In the cluttered hum of the echocardiography room, Lalla turned to Bopa Rai and asked, half-teasing, “What do you see on the screen?”
Bopa squinted at the image. There it was — an enormous globule on the left side of the upper heart, strangely tilted. He ventured, “Could it be Epstein?”
Lalla laughed, “Look again — which side is it?”
It still seemed to be the left, but something was off. He led Bopa to senior cardiologist Dr. Rao, who, with barely a glance, said, “Check again. Is it transposition?”
The room fell silent. What they had half-jokingly hoped was a Nobel discovery turned out to be something far more mundane — cardiac rotation. Lalla, ever precise, nodded. Mystery solved.
The next day, during preliminary rounds for Bopa, an Air Force officer complained of neck pain. On examination, Linear tenderness. A red streak is visible on the left side of the neck, inflammation”. Bopa gave him Brufen and called Radiology.
The radiologist didn’t hesitate: “Bring him in. This might be undiagnosed pulmonary hypertension.”
It was worse. A massive inferior vena cava clot — a dangerous condition, with limited treatments. At the same time, another patient, a case of pacemaker failure, was admitted. Both were shifted to the ICU. Bopa stayed to assist.
That night, the pacemaker patient slept quietly.
The officer, however, began to cough. Bright red blood. Bopa masked him, started high-flow oxygen, and secured an IV line.
The cardiologist, away on duty, gave permission by phone: “Administer urokinase. Dissolve the clot.”
Chest specialists arrived. They isolated the bleeding lung and suctioned it clean. On the other hand, they pumped concentrated oxygen ot the other side of the lung
The patient died in the early hours.
Bopa made the call home. “Is the lady there?” There was silence. Then, a faint sob. It grew louder. The phone was placed down.
Bopa didn’t cry. He went back to his quarters and slept. Dreamless.
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