Duncan Maru, a research faculty at Boston’s Brigham and Women’s Teaching Hospital of Harvard University, said that Mukesh Kayastha would never walk again but was receiving the optimal rehabilitation in the form of parental care and love at his own home.
Kayastha was only 14 when a shot fired during the second Jana Andolan in 2006 left him immobile and speechless.
After talking to his parents and examining medical reports, Maru gently told the guardians on Sunday that the doctors in Nepal had done their best to contain the brain injury and that there was nothing medical science could do to fix the loss of the brain tissue.
The bullet destroyed around one-third of Kayastha’s brain in the left hemisphere. The remaining brain mass suffers from hydrocephalus, a condition in which cerebrospinal fluid collects in the brain cavities, impairing neurological functions. A metal shunt placed in Kayastha’s head drains the excess fluid to his stomach.
“At this point there is no cure for the brain loss Mukesh has suffered. He will never walk and talk again,” said Maru, also a physician at Boston’s Children Hospital.
Kayastha’s lower limbs show muscle spasticity and clonus, a neurological condition characterised by stiffness and involuntary contractions. Kayastha’s foot when pushed upwards beats rapidly, suggesting an irreversible damage to motor neurons.
Addressing Kayastha family’s long-held wish of seeing their son examined abroad, Maru warned that a trip abroad could do more harm and create complications in the patient’s health. The main threats to Kayastha’s life right now are overwhelming complications resulting from chest and urinary infections.
“An arduous journey by plane, the low-pressured cabins, the new hospital environment and its own microorganisms and a lot of poking and probing for tests could easily exacerbate Mukesh’s condition,” said Maru.
As for rehabilitation, Maru was impressed by Mukesh’s present physical condition: no bed sores, well-nourished, and healthy skin.
“A patient like Mukesh does not receive as good of a care even in the US. Instead of flying him abroad for comprehensive rehabilitation, it is better for Mukesh to remain in his family environment. All this love and care is what is keeping him alive,” said Maru.
Mira Kayastha, Mukesh’s mother, although shattered by the prognosis that her son would never walk again, was relieved to know that the care she provided was optimal and that there was no need to take Mukesh abroad.
The American physician stressed that Mukesh be treated as someone normal with consciousness and if possible, the parents should take him out on his wheelchair for short trips. Maru also suggested weekly visit from a physiotherapist and regular follow-ups with a neurosurgeon.
“We would love to take him outside for fresh air, but there are no open spaces here. We wish the government would build a small house with a park for Mukesh. We’ve already purchased land in his name with the fund the state gave him,” said Mira.