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Medical schism over sergeant’s treatment

Calcutta, Jan. 3: Three days after traffic sergeant Bapi Sen was battered into a coma, the board of doctors overseeing the policeman’s treatment is divided whether precious time was lost in reviving him.

Based on reports available at 3 pm on Wednesday, nine hours after Bapi was rushed to the intensive care unit of Calcutta Medical Research Institute (CMRI), some neurologists had recommended an “immediate operation’’, to remove blood clots in the back of his head.

Some others on the medical board, however, felt that surgery, given the patient’s critical state, would not help much for all the tests carried out on Bapi had confirmed that the clots were expanding fast.

These doctors cited the extensive damage to the brain stem and the right hemisphere to press their case against an operation. “How can we operate when he is on a ventilator'’’ a doctor asked.

The doctors advocating surgery said patients suffering from brain-stem injuries had often improved after operation. “It’s risky. But when there is nothing to lose, it is worth going for it,” a doctor said.

“Going by experience, a surgical procedure on Sen on January 1 could have helped pull him back,” the doctor said.

Neurologist Ajay Agarwal is the primary consultant in Bapi’s case. Along with him are doctors G.K. Prusthi, M.K. Manocha, Indrajit Roy and Subir Basu Thakur.

An account of events shows that precious time was lost in shifting the unconscious policeman to hospital after he collapsed on the tram tracks a little after 1.30 am on January 1.

At 1.50 am Bapi’s friends, who looked on from a Maruti while he was thrashed, brought him to Calcutta Medical College and Hospital.

“The doctors examined a bleeding and unconscious Bapi and advised a CT scan. The report indicated he was suffering from serious head injuries,” said M.K. Singh, deputy commissioner of police, traffic.

“The doctors then said it was a difficult case. So his friends shifted him to a private hospital in south Calcutta.”

Between 5 am and 6 am, Bapi was shifted to CMRI. The records of the doctors on duty there show he was admitted with “injuries in the brain stem and several clots that blocked the cerebral artery on the right side of the brain”.

Doctors on the board explained that a brain stem is a vital part deep inside the brain, where neurons or brain cell tissues connect the central nervous system and the spinal cord with the brain.

“It controls the flow of glucose to the brain and the part that deals with memory, sensory organs and supply of oxygen,” a senior doctor on the board said. “It is a most important part of the brain.”

According to him, “the right portion of (Bapi’s) brain is not responding to stimuli and there is a huge blood clot because of damaged nerves and tissues’’.

Ajay Agarwal told The Telegraph that Bapi was put on ventilator the moment he was shifted to the intensive care unit.

The board examined the policeman this morning, he said, and sat down with the reports.

“The CT scan and MRI reports showed severe injuries to the brain stem and revealed that other vital areas, too, were damaged,” Agarwal said.

“We held an intense discussion, weighing our options. We discussed the possibility of surgery. But after scrutinising the reports, we decided against it,’’ he said.

At Writers’ Buildings, chief minister Buddhadeb Bhattacharjee today said the government had already initiated action against the culprits.

Home secretary Amit Kiran Deb said the state would pay for Bapi’s treatment. An inquiry was on, he said, to find out whether the constables were off duty and permitted to leave the police station.

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