Crest and Trough.

Aches and pains that grew by the day,

A pill to ease fatigue, they gave in hope,

Alas, it backfired and he had much more agony coming his way.

The teenage boy now began sliding down a fatal slope.

He came to us, anxious and in despair,

Routinely we worked towards a methodical repair,

Yet some jigsaw puzzles only fit together at the last

And this was a picture we saw only after the mortal die had been cast.

Rallied around by silent supporters,

His was a case familiar to all,

A breathless bout and a hypertensive heart,

His breathing was now by a machine falling apart.

Out of the grim ordeal he emerged one day,

If it was light at the end of the tunnel one couldn't say,

Yet it was a small victory to see the boy breathe,

But one could say he was still ill at ease.

Ravaged on the inside by the viruses unseen,

It was a battle brewing in his own bloodstream.

His anxious parents watched his tumultous path

And wondered why he had incurred medicine's fatal wrath.

At long last, the sun set on the young man's life,

His parents watched as he struggled with multiple wires and tubes in strife,

His doctors wondered what else could they have done

While the virus wreaked havoc, yet seen by none..

 A teenage boy from the nearby taluk referred to Cheluvamba Hospital. He had a history of fever and myalgia for which he had been prescribed Nimesulide ( a banned painkiller) at a local PHC (Primary health Centre where the grassroots of medicine begin). Karthik developed an adverse reaction to the drug the form of severe rashes and itching, swelling of his face and some breathing difficulty.

He was stabilized here and his angioedema subsided over the course of a week but his fever and myalgia were persistent. When we worked up for the cause of fever, Dengue serology came positive. One night he developed high blood pressure and breathing difficulty and was shifted to the PICU. The following morning, his respiratory efforts were strained and he was electively put on mechanical ventilator.

From then on, his issues multiplied and he developed myocarditis, intrinsic renal failure, convulsions  rhabdomyolysis and even a form of polyradiculoneuropathy as sequelae of Dengue. Suspecting something else to be acting in sync with this, we also tested him for Covid Antibodies which also turned out to be positive (although he was RTPCR negative). As this could be a case of the recently emerging Post Covid Illness (MIS-C) among paediatric population, he was given steroids and immunoglobulins in hope of improvement.

He did show some promise and was extubated from ventilator but then he took a downhill course after that. Multiple attempts failed to revive him and after almost 2 weeks of hospitalization, it was the end.