In the quiet hours of the night, when the noise of the day has faded and there is nothing but the sound of my own thoughts, I find myself revisiting the stories of those I have treated over the years. As a neurosurgeon, I live on the edge of uncertainty. Every surgery is a delicate balance between hope and risk, between science and faith. And yet, despite our best efforts, despite the hours spent planning, consulting, and preparing, sometimes things take a course beyond our control.
On this sacred occasion of Paryushan Parv, I reflect on one case that will forever remain etched in my soul. It is the story of a friend, a brilliant artist, a man whose trust I carried into the operating room, and whose outcome I could not control.
He was in his 50s, a vibrant, creative soul who had spent his life expressing the beauty of the world through his art. But life had dealt him a difficult hand—a severe case of cervical canal stenosis compounded by ossified posterior longitudinal ligament (OPLL). His spinal cord was compressed by bone, and the condition was worsening with each passing day. The risk of paralysis loomed, and he came to me, not just as a patient, but as a friend.
We spoke at length before the surgery. I explained the risks—how this was not a simple procedure, how there was a significant chance that he could suffer a neurological deficit even with the most meticulous care. But we both knew that doing nothing was not an option. The surgery, a posterior cervical spinal decompression and lateral mass screw fixation, was his best chance at relief.
I remember the day of the surgery vividly. I took every precaution, anticipated every possible complication, and even brought in my colleagues—orthopedic and neurosurgical experts—to assist. Together, we navigated the complexities of the operation with care and precision. By all accounts, the surgery was technically successful. But as the hours passed in the recovery room, it became clear that things had not gone as planned.
My friend developed quadriparesis, a profound weakness in all four limbs. Immediate post-operative scans revealed spinal cord edema, swelling at the site of the operation. The surgery had caused a temporary setback—a catastrophic one. In those first moments, when I saw his family’s faces and my friend lying motionless in the hospital bed, I felt the weight of the world collapse on my shoulders.
The days that followed were some of the hardest I’ve ever endured. His family, torn between fear and hope, looked to me for answers. I could see their pain, their unspoken questions, and the burden of my own responsibility pressed down upon me. They never blamed me, but as a surgeon—and as his friend—I carried the guilt. I had done everything by the book, but the outcome was still devastating.
Despite these challenges, my friend began to show remarkable resilience. Slowly but surely, he responded to neuro-rehabilitation. His limbs, once paralyzed, began to regain movement. Each small victory—wiggling a finger, moving a toe—felt like a miracle. I watched as he, step by step, fought his way back. He was almost able to walk again, and hope bloomed once more in our hearts.
But life, unpredictable as always, had another plan. Just when he was on the verge of reclaiming his life, he suffered a massive heart attack and passed away. The heart attack had nothing to do with his spinal condition or the surgery, but it broke all of us. He had fought so hard, only to be taken away by something none of us could have foreseen.
Though his death was due to natural causes, I have never stopped questioning whether I could have done more. The guilt, though irrational, lingers. I ask myself if, unknowingly, I had contributed to his suffering, if I could have somehow prevented the series of events that led to his untimely death. It is a question without an answer, and it is one that I will carry with me for the rest of my life.
On this Paryushan Parv, the most sacred time of reflection and forgiveness in Jainism, I seek to unburden my heart. Micchami Dukkadam, I say, with all the sincerity in my soul. May my misdeeds, known and unknown, be forgiven. May the pain I may have caused, even unintentionally, be washed away by the grace of forgiveness.
The Essence of Micchami Dukkadam
In Jainism, Micchami Dukkadam means “May all my misdeeds be forgiven.” It is a phrase that embodies the essence of humility, reflection, and repentance. It is not just about seeking forgiveness from others, but also about recognizing that we, as human beings, are fallible. We make mistakes, we cause harm, sometimes knowingly, and often unknowingly. Micchami Dukkadam is a way of acknowledging that, and asking for the grace of forgiveness, not just from others, but from the universe itself.
Paryushan Parv is a time of deep reflection, fasting, and spiritual introspection. It is a period when Jains seek to cleanse their souls by asking forgiveness for any harm they may have caused—whether in thought, word, or deed. It is a reminder that life is fleeting, that our actions have consequences, and that we must take responsibility for them. It is also a time to forgive others, to let go of anger and resentment, and to embrace the virtues of non-violence and compassion.
