Dr NB then explained to Akash what was actually wrong with his mother. Her liver had been the main cause of her problem. Some disease had affected the normal architecture: probably Hepatitis that she suffered and recovered from, long ago. As a sequel to the disease process the architecture had changed permanently leading not to any derangement of the normal secretory function of the organ but definite changes to the tunnels of blood-thereby causing congestion and blood-logging upstream. This blood had started accumulating in the spleen causing it to enlarge much beyond its normal size and this was the lump Akash had been feeling in his mother's abdomen for months together. Again the bloodhead had started searching for alternative pathways to ease the pressure and in that process they rediscover unused vessels elsewhere and one such group was the group of small arteries at the end of the oesophagus-the food pipe leading from the mouth to the stomach. These vessels under pressure dilate and elongate causing its walls to thin out till they burst one day. This is popularly known as the oesophageal varices. Once they burst and are relieved of the pressure they stop bleeding and heal and the process repeats itself on the same vessel or some other vessel and the vicious cycle goes on and on. Those of such patients who could luckily get medical attention and replenish the lost blood with massive transfusion survive. Akash's mother was one of those few who could survive thanks to his friends who had generously donated blood and his hospital medical fraternity who had extended all help.

The only solution, Dr NB Singh explained, was to get the spleen removed and create an artificially made natural diversion for the blood and these would save the oesophageal varices from bleeding-a process known as shunting. This could only be done in a centre where microvascular surgery facility was available. And Dr NB told that in India, his friend Dr. Nandy who headed the unit of GI Surgery in AIIMS was the right person to do it. From that day onwards Dr Nandy became a much talked about person in Akash's family and friend circle that he became a much familiar person even before meeting him. The next few days Akash went to Dr NB's residence every morning and they tried ringing up Dr Nandy but they couldn't get him somehow. Finally Dr. NB rang up some Dr Deka in ENT a common friend and fixed up the appointment. So it was assured that they could go and get the admission in AIIMS. Akash then started running about arranging for the journey. By evening he had some plans ready about who would be going with them. When he came back to the hospital his mother told him that Dr. Arun from Anatomy Department had come to the hospital and was feeling bad that he scolded him and that he didn't know that she was in the hospital. Akash had by that time forgotten what had happened in the morning and moreover he didn't mind being scolded in the classes-these classes, he thought, he would be missing now. He knew Dr Arun was soft and kindhearted fellow who wouldn't hurt anyone.

The next few days Akash's family was full of activity. His sister had started packing and Akash ran about arranging money and attendants for the hospital. His mother was discharged few days ago. Some of his mother's friends gave some 10,000 and some relative some 20000 rupees and they arranged some more and it was also decided that four of them would go to Delhi. Since they couldn't afford all of them to fly, it was also decided that Akash and his mother would fly and his uncle and aunt would come by bus and then train. The journey was some 2500 kms.

To be continued....