Gislaine Mutatsineza

Thattu Kada. A young man, in his early 20s, with alcohol use disorder and severe alcohol-related hepatitis at the brink of death, two years ago. He only had his father as family, a frail but headstrong 60 year old man with silver hair. The mother died early due to breast cancer. The young man took to drinking alcohol very early on. He never went to college. By the time I diagnosed him with acute on chronic liver failure due to alcohol, he was only 22. We treated him aggressively and got him better. Took him through deaddiction and he became sober. For over a year, his father would come religiously for follow ups with him and made sure he followed my advise and suggestions to the T. The young man was abstinent from alcohol use since two years. Not a single drop. The father and son started a business together. It took his mind off alcohol. Together, they ran a street food cart near by their home. In local language, we call such a setup, "Thattu Kada," a makeshift food corner, where fresh dosas are served with hot omlettes and chutney and kerala parottas with spicy chicken fry, starting in the evening and going late into the night. They invited me to have a meal one day at their street food place. Said they had a special - warm rice kanji with spiced mixed pulses, pickles, spiced buttermilk and lip-smacking beef fry. According to the father-son duo, it was the best in the city. I could never go there, since it was quite far (they stayed approx. 300 km from where I work) I made sure that pill burden from the treatment was kept to a minimum so that they could earn a livelihood and also save and not waste much on medications. The young man missed his last review. That was last month. I realized it today. Today I was visited by some of their neighbors. My patient's father died of a cardiac arrest at home three months ago and in grief the young man started drinking heavily. Again. After two years. He had a sense of complete loss. Unstoppable alcohol binges - sometimes almost 1.2 liters daily. Today I came to know that my patient was admitted in the ICU in at his hometown and on the ventilator with multiple organ failure - due to a second episode of alcohol-related hepatitis. After 2 years. They wanted to know if shifting him on a critical care ambulance, with expenses paid from their pocket, to under my care would be of any benefit, because the last time he was dying, he got a second life here. This time it was different. He was going to die. It was inevitable. He had vomited around 2L of blood, by the time they put him on a ventilator, he was already in a coma and his kidneys shut down by night. By morning he went into a cardiac arrest and was on multiple medications to get his blood pressure up. He wont even last the 300km journey. I wish I had that hot special evening meal with them when they invited me. Maybe I should have made up time for that. Maybe we must all make time for the little things we tend to overlook, only to regret later because we find more value in them in retrospect. My patient will meet his father soon. And embrace his mother, whom he would have missed for so long. And maybe I will pay a visit to that place one day, where once a food cart stood and two people in solitude, served lovely meals to people on warm, humid evenings, which now lay empty.