Emergency Small Bowel Obstruction Surgery in India

After the emergency flight to Delhi, we were transported to a disgusting and filthy facility that was reported to have excellent physicians. I moved Belinda to the Apollo Hospital, which was much cleaner and more modern. The Boston-trained physician was aware of our work and was patient as I continued to try to clear the blockage. Still, we continued to feel a single site with increased temperature. 

Remembering Belinda’s difficulty with the previous post-surgical infection, it made sense that the culprit was likely a persistent infection from that bowel surgery. In the end, Belinda elected to undergo her second bowel resection surgery.

They took Belinda to the operating room at 5:30 in the morning. I was not allowed to join her, but at 8:30, an orderly came in to fetch me. He spoke only Hindi, even though English is the common language that unites India. He was very animated, gesturing for me to follow him. His only explanation, and apparently his only English, was, “come, sir.”

The trip downstairs was other-worldly and sometimes nightmarish. As we arrived at the ground floor, we kept following two arrow signs, always going in the same direction. One read “Surgery;” the other read “Morgue.”

As we finally reached a very long corridor, they were wheeling a dead body from the area, covered by a sheet. Part of me wanted to lift the sheet to see if it was Belinda; another part of me didn’t want to know.

Like being in an “Alice in Wonderland” dream, we passed a small hospital wing whose entrance sign read: “Test Tube Baby Unit.” I am sure they have good doctors there, but the wording of the sign and the feelings it evoked in me seemed strange to my Western mind.

At last, we arrived at the end of the hall where we faced the (now familiar) two signs, now giving very different directions. The “Surgery” sign pointed to the left and the “Morgue” sign to the right.

My guide picked this moment to stop, breathe, and catch his breath from our long trek. 

It was the longest moment of my life.

At last, he stepped to the right, turned and put out his hand, indicating that I should go left into the surgical suite. 

I began to breathe again.

He had me scrub in, put on a surgical cap, gown, and booties, and enter the main surgery room. The room was wide open, about 30 feet square, with eight people being operated on simultaneously. Looking around at this scene in awe, I saw someone gesturing to me from the third table on the right. It was Belinda’s surgeon.

Slowly I approached the table. There was my love. She was totally anesthetized on her back, with a mound of bright red intestines piled up on her rib cage. The doctor started moving her bowels around with his hands to show me what he found. “See,” he said, “No adhesions; you did a remarkable job with her. This entire abdomen should be totally packed with adhesions by now.” It was amazing to see that there were no adhesions at all in an area that had been so severely burned by radiation therapy 30 years before.

“So, what is the problem,” I asked.

“It’s a problem from the prior bowel surgery,” he said. “So often, the problem is post-surgical adhesions, but that’s not it in this case.” He lifted a section of the intestines for me to see. There, ­­­­­like a wedding band or the gold label on a cigar, a tight infected band encircled her intestines in a vice-like grasp, decreasing the 1½ inch (4 cm) diameter of her intestines to a tightly banded closure about a half-inch in diameter. The yellow-green color of the band indicated a state of severe infection.

“It’s good we operated now,” the surgeon told me. “Otherwise, this would have burst the intestine, causing infection to spread throughout the abdomen and pelvis.” He proceeded to cut out the infected area and rejoin the cut sections.

As it happened, Belinda’s physician was an excellent surgeon. She healed without infection this time, despite the proximity of seven other open surgeries of various types that surrounded us.

When Belinda and I met with the surgeon afterward, he offered some words of wisdom. 

“There is nothing you could have done to treat the infection, but you really did a remarkable job clearing adhesions in Belinda’s abdomen and pelvis. The fact that you could clear all of the adhesions that must have been there, considering her history, leads me to believe that you can delay or prevent surgery in people with partial bowel obstructions. I encourage you to explore that area; you may be able to relieve much suffering and hardship.”

Post-script to the story:

After spending a couple of weeks recovering in the hospital, and having totally missed most of our delayed honeymoon, Belinda and I asked permission to move to a different hospital. “We’d like to be near a historic site or a beach,” we said. “Do you have a sister hospital we could move to for our final days in India before our flight home?”

“Oh, yes,” the Administrator said. “We have an affiliate hospital on the Southeast coast, in Chennai. I could move you there Monday.” It was Friday night, Christmas eve. Christmas was coming Saturday, and there was no flight Sunday, so we arranged for the first flight out to Chennai on Monday morning.

Sunday (the day before our flight), the Tsunami hit India, making its greatest landfall at Chennai. I would have been on the beach when it crashed at 9:30 that morning since I always rise early and go to the beach when we are near one. Belinda would have become a very low-priority patient among the survivors of the 53,000 people who died there that day.