Polcino, M. Regis

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The Linacre QuarterlyVolume 34 | Number 1 Article 15February 1967Our Most Unforgettable PatientM. Regis PolcinoFollow this and additional works at: http://epublications.marquette.edu/lnqRecommended CitationPolcino, M. Regis (1967) "Our Most Unforgettable Patient," The Linacre Quarterly: Vol. 34 : No. 1 , Article 15.Available at: http://epublications.marquette.edu/lnq/vol34/iss1/15Our Most Unforgettable Patient SisTER M. REGis PoLciNO, S.C.M.M., M.D. The Reader's Digest has a "most unforgettable character." We in Holy Family Hospital have our most unforgettable "patient." This patient involved not only all of Holy Family Hospital, but also practically all of Karachi, West Pakistan. How well I remember the day si ~~ years ago when June was brought to the hospital. It was a memo-rable day for Karachi. We had just returned froni witnessing the first Ordination of the Seminarians in Karachi- it was January I7, 1960. As I entered the hospital lobby I could see that there was much ado and things were astir. The resident doctor confronted me with the news that an emergency patient had been admitted....:._ a twelve-year old girl bleeding profusely from practically all orifices. We had not had our supper, but all thoughts of food were laid aside as we immediately went to the ward to see the patient. There was this child, extremely pale and vomiting profuse amounts of blood. She also was bleeding from the nose and ·eyes and had numer-ous petechiae over her body. In the meantime, Sister M. Joachim, our laboratory technician, at once typed the patient, and much to our cha-grin, had found that she was B Rh negative group. The Rh negative factor is a rare entity out here in the East and to find someone with this type of blood would be like looking for a n~eclle in a haystack. The child's hemoglobin at this time was six grams. 48 The mother said that the child had fever in the past week, bu~ prior to this she had been well anc never had had any episode of thi· sort. From the history and ou· clinical findings we felt that thi was a case of idiopathic thrombocy topenia purpura. The cause of thi; is sometimes attributed to certai· L drugs or infections. With th· ~ knowledge of her disease and tb = rare type of blood, we knew we ha l a difficult time ahead. Where wei ::'! we to get the amount of bloc 1 needed? The patient was losir g blood continuously. Sister M. Joachi n looked up her list of emergen y donors and was able to find o: e American of this type. Fortuna tel 1, we were able to get this don >r to come, and we were able to trar s-fuse the patient and sedate her, ;o that subsequently that night, blec l-ing did stop for a time. The next day we found on exa n-ination of her blood that the hen o-globin had not come up but bad dropped to an even lower gra-le. We spoke to the family and d ey made all 6fforts to bring in frier.ds and relatives for typing, but t.:1is was not sufficient. Then with he help of some friend who worked for Radio Pakistan,. an S.O.S. was caHed out and various programs ere interrupted with the emergency '~all for donors of this type of blooc.~. to come to Holy Family Hospital. The same appeal was placed in the Ka-rachi n~wspapers. This began an LrNACRE QuARTERLY avalanche of people who came for typing. Of course, this went on for several days, because out of one hundred maybe one or two people could be found to have B Rh nega-tive type blood. People from all spheres responded: Muslims, Parsees, Goans, the priests from the Fran-ciscan Friary, Seminarians, other Missionaries, Americans and English people, and others from the various Embassies in Karachi. There were many human interest stories associated with this patient. One evening at about II :30 a Par-see lady-doctor came rushing in all breathless. She said she had just returned from a movie and put on her radio and heard the urgent call for blood. Knowing that she was Rh negative herself, and having children of h~r own, she knew the need , and felt that at once she should come over and give her blood. I can remember we were very happy to see her because all day, in spite of the many people we typed, we were unable to get one pint of blood. There was another interestina story of a Muslim man who had also heard the appeal for blood. He ?Iso felt the urgent desire to come Immediately because he also had youn.g ~hildren of his own. AI though he dtd not know his type of blood he felt within him that it must be the same~ He told us that as he ~eft the house to come to Holy Fam-Ily Hospital there was no means of transportation. The bus which ran that course was long since gone and no other bus would be expected for seyeral hours. But Providence had FEBRUARY, 1967 it otherwise. As he was walking along, the bus which should have left much earlier appeared at that time. When he was typed it was found that he was the same type as the patient. To this man it seemed all mir.aculous. It seems people from all walks of life - doctors, sweepers, office workers, priests, ministers -'-all responded. It was certainly edi-fying to see such a response. As we took the blood we were able to transfuse our patient, and after five or six transfusions her hemoglobin had come up to about ten grams; she had stopped bleeding and we thought perhaps she would become better. However, she again began to bleed profusely from the urinary tract and also from the gastro-intestinal tract. I had started her on hydrocortisone, this being one of the latest measures for treat-ing the disease, but in spite of lar~e doses she did not respond. The other alternative was to remove her spleen, but the patient was in no state for surgery, her hemoglobin having dropped to eight grams again. I was in a