Mind Matters | To the brink and back

With my dream trip just days away, I stepped out to run an errand. The next thing I remember is waking up in the Intensive Care Unit of a hospital, unable to move. I later learnt a few weeks had passed since I decided to run that errand. In my bedridden state, I painfully started to discover the extent of my severe, life-changing injuries.

Weeks later, I understood that while running errands I was on the pavement and was a victim of a life-threatening road accident. The situation was critical, with six ambulances rushing to the scene as my life was slipping away.

I was losing a lot of blood, and since my blood pressure was falling to dangerous levels, the first responders induced a coma right there on the pavement. They also administered two blood transfusions. I was declared a code red medical emergency.

As I was being rushed to a major trauma hospital, I was administered four further blood transfusions. Surgeons worked tirelessly to fight for my life. In any other city, I might not have survived. London brought me back to life. The dedication of the first responders, police and NHS staff kept me from going over the cliff.

Much to the agony of my loved ones, I remained in a coma for 10 days. Through this time, my life hung in the balance as I underwent multiple surgeries to fix extensive broken bones and repair major damage to my organs.

I did not know it at the time, but as I lay comatose, my unconscious mind helped keep me alive. It took me back to moments of nostalgia; moments where my past and my present collided in inexplicable ways. It cocooned me, defending my identity from the massive trauma I had suffered.

While I was in a coma, my unconscious mind knew something terrible had happened to me, but not what exactly. I believed I was in a wheelchair in an emergency room in a hospital in Houston, US, where my cousin who is an ICU Pulmonologist, had come to pick me up. In reality, I lay in a hospital bed in London, and that cousin had flown in to ensure I was receiving appropriate care. I later learnt she had had to leave before I woke up. Interestingly, even comatose, I was aware of her presence.

At another point in time, I felt I was in the back of a cold storage lorry, being ferried to northern Europe. I was confused and very cold, wondering why I was there. I panicked, wondering what was going to happen to me. In reality, I was probably under general anaesthesia (during which the body becomes very cold) and I was being taken into surgery.

For a prolonged period, in my unconscious mind, I was on INS Vikrant (an Indian naval aircraft carrier) that sailed from New York to Istanbul. Given I am a naval aviator’s daughter who grew up on naval bases and have been aboard INS Vikrant when I was about eight, I now realise that my unconscious mind was keeping me in a very safe environment.

I was on the biggest Indian Naval Ship, being operated on by the best surgeons. Two of the senior-most officers in the Indian Navy were personally concerned about me, and taking very good care of me. I was in awe of the Captain, who I found to be profoundly wise. People on the ship asked him existential questions and his answers left me in awe of the depth of his wisdom and intellect.

The Captain was not a man who had to assert his leadership in any manner. He had a distinctive aura about him, which along with his innate wisdom inspired everyone around him. This gentleman, who was perhaps a figment of my imagination, ended up being my greatest source of strength during my most adverse of times. His words and wisdom were part and parcel of my hopes, shining light as I traversed through a dark path of deep despair.

In reality, I was in an NHS ICU trauma ward, reeling under tremendous pain and agony. I was very frustrated and stressed and felt like I was imprisoned. In hindsight, this was most likely due to the extreme duress my body was under... and the fact that I could not do simple things like lift my head up, or move my hand. I wanted to “escape” from this hospital. I am told I asked numerous loved ones multiple times to help me hop into a taxi. Of course, none of them could do that.

I awoke, but the recovery was long. At one point, a team of surgeons came to review my progress and the lead surgeon asked me grounding questions such as my name and my date of birth. When I got those right, he asked whether I remembered what had happened to me.

I replied, "I was on a horse and a car hit the horse and I fell and hurt myself". I now realise this was a version of events my unconscious mind had concocted, maybe as a way to protect me by displacing my injuries onto another being, albeit one I love. The surgeon (very wisely, I understand now) responded, “Oh, I hope the horse is OK”.

Uncannily, despite being partially delirious, I was very aware of major events that were supposed to happen in my life such as starting my new role at work and my travel schedule for November. I didn’t fully appreciate the extent of my injuries. I thought I could continue with my life and schedule: I was due to travel to Mumbai for work in mid-November. When I raised this ‘travel plan’ with my mother, she informed me that I would need consent from my senior doctors to be able to fly.

I tried to get that consent but, unsurprisingly now, to no avail. How difficult it would have been for a mother, to see her own child in a state of tremendous pain, yet holding on to the optimism of her present reality? But that is a question for another day.

It is said the bond between a father and a daughter is one of the purest there is. My dad had always been — and continues to be — a staunch pillar of support in my life. As I was coming out of my coma, I vividly remember reaching out to him and asking him to put his hand on my forehead and tuck me into bed. Not once, not twice. I did this every time I would get any semblance of my senses back.

Perhaps I wanted to feel the comforting touch of the familiar hand that was instrumental in shaping my beliefs and my values. Perhaps I was hoping that a man who, when I was a child, always had all the answers to all my questions, could help me understand why I was destined to be in this state.

About a week after I was brought out of my coma, I underwent an intense 12-hour surgery. My sedated mind was very active during the procedure — but that is another long story (and potentially a study for psychologists) in itself. Suffice it to say that at that point I was panicking about the multiple surgeries I had been subjected to.

A day or two after, I could see blood seeping through my bandages. The team handling my reconstructive surgeries came to see me, and I exclaimed that I was worried. The head surgeon replied, “Komal, blood is a sign of life.” I was confused then. Now, knowing the details of the microsurgery they had carried out, I understand what he meant. In either case, it was — and remains — a very profound thing to say, in my opinion.

While I continue to struggle to come to terms with reality — one that I definitely did not sign up for — there are moments I experienced which help me endure what I am going through. One such incident happened as I drifted in and out of consciousness for over a month.

One fine morning, I woke up emphatically believing I was in Istanbul. I refused to see or acknowledge any proof that I was still in London. My doctors were worried at the time: I had lost nearly 20 percent of my body weight, and I was barely eating anything. One day during the Istanbul phase, one of my primary surgeons was passing by and asked me what I was going to eat for lunch. I said I had asked my father to bring me a falafel. As he dashed about the ward, he quipped, “Komal, you can do better than that!” Being genuinely surprised at his response, I was quick to reply, “I’m in Istanbul, I HAVE TO eat good falafel.”

Amongst many other experiences, one that is etched forever in my memory was the day I was getting discharged from the NHS major trauma hospital. My head doctor, who had dropped by to review my progress said, “Komal, I’m so pleased you are looking better now than you were a week ago.” By then I was on fairly friendly terms with him. I replied, “What are you talking about? You see me howling for a few hours every morning.”

"Komal," he said, "I am a trauma doctor. If you were doing anything else, I would be worried.”

His response is not something I think I will ever forget.