The surgical serendipity

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"Why are you shouting so much?" I asked, interrupting a girl of about 25 in a grocery store in Tanzania's Dar es Salaam. She was yelling at the store owner over an issue that I didn't fully comprehend; nonetheless, I found it disrespectful that a young girl would raise her voice at an elderly gentleman in this manner.

She was dressed stylishly in a blue sleeveless top and a pair of flowing pyjamas. She wore several chains with African symbol pendants around her neck and carried an indigenous handbag - typical of many of the youth in Tanzania. "It's a generation gap problem," she told me. "He's my father, so we argue all the time," she confirmed, appeasing my anxiety. I couldn't tell if she was a local or tourist. She looked Indian but spoke with an American accent, rolling her R's and slurring the rest of her words. I almost thought she wasn't sober.

I was out to lunch in a local restaurant close to the hospital where we were conducting a medical camp, and had popped into the grocery store to buy the toothpaste I had forgotten to carry. "Be gentle with your folks," I told her tenderly before getting ready to leave, "They are old and need to feel relevant."

"Hey!" she said, stopping me. "Why do you seem familiar?" she asked.

"Maybe because I'm famous!" I replied.

"No, I'm serious, I've seen you somewhere!" she tried to recall.

"I just got here this morning," I told her.

"Are you a doctor?" she asked spookily.

I rolled my eyes and turned to my colleague, wondering if this was some sort of a prank. "Yes, indeed I am," I acknowledged, "and a real one at that!"

Her next question freaked me out: "Are you Dr Mazda?"

I grinned in disbelief as I wondered if I was so famous that a random person would recognise me on the street of a foreign country. I nodded as her father stood up from the checkout counter and her mother walked out from somewhere inside.

"You're my neurosurgeon and you don't remember me?" she chided, almost swatting me away. Several scary thoughts crossed my mind almost instantly. Did she have a brain tumour which I operated upon and made worse, which is why she'd lost her inhibition and was talking this way? Did the surgery cause any change in her personality, which is why she's aggressive with her parents?

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"I'm Shreya - Shreya Patel," she said, as the whole family grinned at me, "I was in a coma for three months," she reminded me. And suddenly, everything flashed back in an instant.

Four years ago, Shreya had met with a horrific jet ski accident and was unconscious for several weeks. She was treated at a local hospital in Tanzania for three months, and came to Mumbai for further treatment once she was off the ventilator. When I saw her, she was in a wheelchair with tubes emerging from every part of her body. She could barely speak, and the entire left side of her body didn't move. I recalled not operating on her because she didn't warrant it, but guided her on the appropriate rehabilitation that she needed, as her parents remained in touch with me for the entire year that she was in the city. Every few months that year, she came to me and I monitored her progress. I didn't hear from them after.

And here she was, sprightly as ever, making her mark in the world. She'd started her business of customising gifts and making events memorable. Her parents were eternally grateful to me for guiding her in the correct direction, and didn't charge me for the toothpaste that brought me to their store.

"What are you doing tomorrow morning?" she asked. "We're seeing patients all day at the camp," I told her. "What time do you start?" she enquired. "9 am sharp," I said to wiggle my way out of any dinner plans she may invite us to. "Well, I'm going to pick you up at 5 am and we'll go somewhere. You'll be back at your hotel by 8 to get to work by 9. Bring your colleagues along too!" As she hugged me and left, she didn't allow me talk or give me the option to say no.

As I began seeing patients after lunch, a six-year-old child walked in with her mother. "Surprise!" she waved her hands wide open and came to give me a hug. Unlike Shreya, I recognised them in an instant. I'd operated on her for a brain tumour half the size of her head two years ago, when she was four. She had an exceedingly stormy postoperative period due to a fluctuation of her sodium levels in the ICU, but she was eventually discharged with a laundry list of medication. "She's back to school, doing everything children her age can do and much better," her mother said with indescribable glee. "Her vision, which she had lost before surgery, is almost back to normal," she confirmed, asking if she could take a selfie with me. "We found out you were coming and drove 400 km to see you," she said, welling up. "Thank you," I said, as I stood up and gave them both a hug, "You don't know how happy I am to see you doing so well. Thank you for allowing us to treat you."

I went through the list of patients I was supposed to see when someone familiar-looking walked into the clinic with his wife. "Remember me?" he asked. Today is an unpredictable day, I told myself. When patients surface after a prolonged absence, your first thought is, have they returned because something's not right again?

I attempted a three-second recall and jumped out of my seat when I made the connection. "Mohammad!" I said in disbelief. Both he and his wife were overjoyed that I had guessed correctly. "You're walking?" I asked in amazement. "I told you, when I see you next, I'll come walking all by myself!" he said with pride. We'd operated on him a year ago for a ghoulish spinal infection that had made him paraplegic and bed-bound. He had uncontrolled diabetes, which made things worse. We were unable to identify the source of the infection, but he needed two spine surgeries to wash it out and I had discharged him after six weeks of antibiotics. When he left the hospital, he'd begun moving his legs in bed but was still unable to stand. He reminded me that I had told him he would walk in three months. "Your prediction was spot on," he confirmed.

We saw the rest of the patients scheduled for the day and headed for dinner. "It's strange that we only remember the patients who don't do well, or whom we've hurt with an operation," I told my colleague on the drive back as I thought about these three serendipitous meetings. "It's not in our nature to cut ourselves some slack," he reasoned. "But you're right, we do need to give ourselves credit once in a while," we laughed.

Oblivious of where we were going, Shreya picked us up at 5 am the next morning and took us to the beach sunrise party. Africans were gyrating against local Indians to the latest Afro-Indian fusion music. Sardars were playing the dhol in one corner, while in another, the colours of Holi filled the air. An orange sun rose in the horizon, galloping its way into the sky - turning crimson, and then yellow in a matter of minutes - its rays falling on us and intermittently changing the colour of our skin, reminding us that we are all one.

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