A TALE OF RESILIENCE: A 22-YEAR-OLD'S REMARKABLE JOURNEY TO RECOVERY AFTER A LIFECHANGING TRAIN ACCIDENT

22yr old Kunal Gondake has been spending the past few months learning how to walk all over again, step by step. Every day he has been painstakingly exercising at home with the help of his family, driven by the hope that one day he will be able to go back to his village and resume his fish farming business. Kunal, like countless other Mumbaikars, took the suburban local to commute to his college every day. However, on December 20, 2023, while travelling from Titwala to Kalyan he fell from a moving train. He was taken to Fortis Hospital, Kalyan, where a multidisciplinary team took over. Fortis Hospital Mulund’sDr Jumana Haji, Director-ECMO Program, Dr Jayesh Sardhara, Sr. Consultant -Neuro & Spine Surgery, Dr Arul Vanan, Sr. Consultant-General Surgery, Dr Vaishali Solao, Director-Critical Care, Dr Rushabh Chheda, Associate Consultant-Neuro Surgery, and Dr Sandeep Patil, Chief Intensivist, Fortis Hospital Kalyan and their teams, worked tirelessly for months, to help Kunal get back on his feet. 

“The day of the accident I was travelling to my village. I remember feeling suffocated in the train, leaving my seat to stand near the door for some fresh air, and the next thing I knew I was falling off! I have no memory of my initial days at the hospital. My elder sister rushed to my side and even left her job to take care of me as our parents are aged. She was at the hospital every day, getting updates, asking questions, and the medical team supported us throughout,” recalled Kunal. 

“The initial month I was at the hospital by my brother’s bedside, as the medical team worked to save his life. He was shifted to the ward after two whole months (towards the end of February 2024) and was released a month later. I quit my job to look after my brother after he was released into our care at home, as he was unable to walk. The doctors told us to ensure he sleeps on his sides and not on his back as he was unable to move his body, so me and my mother took turns to help him turn over throughout the night so he can have a good night’s rest & recover. My father suffers from Diabetes and both my parents are aged. They could not travel to meet the doctors frequently, so I took over. Now that my brother has gotten better, I am slowly stepping back into my life again,” recalled the patient’s sister Ms Sampada Gondake.

The Fortis team had its work cut-out; the doctors found that Kunal’s lungs were punctured, he had suffered rib injuries, a severe spine fracture, and a pelvic bone fracture, which had caused a bladder injury. He was diagnosed with polytrauma, which is characterized by the simultaneous occurrence of multiple severe injuries to different parts of the body, often from one singular traumatic accident.

Critical care specialists worked together to secure various resuscitative lines such as endotracheal tube, haemodynamic monitoring, large bore IVs, chest tubes, feeding tube and urinary catheter. “Kunal needed blood transfusions in the first few days of his hospital admission. Additionally, Neurosurgery and Urology evaluation was done for intervention on the thoracic spine. He had to be stabilized with blood products, blood pressure medicines and ventilatory care” said Dr Sandeep Patil, Chief Intensivist, Fortis Hospital, Kalyan.

However, despite intensive treatment, the condition of Kunal’s lungs worsened, and the ability to exchange gases (oxygen and carbon dioxide) was severely impaired, even with maximum ventilator support. This created a life-threatening situation, making him too unstable for surgery under anesthesia. At this critical point, Kunal required advanced, life-saving care in the form of ECMO (Extracorporeal Membrane Oxygenation), a highly specialized treatment used for patients with severe heart or lung failure.

Talking about Kunal’s diagnosis and the role played by ECMO, Dr Jumana Haji, ECMO Program Director, Fortis Hospital Mulund, said, “ECMO helps stabilize critically ill patients like Kunal, allowing them to survive as their body begins its healing process. It also allows patients who have a 90 per cent chance of perishing, a chance to undergo essential treatments like nutritional support, physical rehabilitation, and medical procedures such as Tracheostomy (a surgical opening in the windpipe) or Bronchoscopy (examination of the airways).”

“In Kunal’s case there were delayed symptoms of a gastric perforation (a hole in the stomach) and a Subclavian Pseudoaneurysm (a damaged blood vessel near the collarbone), both of which required complex treatments like Gastrointestinal Endoscopy, Interventional Radiology, and surgery. Additionally, he had a broken spine, which led to immobilization and the development of a large pressure sore that required plastic surgery,”Dr Jumana Haji added.

Finally, a month later Kunal was released from the hospital under home care. However, he still had a long journey to recovery, as he was still immobile, had an unstable spine fracture and a urine catheter. Even though he was at home, the medical team at Fortis guided the family through extended rehabilitation and nutritional counselling to help him recover his strength. Following which a medical team operated on his spine on May 23, 2024, and slowly he was able to walk again.

Even though Kunal is unable to recall many of his days at the hospital, he remembers the sacrifices his family made. He is now working towards a full recovery and a healthy life. His dream is to continue his fish farming business in his hometown of Akola, a passion which he started nurturing right after the COVID-19 pandemic, turning it into a business venture. 

The journey of a polytrauma patient needs superhuman efforts from all providers, right from the family to doctors, nurses, physiotherapists and the often-forgotten hospital administration who are available round the clock to hand hold the family. 

Today, as the medical team watches Kunal walk back home towards his dreams, the clinical team takes pride in the teamwork that ensured that he has a healthy life ahead.