Once the convoluted medical jargon is removed from the discharge summary, the questions are basic and the mystery over late Tamil Nadu Chief Minister J Jayalalithaa continues. Firstpost had pointed out some glaring issues and disturbing questions in the medical reports of the late Chief Minister on Wednesday.
That same evening, a press conference was called for by first time Minister V Saroja at the party headquarters, in a bid to counter allegations made by the rival O Panneerselvam faction within the AIADMK who were on a day-long hunger strike across the state.
Saroja began by introducing herself as a medical doctor, a gynaecologist and went on to explain how she had worked in Saudi Arabia as part of a government program and then was called in 1991 by “Amma” (Jayalalithaa’s moniker) to join politics and the party. She was at pains to impress upon the audience that her voice and opinions were credible and had the stamp of a medical expert’s authority.
Saroja first began by explaining what menopause was and how different women react to it differently. Stress, she added, was a complicating factor. She also gave a mini tutorial on how the X and Y chromosomes determine the sex of a child. Reporters at the press meet were rather puzzled as to what the point of this medical eloquence was. Jayalalithaa was 68 years old when she was hospitalised and died – an age well past menopause. She was likely under stress – any Chief Minister would – but there was no mention of any such issue in her medical reports.
Finally it was time for the question-answer session. By then the ruling AIADMK’s (All India Anna Dravida Munnetra Kazhagam) mouthpiece Jaya TV, which had been airing Saroja’s speech live, decided to cut out and head to an event of Chief Minister Edappadi Palanisamy instead. Not many watched the session, which was rather revealing.
Here are the answers provided by the Social Welfare Minister, Saroja, to Firstpost’s queries.
A patient who has a combination of high diabetes, who is hypertensive, asthmatic and has hypothyroidism is not supposed to be given beta blockers and oral steroids. Who prescribed it to her and who were the doctors treating her?
Saroja: It was not an individual doctor who treated Honourable Amma. It was a team of doctors that treated Amma.
That was in Apollo Hospitals. Who treated her while in Poes? (Jaya’s Poes Garden residence in Chennai)
Individual doctors meaning, it will be a combined treatment. First one doctor will see her, then another will see her according to their speciality and treat her. So everyone will treat their system concerned. We have to arrive at a team. It was the decision of that team to chart out what treatment to give, what medicines to give, when to give them. It was not an individual doctor who took those calls.
You are speaking about what happened in Apollo. I am asking you about what happened in Poes Garden? Because 5-7 days before she got admitted in Apollo, she had fever as a result of Urinary Tract Infection, according to the discharge summary. Now you are a gynaecologist, you are well aware that UTI is a common infection amongst women. It is very easily treatable and you can cure it within two days. Why was the Chief Minister suffering from UTI and fever for 5-7 days?
There are 2 kidneys. Blood supply goes to the kidneys through the renal arteries. That too at the age of 69 – do you think the kidneys of a girl who is 10 years of age and a girl who is 25 years old – do you think the functioning capacity of the kidney will be the same? There are two parts to this. One is urine secretion, the other is to absorb the waste material and send it out. Now 69 year old Amma already had diabetes. So the blood vessels will narrow, the blood supply to the kidneys will be reduced. When the blood supply to the kidneys reduces, the non-protein nitrogenous substances – the waste meant to go out – will also reduce. She is also a diabetic. A diabetic is prone for infections. You are right when you said UTI is common amongst women. For women the urethra is only 4 mm. You saw that on September 21, 2016, Honourable Amma announced the ‘thaalikku thangam’ (gold for mangalsutra) scheme, proving that she is a world leader. You tell me – she was unwell for a week, you are saying that she had UTI, it shows that she did not get these overnight and that it cannot be treated in two days. The outlying pathology is more – even if it is a 10 year old girl or a 24 year old girl, if you give the treatment continuously for a week, if you give irregular treatment, then you will not be able to control UTI even in the 10-year-old or the 25-year-old.
So are you saying that she (Jaya) was being given irregular treatment?
Because once she came to Apollo, within two days her urine culture was clear. They treated her within two days for UTI. But in Poes, she was suffering for 7 days.
In Apollo, Amma was in Intensive Care. She was immediately given all the necessary treatment. Apollo Hospitals has taken effective measures to contain the fever. They have done everything that was supposed to be done at the right time. Fever has to be controlled. If fever is not controlled, associated problems will crop up and it will add to the already existing problems. So the question that UTI was controlled within 24 hours in Apollo but not earlier – that is… well, they controlled it, yes. But they (Apollo) also took preventive measures to control other systems also.
If you remove all the medical jargon the basic fact of the matter is that she came in with slightly high diabetes, slightly high blood pressure, breathlessness, she was unconscious – she came in with small issues. The initial tests done showed that all her organs were fine – kidneys, lungs, heart, everything was clear. But over 75 days, she developed pneumonia, her lungs had pleuresis and she just died. How is it possible?
Do you know hypostatic pneumonia? In a patient who is lying in bed for a long time, the lungs will bring out a secretion, which can lead to infection if not cleared. Again I am saying, don’t look only at the lungs alone, there are associated complications – hypertension, heart problems, diabetes and its complications. When all these come together, we have to view this not as an individual system.
My last question to you Ma’am – in the discharge summary it says that “family member” along with government officials took a decision to remove ECMO (artificial heart pumping machine). Family member has been named as Mrs VK Sasikala. How was this permitted? She is not a blood relative.
The decision was taken by Tamil Nadu government’s monitoring team of doctors. Former Chief Minister O Panneerselvam was also there. Who took that decision (to take her off life support), why that decision was made – it is only O Panneerselvam who knows the real secrets.
The author tweets @sandhyaravishan
Updated Date: Mar 10, 2017 08:19 AM