation. I am deeply touched by the care and compassion. In fact, no words are enough to express my gratitude to the PGI team for giving me this second lease of life,” says Sheela.
Life has come full circle for Sheela, who was awarded a commendation certificate for her bravery by the Chandigarh Administration on Independence Day, with her children describing her as their strength and pride.