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  Volume 4 - Issue 11 NOVEMBER 2006
 
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THE GIFT OF LIFE TO A GOOD HEART ......



Dazzling Darjeeling

“The one land that all men desire to see, and having seen once, by even a glimpse, would not give that glimpse for the shows of the rest of the world combined.” These words expressed the feelings of Mark Twain when he visited Darjeeling.

Vast expanses of green that carpet the hills and valleys, the refreshing aroma of tea in the air, the bracing weather and the beauty of impassive giant hills that have stood sentinel for eons, Darjeeling’s beauty is a feast for the senses. This is a land rich in history, and the peace it enjoys has been hard fought for and well earned.

Darjeeling is thought to be a derivation of “Dorjeeling,” meaning, the place of the Dorjee, the majestic thunderbolt of the Lamaist religion. The famous Buddhist monastery standing at the top of the Observatory hill was known by this name.

Until the beginning of the eighteenth century, the district was part of the dominion of the Raja of Sikkim. Darjeeling and Kalimpong were independent kingdoms ruled by the kings of Sikkim, but in 1706 Kalimpong was conquered by the Bhutanese. In 1780, the Gorkhas invaded from Nepal and took Darjeeling . Later, the British defeated the Gorkhas and returned part of the land to the King of Sikkim, who operated under British protection.

During this period, Darjeeling was recognized for its value as a sanatorium – where people went to regain their health – and also as a hill station. Politically and militarily, it was a key passage into Nepal and Tibet. The British coerced the King into handing over Darjeeling to the Crown and developed it to suit their needs. Eventually, the British annexed the whole of Bengal. By 1857, Darjeeling, which had been heavily forested and virtually uninhabitable, had roads, sanatoria, and 10,000 inhabitants. Nepalese laborers, recruited to work on the tea plantations established by the British in the 1840s, made up the bulk of the population. The vast majority still speak Nepali as their first language, and the name Darjeeling continues to be synonymous with tea.

Today, the Darjeeling Gorkha Hill Council (DGHC), with a large measure of autonomy from the West Bengal state government, governs the land. Darjeeling remains part of West Bengal but now has greater control over its own affairs.

The Spirited Poonam Gurung

The Gurung family hails from Darjeeling and can trace its ancestry to the original Nepalese immigrants who settled in West Bengal. Poonam Gurung is the second daughter of Shyam Gurung and Kamala Gurung.

Shyam Gurung runs a school canteen in their village, Nali Chour, which has many temples devoted to Sai Baba. Her mother is a tea garden laborer. Father Shyam Gurung made sure his three children received an education. Neelam, the eldest daughter, completed her B.A., is married and employed as a private teacher in Darjeeling. Brother Ritesh completed his Twelfth class/ PUC in Arts. Poonam herself has a Bachelor of Science in Botany.

Nali Chour village is set along a two kilometer stretch about seventy kilometers from Darjeeling. The roads are full of hairpin turns, so small jeeps are used for transport. Early in her education, Poonam stayed in Darjeeling, but later traveled this road daily. Today, all three siblings have found their place in society or are in the process of doing so.

Poonam’s young life had many blessings. Her parents were devout and God-loving, so it came naturally to her to turn to God for guidance and support. As a child, her favorite deity was Goddess Saraswati. At age seven, she came into Swami’s fold. Poonam attended Bal Vikas classes in Darjeeling and was a bhajan singer in the local Sai Samithi. Her involvement in the Sai mission and the teachings and values she absorbed helped her develop a mature perspective towards life. Nevertheless, there come times when it seems nothing can prepare us for the shocks this material world can present us with.

 
 
Poonam singing bhajans
in her younger days

 

A Disturbing Diagnosis

At 13, Poonam was diagnosed by her family physician, Dr. S. R. Khanra, with valvular heart disease. Surgery was the only option. Unfortunately, that particular procedure was not available in Darjeeling. It could only be done in Bangalore, Vellore, Delhi, or another major city. The fee for Poonam’s operation would be 1.5 lakh, an amount far beyond the family’s means.

The North Bengal private clinic, and the Sadar and Eden Government Hospitals in Darjeeling, are facilities she could have visited, but the family did not have the financial resources to seek multiple opinions. One verdict was enough to sentence her to a life of dependence.

