Battling A Remedy

THIS is a quote noted by Venkatesh Iyer, 32, in his diary as he readies to fight his Rs 47-lakh suit against Dr Arvind Kulkarni, former head of the radiation therapy department, medical director and superintendent of Bombay Hospital. The plea: a recovery of damages caused by negligence in medical treatment.

Iyer argues that the second dose of radiation given to him for treating suspected recurrence of Hodgkin's Lymphoma, or cancer of the lymph glands, was callously recommended. This, he claims, resulted in permanent physical disability and mental trauma which could have been clearly avoided.

In 1985 Iyer was diagnosed to be suffering from Hodgkin's Lymphoma. A 4,000 rads radiation treatment was followed by chemotherapy. Limb oedema, a stubborn swelling of the left leg, during chemotherapy led to a CT Scan. Kulkarni immediately decided to repeat the radiation dose to combat a recurrence of the cancer.

But the swelling never did go down. A follow-up examination at the Tata Memorial Centre in Bombay revealed that Iyer had, in fact, recovered from cancer. Several ailments have traumatised Iyer since then which, he contests, are due to the second dose. First his penis swelled grotesquely causing extreme pain. Then a limb abscess left his left thigh filled with pus. Hepatitis and severe stomach pain were followed by the irradiated area bursting open with faecal matter and mucus dripping. An emergency colostomy operation had to be performed. This has left a large hole in Iyer's stomach to help remove faecal matter artificially. A plastic bag is attached to collect the wastes till today. Profuse bleeding from the irradiated hole followed. The mucus-leaking fistule has to be dressed at least five times a day.

By studying medical literature and corresponding with leading medical practitioners around the world, he has collected supporting evidence for his case which is due to come up for hearing after the summer vacation in the high court. For one, when his cancer was detected, it was in the initial stages and thus there were very few chances of recurrence in the same location. Besides, this lymphoma is a slow-growing condition. Limb oedema can arise from recurrence of the cancer or as a side-effect of the radiation treatment. Leading doctors thus describe the step as "unwise and potentially dangerous". Iyer contests that, given the effects of radiation, he should have been kept under observation to check further enlargement of the lymph nodes. Or a needle biopsy should have been done to re-con-firm the cancer.

Given the symptoms, Kulkarni says such treatment is not unique. He argues that the effects started to show more than six to eight months after his treatment. The cause could thus be infection in the following period due to negligence. But medical texts say that the effects of radiation can cause physical deformity and late complications.

Kulkarni dismisses the need for biopsy, saying it could also retard the healing process. "The CT Scan indicated clearly the recurrence of cancer and this could be treated only with radiation," he explains. Others feel that there could have been a shadow or a scar tissue in the scan. The patient argues that if a biopsy could have been harmful, what was the logic behind radiation.

Kulkarni also points out that the Maharashtra Medical Council has dismissed the case. Iyer, however, argues that it he was not even called to plead his case at the meeting.

Iyer has cause to worry. The local medical fraternity is shying away from commenting. The continuing ailments have brought the family close to penury. Dr Asha Veer, the doctor who treated him initially and passed the case on to Kulkarni, has passed away. This can leave a wide gap in his argument. Further treatment is possible only abroad at astronomically high expenses. That too can only rid Iyer of the colostomy hole. Effects of radiation will keep occurring. A year ago boils started appearing on his left calf which doctors say are incurable.

But Iyer is pushing himself beyond limits to fight his case. He devours novels dealing with such medical cases to prepare for his court hearings. And though he seems to have long forgotten how to smile, he is surprisingly active. In fact, this mental stamina makes up for the lack of physical strength.?