It was 7th May 2007....Surprised how this date has got engraved in my memory!
Precisely 3rd day as an assistant professor in department of Orthopedic Oncology at Gujarat Cancer and Research Institute (GCRI) running my first ever independent OPD...
Having an extensive 2 years fellowship at Tata Memorial Hospital, i had taken up this job....
Orthopedic oncology was a subspecialty never heard before.....and Limb salvage existed mostly in the books!
I too was having doubts and trepidations in my heart......will i ever get recognition? Can this branch be a viable option of career?
However, fortunately, there never was any doubt in my mind about my training and capabilities!
Here walks in Mr Husain....a 35 year old gentlemen who had come all the way from costal town of Mangrol.
His facial expressions were telling a story!
He was diagnosed with a high grade chondrosarcoma of distal femur....An aggressive large cancer!
Doyens of Orthopedics had discarded him.....He was told to undergo amputation at the very next morning by multiple experts.....
Many had already started playing God by predicting that he wont see the sunrise of 2008!
Deep creases on his forehead and dark circles under his eyes were evidence that sleep had vanished from his life!
I am sure, seeing a young 29 year old doctor in the OPD must not have made him feel any better!
"Sir....please amputate my leg but save my life! I have 2 young kids.... the little one is just 2 months old! I cant die sir.....I cant die!"
Tears rolled down his eyes as he practically fell on the floor. His old mother couldnt help but broke!
Having trained at centers like Tata Memorial Hospital, this kind of scene wasn't new to me....but there was something very different this time!
This time around, i was suppose to take decision and i was responsible - accountable for the decision i take!
I had never experienced this feeling! It made me feel nervous and empowered at the same time!
When i counselled him regarding a possible limb salvage, he was in a complete disbelief!
He was suggested to undergo amputation by stalwarts of Orthopedics who had stated practicing even before this so called young "Orthopedic Oncologist " was borne!
Can he really trust me? Or should he really trust me?
He left that morning after listening to my advice...
That night i couldnt get a sound sleep....kept wondering what will be his decision? Was i good enough? Did i inspire confidence in him or not? Will he ever come back?
I was eagerly waiting to see him in my next opd. I was sincerely hoping that he shows up! And he did!
Came along with his wife, 2 kids and old mother.... My heart beating fast....to know his answer!
"Sir, we thought a lot.....When i came here, I was absolutely prepared to loose my leg! I still dont know why i should trust you....but my heart says that i should! I dont know whats my destiny....but i want you to treat me with complete faith in yourself and God!"
Now it was my turn to get teary-eyed!
On 14th of May 2007...I did his surgery... That day I did my First Ever independent limb salvage surgery
Resected distal femur and reconstructed with a Megaprosthetic Total knee replacement! Again, first in the city!
Since then it has been an exhilarating journey..... There has never been any looking back...
Having done close to 2500 limb salvage surgeries, i can proudly say that today, limb salvage has become a norm rather than an exception!
15 years down the line, recently i got a visiter......a guest.....now an older gentlemen in his early 50s, with his beard having more grays than black....walking on his legs with 2 sons by his side...both now grownup teens!
Here is Husainbhai....absolutely healthy.....
Handing me over the box of Mangrol's famous coconut Halwa, he hugged me warmly!
He looked deep into my eyes...didn't utter a single word! He didn't need to!
It was now time for both of us to get teary-eyed....... together!
Dr Mandip Shah
Sparsh Orthopedic Oncology Clinic,
It was a cold winter morning in 2013 when a 13 yrs old girl was brought to my OPD from modasa.... moaning with pain on a stretcher....unable to walk since a week!
The parents were told by a local orthopedic surgeon about possibility of a sarcoma in her pelvic bone.....
They looked at me with immense expectations as their eyes were full of fear and filled with apprehension....the little loved one was staring at a life threatening disease!
Her work-up revealed a large tumor in the left pelvis - from the SI joint to the ischial tuberosity and into the adjoining sacrum.
Biopsy confirmed the diagnosis as Ewing's sarcoma. It couldn't get worse for this eighth standard schoolgirl as her staging work-up revealed lung metastases - stage 4 disease. It was devastating news for her and her family.
This was a fight for life and she was appearing to be on the losing side.
What followed was a year long ordeal with a multi modality management....
She started receiving chemotherapy to which she responded very well. The disease shrank significantly which made it amenable to surgical resection.....Most lung nodules disappeared....
She then underwent a supra major sacro pelvic resection (Type 1+2+3+4 internal hemipelvectomy) which necessitates removal entire half of pelvis along with acetabulum.... with no bone left there, reconstruction of the defect was done with sacro femoral pseudoarthrosis....
It is a life changing procedure - functionally and cosmetically.
She adjusted bravely to the consequences of her surgery - coping with the surgical pain, limb shortening, instability, months of walking with support etc.
Postoperatively she recieved another 8 months of chemotherapy....
Despite completing the management optimally, there were persistent nodules in right lung. Which had to be taken out surgically as she underwent pulmonary metastasectomy followed by whole lung Irradiation!
More than 5 years after completion of the treatment, It was another cold morning of winter 2019.......as she confidently walked into my OPD completely disease free....
Today she is no more my patient.....But a fellow colleague as she embarked upon her journey to becoming a doctor!
Yes..... She cracked the NEET exams with flying colors.. and has been secured a MBBS seat in Ahmedabad.
Life has come full circle for this kid who faced the most trying of life's challenges and dug in her toes and not just fought it out but dared to fly and touch the sky.
She did it.....
She touched my heart.....
I salute her courage.....
The team which treated her....
Medical Oncologist - Dr Mithun Shah
Radiation oncologist - Dr Kinjal Jani
Thoracic Oncologist - Dr Mukul Trivedi
Orthopedic oncologist - Dr Mandip Shah & Dr Chetan Anchan