The strange case of the

PUNE, June 25: This incident occurred about eight years ago, but the case is still clearly etched in my memory, simply because it has been t...

PUNE, June 25: This incident occurred about eight years ago, but the case is still clearly etched in my memory, simply because it has been the most unusual case I have handled in my 30-year practice,” begins Dr Ashok V Kanetkar, as he goes back to the evening he received a frantic call from the Sassoon General Hospital, asking him to perform an emergency operation to remove a foreign body from a patient’s heart. “Never in my wildest dreams did I imagine that the foreign body would turn out to be a pen,” states this cardiac surgeon at the Ruby Hall Clinic.

It all happened when 17-year-old Master Joglekar’s two-wheeler collided with a tempo on the Senapati Bapat Road. The blow on his chest was such that the ballpoint pen in his left pocket pierced the skin. “When the boy got up, I believe, he saw half of the pen sticking out from his chest. He was rushed to Sassoon by the people around, but by the time he reached there, the pen had got totally embedded in his chest. The only thing visible was an injury point with very little blood oozing out.” When Joglekar tried to tell the doctors about the pen in his chest, few took him seriously. Some perhaps thought that it was just his way of pronouncing pain’!

“But by the time I reached the hospital, the junior doctors had already begun the operation and extracted the pen. This was after a resident on emergency duty decided to take him to the X-ray department before the operating theatre. "The radiologist there displayed tremendous presence of mind by taking a lateral X-ray of the chest, which clearly showed the pen inside the boy’s chest, lying backwards and pointing downwards towards the spine. In fact, it had even penetrated the heart, piercing the left arterial appendage. When they opened the boy’s chest, they found out that a small conical tip of the pen had also broken and fallen inside the chest. This, too, was removed.

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“Now, once a foreign object is clogged inside the body, there is not much bleeding because the object blocks the flow, but once it is removed, the blood begins oozing out. As it happened in this case. Since the doctors present were still inexperienced, they tried to stitch up the tear in the left atrium to stop the bleeding. But the tear was in the pericardium, near the hilum of the left lung, which had to be repaired, and I did it. The entire operation took about one and a half hours. The boy had a smooth post-operative recovery and was discharged from the hospital on the 12th day. Of course, the case continued to be the talk of the hospital for months to come,” narrates Kanetkar.

According to the doctor, the boy was exceptionally lucky in that the pen did not penetrate the heart through and through or enter any valve. “In theory, there is little difference between a pen or an arrow piercing the body. If he had not been operated upon immediately, it would have been fatal.”

However, Joglekar did get some pus infection later, for which Kanetkar operated on him again, some six months later. “The boy continued to come for dressing and check-up for another two years, after which I lost contact with him,” says Kanetkar. But the doctor does recollect the boy’s father – a priest in Konkan, who came to Pune on hearing about the accident.

“The man was amazingly composed and would quietly sit by his son’s side all day long. He never questioned our treatment. Being religious, maybe he got his strength from his philosophy that everything in life is predestined.

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“Joglekar himself was studying in Std XI then, and would often tell me that his ambition was to become a doctor. However, his uncle called me up later and informed me that he could not get admission to a medical college as his Std XII results were not too good.” Perhaps the poor boy just got extremely nervous every time he picked up the pen to write his examination.