S.P. Balasubrahmanyam (1946 - 2020)

A patient who inspired his doctors, to the end

The body of S.P. Balasubrahmanyam being brought out of the hospital in Chennai on Friday.  

Singer S.P. Balasubrahmanyam’s (SPB) journey through 52 days of hospitalisation was pretty much along the lines of how he lived life — pleasant, patient and courteous even in the most extenuating circumstances, positive and determined to triumph over the crisis.

Doctors who treated him at the hospital feel his passing as a personal loss, having spent just under two months with him, with his battle theirs, too. V. Sabanayagam, clinical lead, Multidisciplinary Intensive Care, MGM Hospitals, revisits the singer’s stay in hospital, marking its ups and downs. SPB was admitted to the hospital after he tested positive for COVID-19, based on the advice of his family doctor Deepak Subramanian, who heads the Minimal Access (GI) and bariatric surgery unit at MGM. “He told me: ‘I’ll do what you want me to do to overcome this’,” the doctor recalls.

“For the first three days he was doing okay,” Dr. Sabanayagam explains. “But in the background, his disease was progressing and his oxygen requirement was increasing. So he was shifted to a high dependency unit on August 9, and received oxygen through a high-flow nasal cannula and non-invasive ventilation, alternately. Despite this, when he became breathless, we decided to escalate his treatment on August 13. Meanwhile, he was on the antivirals, steroids, plasma therapy and supportive therapy usual in COVID-19 treatment.”

 

When the decision was taken to put him on the ventilator, doctors were apprehensive of how they would tell the singer that they would have to do a procedure which would silence him, literally. “We expected to have a long conversation. But the only thing he said, calmly, was: ‘Go ahead and do whatever is appropriate’.” When his oxygen demand kept growing, on August 14, the multidisciplinary team treating SPB decided to use the Extracorporeal Membrane Oxygenation (ECMO) device to provide cardiac and respiratory support.

After this he slowly started to improve, Dr. Sabanayagam adds. His lung condition improved, he was awake, was able to sit up, and began to interact with people.

“Up to 48 hours before, he was doing well. But then he developed a severe infection. His blood pressure dropped really low and he required a larger volume of medications compared to the past,” Dr. Deepak explains. A CT scan showed a severe bleed in the brain, and it was clear that the infection had triggered multi organ dysfunction. Due to the extent of damage then, the situation would not be reversible, doctors felt. “The family understood and thanked us for all our efforts,” Dr. Sabanayagam said.

SPB’s condition continued to deteriorate and he expired at 1.04 p.m. on Friday.

“We feel so exhausted today, as if a close friend has passed on after a valiant fight,” adds Suresh Rao, director, Heart and Lung Transplantation Programme, echoing the sentiments of the entire team.

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Printable version | Nov 26, 2020 10:28:40 AM | https://www.thehindu.com/news/national/a-patient-who-inspired-his-doctors-to-the-end/article32699041.ece

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