Free Doctored by Sandeep Jauhar Page A

heart that could have partially dislodged and landed up in his brain. There was not. He also got a transesophageal echo, in which an ultrasound camera was passed via a stiff tube into his mouth, down his throat (numbed with anesthetic), and into his esophagus to get close-up views of his heart. Apart from showing a mildly leaky aortic valve, probably a result of hypertension, it, too, was unremarkable. Again Rajiv and I got on his case about his blood pressure. “Do you want to end up with a stroke?” I blared. (Admittedly, I derived some pleasure from the scolding after a lifetime of his preaching.) “You won’t be able to work.”
    â€œI’d rather be dead,” my father replied quietly.
    Over the next couple of days, my father underwent a battery of further tests: carotid ultrasound, transcranial Doppler, lower-extremity Doppler, and chest CT. It seemed a bit excessive to me, but I said nothing. The studies were normal. Since he was symptom-free with no speech or other neurological deficits, Dr. Davenport decided to observe him for one more day and then send him home. We hardly saw her during the hospital stay. Even when she did show up, she spent no more than a couple of minutes with my father and then rushed off. On the day of discharge, my father was given prescriptions for four medications—lisinopril, aspirin, Lipitor (a cholesterol-lowering drug), and Aggrenox (a blood thinner used to prevent strokes)—and was told to follow up with a neurologist once he got back home. Grateful for the reprieve, and appreciative of the efforts of his doctors, he said he had learned a lesson and pledged to take his medications regularly and his health more seriously.
    Three days later, when I was back at work, my sister, Suneeta, called me from Rajiv’s house, where she and my parents were still staying. Dad’s symptoms had returned, worse than ever. He now had virtually no sensation remaining in his left arm.
    â€œBut he’s had all the tests,” I said skeptically. “Let me talk to him.”
    Suneeta was hysterical. “He says he’s having a stroke!” she shrieked. “He says he can’t feel his arm!” The strength she struggled to show as the baby girl in a traditional Indian family often devolved into anger or panic under pressure. In the background I could hear my mother yelling out in alarm, as though my father were falling down.
    â€œIt is happening,” my father announced when he finally got on the phone.
    â€œWhat?” I demanded.
    â€œI don’t know, but I think I am dying.”
    He had never sounded so frightened to me. I told him I would call an ambulance, but he insisted that Vandana, Rajiv’s wife, drive him immediately to the hospital.
    About an hour later I heard “LIJ, code stroke to the emergency room” over the intercom. Racing downstairs—even though I was running, I still didn’t believe anything could be seriously wrong—I arrived to find Robert Holman, Dr. Davenport’s portly associate, evaluating my father on a stretcher with a neurology resident and a rather severe-looking Filipino nurse. My father was whisked away for another head CT before I could even talk to him. When it revealed nothing new, preparations were made for a repeat MRI. As my father lay there among shouting drunks and screaming children, appearing about as miserable as I’d ever seen him, a nurse took me aside. “Don’t know if I should mention this, Dr. Jauhar, but I’ve noticed your father’s symptoms get worse when he tilts his head,” she said. She’d had him do certain maneuvers, like touching his chin to his sternum, that reproduced his symptoms exactly. I went over to his stretcher and had him repeat the motions. “That’s it,” my father said, dipping his chin down unnaturally. “Now I cannot feel my arm.”
    I found Dr. Holman in the radiology room, reviewing the head CT