From ecstasy to a fall…A tale of endurance.
After my internship in 2011, I decided to join the trekking and caving expedition in Mizoram. I had read of caving and spelunking only in story books and the impression I had about it is almost laughable. I thought caving was akin to walking through a tunnel 😀 ,maybe one with a low roof and narrow spaces. Some squeezing in here and there, a bit of crawling and that would be it. Big deal! I was going.
So on the second day of the trek we were taken below the cave entrance. The actual entrance was at a height of approximately 3 meters above some boulders. So we had to be hauled up first one at a time. I was the third in line. After being pulled up by our local guide who was maybe half my size(amazing arm strength),I reached the actual entrance and then came the big surprise-
THE CAVE DIDN’T HAVE A FLOOR.
It was a straight downward drop and I could see rivulets and pockets of water below. The roof was low; boulders on either side and the crevices between these boulders would serve as hand and foot grips. Also it was pitch dark inside. On second thoughts, I think sometimes ignorance is bliss. Had I known in detail what we would be doing, the level of paranoia would have been greater.
As I was being pulled up my torch had fallen off my jacket pocket into the water below. For those who attempt this, please always carry a head lamp. The irony was that the ones with previous caving experience were using headlamps and the first timers were juggling their torches like circus jokers. Trust me; trying stunts in there without both your hands free is a fool proof way of landing with a fractured skull bone or a broken spine. So in retrospection, I am thankful that the torch fell off and as for the light, the guides’ head lamp did the job.
The initial step was climbing on to this small piece of rock jutting out through the cave wall. There was only enough place on that rock to accommodate both my feet and I was sitting on my feet crouched. I was then asked to make the next move. This was when I found that my leg was stuck in an awkward position. My guide was now giving me every suggestion possible-try standing, turn this leg a little etcetera and I told him that all I wanted to do first was take a few seconds to gather my wits and then maybe I could figure out what to do with my leg.
So he waited there until I managed to alter my position slightly and moved to the next big boulder, one on which I could comfortably stand. The next few portions we maneuvered were not that difficult. I don’t know, if anybody else felt the same way but I thought having a tall frame put me at a disadvantage in some places. A shorter person can simply bend a little and pass through a low opening, whereas taller ones have to bend even more to reach the same level and when you bend too much at your knees, you can no longer maneuver your legs the way you intend to.
So at one such place, I had to go headfirst horizontally parallel to the ground, and once my upper body had passed through the opening, I could use my arms to get grip on either sides and draw my legs out. Finally it’s on you how to figure out what works best for you. The penultimate portion was the toughest. Here the walls were relatively smooth. That meant no hand or foot grip. However the space between the two walls was narrow, so one could jam himself between the two walls. Now I know that the technique is called as chimneying. Your feet presses on one wall and your back on the opposite one and once you fix yourself that way, you can move slowly sideways until you reach the next big rock.
At times we sat in pitch darkness and the eerie silence until the rest of the group joined us. The only occasional interruption was the screeching of the bats and the slow trickling of water from the roof above. The last bit was frog climbing, gliding up a smooth boulder face down and then the final climb upwards to the exit. In all a 130 meter long, heart in the mouth experience. Finally when everyone exited, the exhilaration was obvious. It was once in a lifetime feat for most of us and there were claps, laughter and high fives( and thankfully no casualties).
Just as we were moving back to the camp site, someone mentioned an other cave in the vicinity. Half the group continued to the camp site and the rest of us to the next cave. This one matched my imagination. It had a solid floor although a wet and muddy one and a very low roof so we had to do belly crawling all the way to the end and back again. When it all ended I looked as though I had been plastered with cakes of mud from head to toe.
It’s the only time I felt happy to look that dirty.
A few months later, I decided to go on an other trek. This time we would be climbing the second highest peak in the State of Maharashtra, Kulangad. Because, why not? However, this time I wasn’t that lucky. My fitness levels were questionable at best and I was going to try this feat with some seasoned trekkers and trained mountaineers. After we reached the base of the mountain and had a small breakfast, we started our climb. I was light headed at the very onset having not slept a wink the previous night. Soon enough a few meters up and I twisted my knee and fell. ‘It is no big deal’ was what I thought.
I then made the next terrible decision. To continue onwards with my injury. Half way up I realized that I had probably torn a ligament. I could barely carry any weight, my knee was unstable and I was crawling up on all fours. There was no other choice but to go along with the group.
After I reached the peak, I realized that I could barely walk a few steps without falling. An uneven ground made it all the more worse. Now I was even more worried because it was seeming next to impossible to make my way down the mountain. I was wondering if I would have to be airlifted and how I had managed to screw up the experience for everybody accompanying me. I spent that night sobbing in terrible pain and helplessness.
The next day, I composed myself and we started our decent. One good thing about trekkers is that they won’t leave a mate unattended for. They will make sure to drag you along if need be until you reach back to safety. My modus operandi was to crawl down in a seated position thus managing to keep any pressure off my knees. As is mentioned in the medical literature, anterior cruciate ligament injuries of the knee make it difficult to climb downwards.
Half way through I had badly bruised arms and legs, my trackpants were in shreds since I was gliding over rocks, dry mud and thorns. I managed to change into an other pair when I found a little cave by the side and continued downwards. I had sworn to myself the night before that I would not trek ever again. However, when I did reach the base of the mountain, I was reconsidering the promise I made to myself. I had eventually made it down alive though not in one piece.
My parents then managed to pick me up from there and then began the ordeal of numerous visits to orthopedic surgeons. This is one instance when I realized why certain doctors earn a bad reputation. Even with a history as clear as daylight and pointing very obviously to a serious ligament injury, a certain stalwart in the profession(supposedly one of the best in town)had decided to not take my concerns seriously and instead treated me with a knee brace. Not just that I spent a year and half with an unstable joint, the same doctor hadn’t bothered to ask for an MRI.
Only later did I find an orthopedic surgeon apt for me who post an MRI diagnosed me with a triple ligament injury and suggested that I undergo surgery to fix the same. I went on to undergo an ACL reconstruction and a meniscectomy and was soon walking normally again.
I won’t take any names here since they are colleagues in the same field. But, today after years in the field, I know that there is a difference between a good doctor and a famous doctor. The first doctor may or may not have done a good job for some others, but he certainly botched up my case. I agree that not everybody will get everything right all the time, but do not deliberately screw someone over. When your patient complains of something, believe them. Get an extra test if need be. The patient may spend some money, but it may also save a life. Also if it is something beyond your expertise, keep your ego aside and take a second opinion.
That is what the surgeon who finally operated on me did. He was a good orthopedic surgeon but wasn’t an expert then in the field of laparoscopic ligament reconstructions and called in an other expert in the profession, assisted and oversaw the whole procedure.
Also, those fluroquinolones we so commonly consume for everything from diarrhea, skin infections, respiratory infections to being a part of our AKT regimen, do come with a black box warning. They cause damage to your tendons and ligaments apart from numerous other side effects.
All in all, a lesson in endurance, kindness and medical ethics. Famous or no, someday I want to be known as a good doctor.