quandary as to what to do, when I decided to con-sult with Doctor Cash, professor of pathology who was at the Basic Medical Science Institute at Jinnah Central Hospital. This is one of those joint aid programs of the United States through Indiana Uni-versity. The Institute gives post-graduate courses in the basic sciences for the Pakistani doctors. I went over to see Doctor Cash and told him of our patient and the problem. We combed the literature and found that one of the latest treatments for this disease was to transfuse the 49 'I patient with fresh platelets, but the equipment needed for obtaining such blood was not available in Karachi. However, Doctor Cash was able to help us in another way. We also found in the literature that by siliconizing bottles into which the blood is drawn the platelets are not broken and remain whole and were thereby more beneficial to the patient. Since · this was his depart-ment, he asked Doctor Minton to do this for us. With this method we were able to draw fresh blood which kept intact the platelets. Also at this time the American Embassy offered their help to wire the States to have fresh platelets sent in, but this would have entailed too much of a problem, so we did not follow through. So June was transfused with a least SOOcc of blood taken in sili conized bottles. She was still onl· eight grams of hemoglobin and But now that we had the silcon-ized bottles, our next problem was that we did not have any more donors. All I could think of at this moment was to look up two donors from whom we had taken not a full SOOcc each. One of them was a Franciscan priest whom I con-tacted and he was willing to be bled again. A. Protestant minister, a friend of the patient's family, had offered to pick Father up by car late that night. (This is one of many examples of help from numer-ous sources.) The other donor was an English sailor who also had given blood within the past week. He willingly came and again we bled him, although almost to the detriment of his own health; he tainted. However, with rest and advice to take iron tablets, he recov-felt that I had to take courage h . hand and operate. It was now c · never! Various doctors who kne' · of the case felt that she was doome l and that they would not take tb ~ chance of surgery. I could nc t watch her die without that fift .r percent chance of operating. I remember asking our anesthesiol( -gist, Doctor Rahman, if he we e willing to stand by me and give tl e anesthetic. He agreed as he . w .s not afraid to take the risk. T~ e parents also acquiesced for this sli n chance of recovery. It must be not d that June was their only child a: .d they loved her very much. Throu: ;h all her illness, although June ¥. 1s still a child in many ways, s 1e complied with our many requests to transfuse her and to give her rna 1y injections without much murmur I remember before operating I w< nt in and sat down and spoke with 1 er as though she were an adult. I explained to her the illness and h lW serious the condition was and t} tat only surgery would cure her, fnd asked if she would let us perfc ( IIl it. She listened to us quietly r nd said she had complete faith in us. With much prayer and m ral support of our staff, we made the incision and opened the abdorr en, and within forty-five minutes, re-moved the spleen and had her sutured. All went well with anes-thesia and surgery. Post-operatively we knew we still needed more blood and also th ere ered fully. LIN ACRE QUARTJ~RL "{ so was the hazard of her bleeding be-neath the wound. Again we had to send appeals for more blood donors, and again many responded. After a few days the bleeding subsided completely and her hemoglobin began to rise, as well as the platelet count. When we added up the number of bottles of blood that she had received, we found the total to be twenty-two! As the days passed, all bleeding was definitely stopped and her con-valescence progressed satisfactorily. There was much rejoicing when we were able to get June . up and in to a .wheel-chair and out to the garden. Fmally, she was discharged. We followed her case throughout the months and no.ted there was no recurrence of any bleeding and b.lood studies always showed suffi-Cient number of platelets. With the passi~g of six years June has done well and has grown to be quite a young lady. ~ere is indeed an unforgettable patient. We have often wondered ~hat the design of Providence has In store for her for having spared FEBRUARY' 1967 her life. Also, here was a patient for whom all the hospital personnel, both administrative and medical responded with their unstinting and dedicated efforts. All rallied to her care, besides fulfilling their routine duties, and worked beyond the call of duty. Here also was manifested brotherly charity, when all people from all walks of life, regardless of their color, creed, or nationality responded not only in giving their blood but in many other ways. The prayers of Christians and Muslims, and Parsees reached to God for a cure. Certainly only Christ can reward all for their service to the sick, because it is He who has told us that whatever is done for the least of His brethren is done for Him. Thus at the end of time we will hear Him say, "Come, you blessed of My Father, possess you the Kingdom prepared for you from the foundation of the world." (Matt. 25:24.) [SISTER M. REGIS is a member of the Society of Catholic Medical Missionaries. She is a graduate of the Woman's Medical College of Pennsylvania. She serves as ~edical ~irector and surgeon at Holy Fam-rl y Hosprtal, Karachi, West Pakistan.] 51 

Our Most Unforgettable Patient

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Our Most Unforgettable Patient

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