Excerpt #52: Major Operating Room Royal Faux Pas

Excerpt #52:  Major Operating Room Royal Faux Pas

         With everyone busy, the anesthesiologist ventilating (using an airbag to breathe for) the patient, the neurosurgeon in the operating room checking over the instruments with the scrub nurses, and Bhattal the senior surgeon back in the Royal Suite with the Sultan, I took over in the hallway. I asked that those not in scrub suits to leave. I spoke in English. It sounded more authoritative, what with my dispensing with the usual long salutations that I would have to do had I spoken in Malay. That got rid of the assorted princes and princesses as well as the hangers-on, reducing the crowd to a more manageable level.

         In the end, all except one left. She was a Malay lady who had comfortably stationed herself at the head of the stretcher, holding tight the Sultanah’s hand. She fancied herself more important than the anesthesiologist, and he in turn had acquiesced. She refused to leave when I told her to, and she was in her street attire. I imagined that if the Sultanah had died she would have accompanied her right to her grave and be buried with her, in the manner of a Hindu wife immolating herself on her husband’s funeral pyre. Such was her devotion, at least as displayed.

         I now had a crisis on hand. In desperation, I asked one of the nurses to get an oversized scrub suit top and an operating room sheet to put over her clothes, a jury-rig operating room sarong over her street one.  Her own sarong had precluded her from putting on the scrub pants. I also had her put on head and shoe covers and a face mask so she could now accompany the Sultanah into the operating room as she was determined to do. At the very least the mask would shut her up.

         That settled, I focused on readying the Sultanah for surgery, positioning her on the operating table as well as shaving and prepping her head. I was about to throw the shaven lock into the garbage as we did with every patient when this Malay woman grabbed my hand so hard such that I could not release my grip of the hair. I froze. I realized then that I had nearly committed a severe royal faux pas.

         To Malays, sultans and sultanahs are divine. Everything about them, including their hair and even nail clippings, is blessed with rahmat, divine qualities mandated from heaven. Here I was ready to toss off those holy locks into the garbage pail. How uncouth!

         I froze, paralyzed. I could not very well push away that dainty hand. What was I to do? Just at that moment another nurse came with a silver tray lined with yellow embroidered songket. The royal attendant directed my hand to that tray and I dropped the clippings. After a few more perfunctory attempts at shaving as if I was unperturbed by that initial gaffe, I asked the nurse to take over on the pretext I had to scrub.

         We were about to drape the patient and that personal royal attendant was again in our way. This time I asked the Malay nurse to tell the royal attendant to leave as we were now ready to operate. She resisted but after seeing all those menacing stainless surgical instruments on the table she did, but not before making a big ritual of kissing the Sultanah’s hand, saying a not-so-silent prayer, and bowing backwards all the way out, accompanied by one of the nurses.

         The Sultanah regained her consciousness briefly after the surgery. That however, was her only improvement. Meanwhile other complications arose. She bled internally from stress ulcers, a common development after this kind of injury as well as from her steroid treatment. She needed an extraordinarily large number of transfusions as the family refused further surgical interventions. Later she developed pulmonary and other complications culminating in multi-organ failure.

         Bhattal was glued in the royal suite; his wife had to bring him his daily change of clothes! With him tied up in the royal suite, I had to take over his unit. After about three weeks of this double duty, I was exhausted. I told Bhattal that I desperately needed a break. With the Sultanah’s situation now reduced to a death vigil, he agreed. It was also near the end of Ramadan.

         There was another reason for my wanting to return to Seremban apart from the up-coming Eid celebration with my family. My younger brother Adzman would be getting married to Azzizah Ghani right after Hari Raya, the last of my siblings to get married. They were engaged a year earlier while we were in KL. We felt that it was important that we be with the family for this last wedding of my siblings.

Excerpted from the author’s second memoir, The Son Has Not Returned. A Surgeon In His Native Malaysia, 2018.

Next:  Excerpt #53:  Joining The Hari Raya Exodus Out Of Town

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