Vrana-ropana^

Around the corner from the expansive, dilapidated Ayurvedic Hospital is a courtyard made of sand leading like a ghat to three new marble stairs. Inside the wrought-iron accordion gate at the top is an entry hall freshly-painted, covered on one wall with a beautiful mural of Ayurvedic surgery, and as elegant as any Manhattan office building …. except ….. that it is teeming with people in every corner,
on every bench, on the floor, leaning on the walls. One has to infer that the invisible floor is also marble.  There is a narrow passageway lined with bodies sitting, lying and standing, through this immense lobby down a corridor lined with medical graphic photos of operations in progress, before and after photos of gross injuries, fistulas, and stubborn wounds.  

This building is the haven of a team of Ayurvedic surgeons who are limited to a small corner of surgeries permitted to them by the mainstream conventional physicians, and thus by the law of the land.

My long-time Bengali friend and colleague is a fan of two academic topics:  colorectal diseases, and wound healing.  He knows the modern techniques and the ancient ones, and uses tools from both, bridging and designing what will work. He is fascinated with skin physiology, herbs that heal the skin and the lower gut, and with natural antibiotics, anti-inflammatories, and techniques for diagnosis and successful treatment. He is always watching, like a surgeon.

The lobby is the nonverbal testament to his popularity:   he sees more patients per day than most of the allopathic doctors do in a week. The statistics of the hospital have confirmed it, so the allopaths have conspired to stop him. How?  They have assigned him to be the next Dean of the Faculty, riddled with paperwork, pomp, and protocol.   

He looks at the brew of patients growing and remembers each and every one, and lets me know in no uncertain terms that he will not give up his patient load.  The practice of medicine is what makes a physician a physician, not a degree, not an award, and certainly not a tenure position and title.   All the while he is both serious and humorous, attentive but expansive.  His team of students, residents, assistants, and technicians keep his pace, travelling from the dozen spaces: consultation rooms with computers, and discussion space; several minor operation spaces; several larger operation spaces.  Ultrasound machines, colonoscopy machines, probes, and parts sit waiting next to autoclaved steel boxes, carts and bowls. He can tell you where each was manufactured, how much it costs on a good day and how long it takes to import.  The rooms do not have the haughtiness of the American hospitals in which I was trained, but they have all the necessary equipment, well-kept and clean.  The fans whirl 15 feet above, and a sea of white flip-flops sits at the entrance to the operation area.

Luckily, my mother does not have internet access, so she will not read why I had to visit the center.  Last week, I was in a motorbike accident.  Seems pretty rare here, with all the traffic, narrow lanes, complete lack of traffic rules, and absolute abundance of napping traffic cops at many intersections.  Eighteen thousand students and fourteen hundred professors, along with patients, friends, visitors, and staff, go in and out through 3 gates of the University into a city of 1.6 million people.  So few accidents for the volume of living things, and the space we occupy together.   After the first day in the triage center of the nearest hospital, however, I decided to hobble home and pull out my black doctor’s bag.  My own prescription and house-call to myself was the best thing I could do.

But now, five days later, after the crushed artery has closed and the superficial wounds are granulating with no signs of infection, it is time to debride the 3cm orange-red-black space, and I have been fortunate that Dr. Sahu will allow me to use his operation theatre. All I need is a clean space, some normal saline, some cotton gauze, some clean instruments, some high-quality turmeric, and some good light. I bring my own surgical scissors and some small items just in case.  Only here do I find freedom from allopathic bullies ready to cut me and drown me in antibiotics.  Dr. Sahu makes sure I am set, then whizzes off to his whirlwind of awaiting patients. He is permitting me to debride my own leg, as two assistants stand nearby watching the patient perform surgery on herself. 

At some point, I realize I am cutting my own tissue from my leg. It is a bit surreal as I hear the crisp cutting of tissue, sounding just like hard cloth, or the chicken I would help my mother prepare...  I turn my attention to a mental list of all the tools I would like to bring from the USA, to donate to the clinic, in thanks for their permission to allow me to operate in their space.  We throw away so many items in the USA that would be of such great use here.

Toward the end, Dr. Supriya, a junior surgery resident,  insists I cut some tissue that my rostral angle will not permit me to do. She politely and quietly takes the scissors and approaches from the end of the table and cuts away until blood oozes. She is satisfied that now the inflammation has a path, or marga, to egress.  We discuss the possibility of using jalautha (leeches) for this to get a cleaner margin of live tissue as Dr. Sahu is called for inspection. He probes and checks for winces and signs of pain, then announces that the wound margins look… great.

I clean outside the edges with saline, apply a light coating of pure ghee, sprinkle some pure turmeric powder around the edges, and cover the gaping 3cm x 2cm wound with cotton gauze, sealing only the sides with hospital tape so it can breathe.  I hobble home, happy to know I did not disrupt my body’s physiology any more than was necessary. No antibiotics, no anti-inflammatories, no anesthesic toxins for my liver, no gels, no plastic coverings or band-aids or steri-strips, no skin-sterilizing stuff. 
 
After all, I muse: I have eight big lovely drops (ashta bindu) of Ojas in me for my endogenous pharmacy.   That is my best medicine cabinet.  

^ The Ayurvedic term for promoting wound healing is vrana-ropana.