Poonam’s parents were able to provide their children with a good education, but such a huge amount for an operation was out of the question. So, Poonam, the good daughter, understanding her father’s predicament, declined the surgery and said that she would live as long as the malady allowed and the rest would be in God’s hands. In December 2000, the local Samithi members came home bearing tidings of hope. They told the family there was a Super Specialty Hospital, the Sri Sathya Sai Institute of Higher Medical Sciences, at Prasanthigram, Puttaparthi, where all treatment is free of cost, from diagnosis to surgery and even postoperative counseling.

Poonam in traditional dress
   

Swami’s Hospital – A Ray of Hope

Her family was convinced and she came to Prashanti Nilayam, the abode of the Lord she had worshipped since she was seven. Being part of the Samithi, she came as a seva dal volunteer and during the course of her stay underwent investigations into her malady. After performing catheterization on her, it was found that her mitral valve could be dilated, so a PTMC (Percutanious Trans Mitral Commissurotomy) was done in SSSIHMS PG in 2001 and the valve was dilated. She came with her sister Neelam this time, because it was mandatory that a helper accompany the patient. Before the dilation, she was having breathing trouble and would tire quickly and could not perform any heavy tasks. After the PTMC, her breathing problem was solved and she could get back to a near normal life.

During her seva visits to Prashanti Nilayam, she met the Rai family, also from Darjeeling. Time passed, and it was decided that the friendship between the families should find fulfillment in matrimony. Poonam Gurung married Pramod Rai, the son of Lal Bahadur Rai and Dhan Kumari Rai from the Seeyok tea estate. He had come to Prashanti Nilayam at the behest of a friend for seva at the Chaitanya Jyoti Museum. On one such occasion, Swami personally called him and told him to work at Brindavan in 2001. Since then, he has been employed as part of the Trayee Brindavan security team. Food was provided in the Sri Sathya Sai Boys Hostel Brindavan, and residential accommodation was given in the quarters behind Trayee Brindavan, Swami’s Residence at Whitefield.

Poonam’s Forte - Firm Faith

After her marriage in October 2005, Poonam shifted to Bangalore in November to live with her husband. She found a job as a registration assistant at the Sri Sathya Sai General Hospital in Whitefield. By then her case had been transferred from SSSIHMS PG to SSSIHMS WFD. Though the earlier procedure of valve dilation gave relief, it is not always a final procedure. For many it is only palliative. The final solution for valvular heart disease is valve replacement. So it was with Poonam, too. On one of her checkups, it was discovered that the valve was again losing its function and it was determined that the dysfunctional biological valve should be replaced with a mechanical valve. She was slated for a MVR (a Mitral Valve Replacement).

 
   
Swami with Pramod - far right

The conversation Poonam and Pramod had with the cardiologist was the clincher. Till then they were on the fence, whether to go ahead with the operation or not. The cardiologist clearly explained the process and they decided to have the procedure done. At first they did not inform the parents but spoke to Poonam’s elder sister and brother-in-law. Concerned, the parents would be distressed if informed of the seriousness of the situation, the daughters told them it was only minor surgery. The parents gave their consent. Later on, after the surgery was successfully accomplished, the true nature was revealed. Poonam never felt any fear regarding the surgery. She had implicit faith that Swami would look after her and nothing untoward would happen.

A Rare Blood Condition

When she was admitted as an in-patient and the preoperative protocol was done, a surprising fact emerged. Poonam had an abnormal blood condition. It is common knowledge that blood is of four groups: A, B, AB and O. Within these four groups there is a factor called Rh factor, the presence or absence of which gives the nomenclature positive or negative. This is the primary differentiating factor but there are many more factors which have a bearing on blood transfusion. The details of blood types and their grouping are too complex to discuss here, but basically, different blood groups are incompatible and if they intermix, a biochemical reaction called clumping occurs where the blood forms blobs which look like clots.

