This is Jacky. 6 yrs old and a good friend of mine. I had immense pleasure of meeting him again today in our hospital. It was on 24th July, 2023 that I met him first. He came to us referred from another hospital with very poor sensorium, barely feeling pain or other sensations because of a brain infection which we confirmed as Japanese Encephalitis. He was unaware of the doctors working on him — quiet but urgent — their muted commands blending with the shuffle of nurses, the beeping monitors, and the soft hiss of the ventilator. He was placed on respiratory support shortly after admission. With his father working out of state, his mother was the only family by his side.
He had bloodstream infection detected in his first culture . After intensive interventions for 5 days, he came to his senses . We were happy and hopeful to get rid of the ventilator. But God had other plans. He had collapse of lung 8 hours after removal from ventilator. Back in support , he remained conscious and communicated well with us by signs. Although supported with nutrients parenterally, he started to loose muscle mass. He developed critical illness neuropathy, which made weaning him off the ventilator challenging.
We had to perform a tracheostomy — making a small opening in his delicate neck to insert a tube for prolonged ventilation. From the sixth day onward, he remained lucid. He pleaded with us not to adjust the ventilator settings when we attempted to scale down the support, and he shared quiet moments with the staff and his mother throughout. The whole team of intensivist, occupational therapist, neurologist, dietician ,otorhinolaryngologist and residents spared no effort to wean him off ventilator. We managed to treat the bloodstream infection, possible ventilator-associated pneumonia, and the major brain infection — but he still couldn’t come off ventilatory support.
He remained on ventilator for 38 days, the longest ever in our hospital.
Intensive Care Unit stay is very expensive specially on ventilator. His family was scraping their last saving to meet the cost. They could not see any means to sustain the care for more than 15 days. The was no way other than giving up on this beautiful boy.
Meanwhile the PICU team was working tirelessly to secure the Luningla Elizabeth Bed which was till then occupied by another child. On the 50th day , with utmost relief and joy we grabbed the charity bed which means that Jacky will be taken care at PICU without spending anything for bed, ventilator, In-house consultations, investigations and nursing care, all supported by the hospital. So Jacky stayed with us.
He remained stable, and the hard work by the team gave fruit. Jacky was finally given his discharge summary after 78 days. He was walking again- cheerful though noticeably lighter, having lost 5 kgs during his treatment. The tears that welled up in his mother’s eye when she said thank you to the PICU team expressed all that needed to be said. The team of PICU missed him dearly.
And today, Jacky goes to school routinely, plays football and ranks 8th in his class. I am putting this photo after permission from his mother just to show how merciful God is.
Jacky Gurung, we wish you all the best in life, grow up to be an intelligent, responsible and good human being. Contribute to the society. Believe in yourself, you were the the bravest of them all.
