The surgical mom

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When I was a resident in my final year of training at the Christian Medical College in Vellore, a malnourished lady onerously walked into the emergency carrying her six-year-old child in her arms. Blood pouring out from his lacerated scalp had soaked them both. He had been run over by a car close to the hospital, and rather than wait for a ride, she had simply picked him up and run to us. He was unconscious when we saw him. She looked like she was going to follow suit. The ER doctors expeditiously plugged in an intravenous catheter and shoved a tube down his throat to protect his airway, while I pressed on his head with a dozen Gamgee pads to control the bleeding. Once we got the blood pressure up and stabilised his heart, we rushed him for a CT scan. The temporal bone was shattered into pieces and beneath it was a large extradural hematoma, a blood clot between the bone and the dura mater. The underlying brain, however, looked surprisingly okay.

We took him straight to the OT and cleaned out all the debris and rubble of the road from his skin, the stench of dried blood permeating though our masks. We fashioned a skin incision to expose the fractured bone and removed all the pieces. There was a large hematoma underneath the fractures pressing on the brain, which we slurped out in our suctions, and I coagulated the artery that was slit by one of the sharp fracture fragments. For that kind of injury, I was surprised to find the dura intact.

The dura mater, Latin for tough mother, is a thick durable membrane that covers the brain. The dura mater is the mother of the brain: mater, rooted in the universal maa, means mother. The primary function of the dura, akin to that of a mother towards her child, is to protect the brain - and what a fabulous job it does of that. Like a mother for her family, the dura guards the brain's internal environment.

We put back the pieces of bone like a jigsaw puzzle and neatly sutured the scalp over it. As we wheeled him out, his mother stood there with her anxious hands folded in appreciation. He gained consciousness after a few days and was transferred out of the intensive care. She nursed him with love, feeding him, turning him, and exercising him to ensure he was on his way to a full recovery. Every time I walked into the ward, whether it was in the middle of the night or early hours of the morning, she was awake next to him, one hand of hers literally on his pulse. She took him home walking two weeks later. "A mother never outgrows the burden of love," said the famous writer Florida Scott-Maxwell, "and to the end she carries the weight of hope for those she bore."

The deepest grief is also borne when a mother loses a child. One of my closest friends gave birth to a stillborn child, and I held her hand as she had to let go of the life she had lovingly nurtured within her for months. I lost one of my best friends in a bike accident at 18; his mother's womb was so scarred by the loss that she developed uterine cancer a few years later, which she's overcome with the mettle of a mother. One of my mother's friends lost her beautiful son in his 40s to stomach cancer that showed up out of the blue and consumed him in a matter of months. Another of my friends was recently operated for a ruptured appendix and he never woke up after surgery; his mother's earnest plea was for her to pass before he did, but she is still braving his passing. "Life doesn't offer happy endings; only the prospect of finding happiness in the midst of endings that will seldom be simple," I once read somewhere.

If given a chance, any mother would be willing to interchange and take upon herself an ill-fated outcome her child must go through. In a book I was reading the other day, the sole survivor of a plane crash was a little girl whose mother had completely wrapped herself around her. The four-year-old was found alive under her mother's scorched remains. Nature has its own rules.

I vividly remember the time when my own mother had Guillain-Barré syndrome, a viral affliction of the nerves that paralysed her neck down. She was in the ICU, on a ventilator for a few weeks, with everyone involved in her care uncertain if she would make it. Her then 80-year-old mother would trek valiantly each day to the hospital and sit in one silent corner of the waiting room for 12 continuous hours only to return home to attend to her ailing husband. She wasn't unsettled about whether her daughter would make it and she didn't question the doctors even when she was given the same discouraging news every day for many days. "I have faith in my God, and I know he will watch over us," she used to tell me, when I asked her why she didn't look worried, while I trembled with sorrow, bewilderment, and fear myself. She was a stoic lady, having suffered the unsurmountable loss of her first daughter a few decades ago in the infamous Handloom House fire of 1982, and was now on the brink of losing the second one. My mother survived because of her mother's certitude. When my mother eventually lost her mother, it was the cataclysm of a lifetime.

While more phone calls are made on Mother's Day than any other day of the year, and phone traffic spikes by as much as 37 per cent on this one single day, let us take some time on this day of joy and celebration to remember the mothers who might not receive that call or the children who have no one to make that call to. "Grief, when it comes, is nothing like we expect it to be," Joan Didion observed in her classic meditation on loss.

So, to all the mothers who've been through an unfathomable illness or the fading of a child, be gentle and more generous with yourselves. You did more than your duty. To every child who has been through an abysmal illness or the passing of a mother, be grateful to the time you spent together and help carry her legacy onward.

And on a lighter note, if you're Parsi or Punjabi, Greek or Jewish, don't worry - your mother will never leave you. Even if you want her to. It's a matter of lifelong complexity.

The writer is practicing neurosurgeon at Wockhardt Hospitals and Honorary Assistant Professor of Neurosurgery at Grant Medical College and Sir JJ Group of Hospitals.