This can sometimes occur even if the blood is of the same group. So before blood is transfused to a patient, the patient’s blood sample is cross-matched with the donor’s sample. Usually it is not a problem to arrange for compatible blood. In some patients, the presence of cold agglutinins (a rare condition when blood temperature falls below normal body temperature and clots form – an irreversible condition with fatal consequences) creates clumping of cells at subnormal temperature. Still, we can do open-heart surgeries in such patients at normothermic cardiopulmonary bypass. This means we do not reduce the patient’s temperature on the heart-lung machine. Poonam’s case was unique. She had both warm and cold agglutinins, a very rare condition where the patient’s body totally rejects blood transfusions; she could not receive any transfusion because the body will react and clumping will occur immediately. Despite the best efforts of the blood bank officer, Dr. Nandita Ghoshal, not a single unit of A positive blood was found to be compatible with Poonam’s. This was reconfirmed at St. John’s hospital.

 

Support from Sai

The case was postponed many times. On August 16, while sleeping, Poonam had a vision of Swami. Swami used to come in her dreams and advise her on various matters and she kept a meticulous diary of her “conversations with God.” These conversations were sometimes more than just dreams. In the Hospital, she felt Swami’s physical proximity on more than one occasion. These ethereal experiences calmed her and helped her through these troubled waters. Throughout all this, her husband Pramod was a bulwark of support and both of them prayed to Baba for guidance. One day, Pramod found an opportunity to express their predicament to Swami and on July 6, 2006, He gave them both padnamaskar.

As for her physical aliment, the doctors had two options: one; avoid the risky procedure and let her be. This would leave Poonam with a less-than-satisfactory quality of life and she would eventually succumb to heart disease. Two: be innovative, and get on with the operation

The Lord advises His children in their hour of need
   

The Procedure is a “Go”

After deliberation among the doctors and discussions with Poonam and her husband, it was decided to proceed with the surgery. Poonam donated her own blood on two occasions before the operation. This was stored in the blood bank.On the operating table, another unit of blood was collected minutes before the surgery. Using a combination of chemicals and a cell saver/auto transfusion set, the operation began. A mitral valve replacement was successfully performed followed by an uneventful postoperative recovery.

Auto transfusion is a process of transfusing to the patient his or her own blood. During surgery, blood leakage is unavoidable and in cases such as these where the patient is unique, it is crucial to salvage as much as possible of the patient’s blood. A mechanical device connected to a vacuum pump sucks up all the blood and other fluids that enter the surgical field. The fluid is then subjected to a centrifuge, a device which separates components of a colloid on the basis of density.

The blood spins at very high speeds and the heavier red blood cells collect at the periphery and are collected through reverse suction. These cells are then returned to the patient and the other clear fluids are discarded. This way the patient gets back their oxygen carrying cells. The other components of blood are slowly regenerated by the body. The cell saver kit used for auto transfusion is a disposable one-time-use only item and is very expensive.

 
   
The doctors deliberate over Poonam's case

Poonam and Pramod – Singing and Smiling!

Everything went as planned and the surgery was a success and Poonam had the best kind of recovery, an absolutely boring one, and was discharged after a short stay. Now she is back at her job in the General Hospital with the mechanical valve ticking away inside her stout heart. Perhaps it was the stoicism she inherited from her ancestors from Nepal, who came to the wild hills of West Bengal centuries ago; perhaps it was a maturity of mind and calmness of spirit that God had blessed her with; perhaps it was God himself, working through her as an instrument and an example to teach us all forbearance and sacrifice. Poonam’s case is yet another instance which teaches is that we “normal” people have to realize that a normal life is a miracle.

As for Poonam? She is back to normal, and really quickly. Her indomitable spirit illuminating her bright smile is a beacon to us all. She loves Chinese food, noodles, and mo-mo (a delicacy of steamed corn flour and cabbage eaten with spicy pickles), her favorite dish. Both she and Pramod are good singers and Pramod also plays the guitar and drums very well. They both get opportunities to sing on Sundays when bhajans are held at Brindavan. The couple share a common desire that they be blessed with an opportunity to sing in the Divine Presence of Swami. When the Lord has granted her the sweet gift of life, this wish will be a small one for Him, for the hand that rocks the cradle also moves the world.


Dear Reader, how did you like this story? Would you like more of such patient stories in this section of our magazine? Do you have any suggestions for our 'Healing Touch' section which will help you better? Please let us know at [email protected]. Please mention your name and country when you write to us.

– Heart2Heart Team




 
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Vol 4 Issue 11 - NOVEMBER 2006
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