An act of amazing generosity by the grieving family of a working class man who had suddenly died resulted in restoring life to another ordinary working class man, whose tenacity and optimism helped him wait for a long time on the organ waiting list.
What makes this miracle even more amazing, says Dr Sanjay Nagral, is that transplant transcended what is perhaps one of the deepest fault lines in Indian society, the chasm between two religions.
In November 2010, Abdul Razzak, a tall, gangly 45-year-old man living near Mumbai's Crawford Market walked into our outpatient clinic at Jaslok Hospital accompanied by a large number of family members.
Abdul, a taxi driver, was suffering for the last few years from the ravages of a liver damaged by Hepatitis C infection.
He had stopped driving his cab a long time back. He had been admitted several times to the hospital for vomiting blood, accumulation of fluid in his abdomen and bouts of jaundice. All these are classic signs of severe liver disease in the form of cirrhosis.
With three small kids and a housewife to support, the disease was also making him bankrupt.
Our liver transplant team discussed his case and there was no doubt in anyone's mind that Abdul desperately needed a liver transplant. We discussed the possibility of putting him on Mumbai's waiting list for a cadaveric liver transplant. But, given his background, we had serious doubts about the feasibility of doing this.
On the one hand, we had concerns about the family's ability to afford the transplant as well as the post-transplant long-term medication. On the other, we had reservations about Abdul's ability to survive the long waiting time that is usually needed for getting a cadaveric transplant in Mumbai.
We spoke to the family members and expressed our reservations on these counts. We actually tried to discourage them from having too much hope.
"Don't worry, doctors; we are people of limited means but we will all pitch in and help. Khuda kare (God willing) Abdul will get a new liver," we were told. His family's optimism seemed unrealistic. We reluctantly agreed to put him on our waiting list after warning them once more that he was unlikely to make it.
Abdul struggled with his disease for the whole of 2011. The family scrambled around and collected money from multiple trusts, friends and wellwishers. He was admitted to hospital on multiple occasions with life-threatening complications, but somehow managed to pull back from the brink every time.
By the end of 2011 his family had all but given up hope and resigned to certain death. But Abdul remained optimistic and would often be seen consoling his family that all would be well.
On the morning of January 13, 2012, Shailesh Katkar, a young 24-year-old man went to work at a construction site in Ulhasnagar (on the outskirts of Mumbai) as was his daily ritual. Like many lakhs of people from the city's working class, he was toiling day and night to support his parents and family. He had been just married and had a 9-month-old child.
Whilst performing one of the precarious balancing acts that construction work often demands, Shailesh slipped and came crashing down two floors to the rough ground. The impact of the fall was mainly on his head, causing his brain to be severely damaged.
He was rushed to a nearby hospital where preliminary medical help was given. He was then transferred to KEM Hospital at Parel for better care with a hope for recovery.
The KEM doctors, after doing a preliminary examination, suspected the worst; his brain was irretrievably damaged.
Shailesh was brain dead.
It was a matter of time before his heart would come to a standstill.
They approached his father with the bad news and also made a request for donating his organs for transplant. In what is always an astounding act of charity and compassion in the midst of overwhelming grief, Shailesh's father agreed to donate his organs for transplantation.
The morning of January 15 was not like any other Sunday morning in Mumbai.
The city, or at least a part of it, was agog with the excitement of the Mumbai marathon. A large part of the island city's roads were closed as they were part of the marathon route.
Just when I was looking forward to a relaxed morning, I got a call from our transplant coordinator that there was a 'donor' at KEM Hospital whose family had consented to giving his organs for transplantation and that Abdul Razzak's turn had arrived and he was being offered the liver.
Within minutes of informing him, Abdul came into the hospital ready to receive his new liver. It was almost as if he was waiting for this phone call.
Shailesh Katkar's liver and kidneys were carefully removed at KEM Hospital by a formal operative procedure. As this was being done, Abdul was being wheeled into the operation theatre at Jaslok to get him ready for the complex and long operation.
As the Mumbai marathon ended, our surgical team conducted a marathon 10-hour long operation to remove Abdul's diseased liver and put in the healthy liver.
Within a few hours of the operation, it was obvious that Abdul's new liver was working.
The next day, Abdul was awake with normal health parameters. The breathing machine that he had been put on was slowly removed. By the third day, he was eating and sitting up in his bed. By the fifth day, he had shifted out of the intensive care unit.
On the twelfth day Abdul walked out of the hospital with a new liver in his abdominal cavity, working well and infusing a new spirit into his life.
Abdul is now ready to start doing what he knows best -- driving his cab. Every time we meet him, he asks us to express his thanks to Shailesh's family.
Such cadaveric transplants are now routine procedures in most of the developed world and restore life to thousands suffering from advanced disease of various body organs.
Although progress has been slow compared to the rest of the world, India is now seeing such transplants performed in major cities with some regularity.
So what was special about this transplant?
That it was performed on the day of the Mumbai marathon perhaps just makes it easier to remember the date.
This transplant transcended what is perhaps one of the deepest fault lines in Indian society, the chasm between two religions. An act of amazing generosity by the grieving family of a working class man who had suddenly died resulted in restoring life to another ordinary working class man from the other end of the city, whose tenacity and optimism helped him wait for a long time on the waiting list.
Two men who did not know each other are now connected by a strange bond.
As we celebrate organ donation day, it may be worthwhile to remember the sacrifice of such ordinary individuals and their families, who often get a raw deal in our healthcare system which is increasingly catering to the elite and the connected.
In the next marathon, Mumbai should run for Shailesh Katkar and Abdul Razzak.
Dr Sanjay Nagral is a consultant surgeon, department of surgical gastroenterology , Jaslok Hospital and Research Centre, Mumbai.
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