The surgical guru

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It was when I saw in the news that Sadhguru had undergone brain surgery that I realised his full name is Jaggi Vasudev. He apparently had a chronic subdural hematoma, abbreviated as SDH in neurosurgical parlance. It occurs when tiny bridging veins between the surface of the brain and its covering, the dura, snap. The rupture can either be spontaneous or precipitated by even minimal trauma. It often happens in the elderly, who sometimes don't realise they might have bumped their head somewhere. It is also more common in this age group, as with age, the brain tends to shrink a little and there is a potential space between the brain and the dura. In young adults,the brain has more ego and hence is fuller, disallowing for this potential space.

Over time, blood accumulates in this void, and when full, the liquefied blood causes physical pressure on the brain, which brings on symptoms such as headache, vomiting and occasional weakness of an arm and leg. If left untreated, this can rapidly progress to confusion, altered sensorium, and even a quick slip into coma. Allegedly - and I must confess that this is all hearsay - Sadhguru worked through several days of ignoring his headaches, performing rituals, giving sermons, and attending conclaves until his condition deteriorated to a point where it required an emergency operation to make a hole in the head and drain the blood that had collected.

The surgery itself is one of the most gratifying operations in our field, where a person can be pulled back, quite literally, from the jaws of death. You drill a hole in the skull and nick the dura with a knife, and a fountain of blood spurts, causing a comatose patient to instantly start talking if the surgery is performed under local anaesthesia. Sadhguru's surgery was performed under general anaesthesia, and once he was alert enough to record a video for his well-wishers, he joked about how doctors couldn't find anything inside his brain. I'm surprised he isn't Parsi. I'm also happy to note that he doesn't take himself too seriously. No one should.

What struck me instantly was that here's a man always adorned in grandiosely flashy turbans and flowing shawls, reduced to wearing a hospital gown, looking like a miniature version of the one we see in the media. The bike bouncing, soil saving, river rallying, inner engineering man was no different from the hundreds of Muthuswamys or Annamalais I had treated for SDH. I have often maintained that medical illness is a great leveller.

But what I found even more amusing was that neurosurgical WhatsApp groups were rife with doctors who were irate that the medical community was not being acknowledged for the role it had played in saving Sadhguru's life. They pulled out old posts where he had spoken about why "one should not hand over your health to your doctor," probably in a completely different context. How one's "brain need not deteriorate with age; with simple yogic practices, you can keep enhancing it." His own treating physicians released a press statement which mentioned that "Sadhguru is healing himself, apart from the medical measures instituted by us." It is probably true that if he hadn't had surgery, we would have lost him. But we'll never know if that is how he had chosen to go. I'm told truly spiritual people can choose their time and mode of exit, although I wonder if anyone would choose SDH to do so.

I wouldn't have blamed Sadhguru for not opting for surgery either, because the treatment for chronic subdural hematoma has also undergone a paradigm shift in the recent past - although I doubt he may have known the full extent of it. Smaller amounts of blood can now be resolved with a course of steroids, and newer medication, which works by blocking the breakdown of blood clots to prevent bleeding. This has also helped some people avoid surgery. In some cases, we have embolised the blood vessel that is partly responsible for the bleeding by injecting glue through the groin. Perhaps Sadhguru was on some kind of medication to see if the condition might reverse itself, and hence, we shouldn't pass judgement on his decision to not opt for surgery immediately, although a lot of doctors did. When he gave his surgeons the go-ahead to perform the procedure, it was apparently because he was losing function of his left leg.

This brings us to another interesting question posed by a friend: Does the constant evolution of science make you lose faith in its accuracy? The treatments that we offered for certain medical conditions a few decades ago are considered barbaric today. It is highly possible that what we consider state-of-the-art practice today will be scoffed at soon. There are innumerable instances of people having healed themselves with unconventional and alternate techniques. But for the rest of us, for now, we have to make do with what science has to offer us today, because science is a self-correcting process where new evidence, discoveries, and insights lead to revisions and refinements of existing knowledge. This process is what drives scientific progress and allows our understanding of the world to become increasingly accurate over time. Through the work of various spiritual foundations across the country, what is also evolving is the ability of people to explore their inner selves and transcend limitations to live a more conscious and fulfilling life. Thanks to people like Sadhguru, individuals are able to explore and enhance their inner dimensions, leading to greater peace, joy,and fulfilment in life. While he heads the non-profit Isha Foundation, most of my profits are nullified when my wife orders their products home.

I am relieved to learn that Sadhguru has recovered completely and is doing well. The neurosurgical community wishes him good health to continue his humanitarian work. He has a global following and his teachings are imbibed by all generations. I'd like him to tell his followers that while it is paramount to take responsibility of their own health, it is equally important that they pay heed to their doctors. I hope he uses his rich baritone to spread awareness of this condition and enlighten people on why a headache should not be ignored. After all, he is now SDHguru.

The writer is practicing neurosurgeon at Wockhardt Hospitals and Honorary Assistant Professor of Neurosurgery at Grant Medical College and Sir JJ Group of Hospitals mazda.turel@mid-day.com