As a neurosurgeon, the philosophy of Micchami Dukkadam resonates deeply with me. Every surgery, every decision we make in the operating room, has the potential to change a person’s life. And while we strive for perfection, while we do everything within our power to ensure the best possible outcomes, the reality is that we are not always in control. Despite our best efforts, there are times when things do not go as planned, when outcomes are not what we hoped for.
In those moments, as much as we seek to explain, to reassure, to comfort, we must also seek forgiveness. Not just from the patient and their family, but from ourselves. We must forgive ourselves for the limits of our abilities, for the unpredictability of life, and for the pain that, despite our best intentions, we sometimes cause.
The Fragility of Control
This case, more than any other, has taught me the fragility of control. As a surgeon, I am trained to plan, to anticipate, to execute with precision. But life is not always something that can be controlled. The human body, with all its complexities, sometimes reacts in ways that defy logic or expectation. And while we can do everything “right,” the outcomes can still be devastating.
In medicine, as in life, we must accept that we are not infallible. We must learn to live with the knowledge that, despite our best efforts, there are forces beyond our control. And in that acceptance, we must find the humility to seek forgiveness, and the courage to forgive ourselves.
On this Paryushan Parv, I offer my heartfelt Micchami Dukkadam to all those I have treated, to their families, and to all those whose lives I have touched, whether through success or failure. For any pain I may have caused, knowingly or unknowingly, I ask for your forgiveness. For the trust that was placed in me, and for the times I may not have fully lived up to that trust, I ask for your understanding.
And for my friend, whose loss still weighs heavy on my heart, I ask for forgiveness from the universe, from his family, and from myself. His death, though unrelated to his surgery, will forever be a reminder of the limits of my control and the fragility of life.
May we all find peace in forgiveness, and may we all have the grace to forgive one another. Micchami Dukkadam.
With sincere forgiveness-seeking,
Dr. Nitin Jagdhane
Your Trusted Neurosurgeon
The Author is a distinguished Senior Consultant Neurosurgeon and Professor of Neurosurgery in Mumbai, specializes in endovascular neuro-intervention, microneurosurgery and endoscopic spine surgery, renowned for his precision, innovation, and commitment to patient care.
Nitin..knowing evrythinng factually, i really felt proud of u..
Best wishes for ur wonderful writting skills..
Excellent masterpiece of research for improving quality and treatment of patients in affordable cost.
As always Doctor your articles are so profound in meaning and, this article just showcases the best version of you. A lot of learning. Humility at its highest.
Jai Jinendra
Excellent
Very well written and expressed your thoughts clearly.This has given a different view to what doctors feel and how much pressure they carry while performing each operation.And asking to forgive for all the deeds is always a humble and noble gesture.Thanks Ni3.
very true and nice Dr Nitin.you have reflected what we all go through every day it’s universal .if you have repentance and feel it, it’s our tribute. As you written many things not in our hands,and human body behaves unpredictably, saying goes I treat ,he cures. you have penned it very well congratulations and best wishes
It is true sir few things are not in our hands despite our heartfull efforts.
Beautifully penned by you doctor. It gives us great insight in your a doctor’s mind works.
You are a noble soul .God bless you
Simply Great write up boss…very nice philosophy u have narrated sir..
Heart touching
Very well written
Dear Nitin, very good write up. We all neurosurgeons gone through such stage. Means faced clinical cases like this of relatives or close friends. But have penned it down very well. Keep it up. Best of luck.
very true and nice Dr Nitin.you have reflected what we all go through every day it’s universal .if you have repentance and feel it, it’s our tribute. As you written many things not in our hands,and human body behaves unpredictably, saying goes I treat ,he cures. you have penned it very well congratulations and best wishes
सुंदर संस्मरण के साथ इस विशेष अवसर पर क्षमा याचना हेतु लिखी रचना पठनीय है। एक चिकित्सक के जीवन में अनेक बार ऐसी परिस्थिति आती है जब उसे मरीज और उसके परिवार के सदस्यों से विचार विमर्श कर कठिन निर्णय लेना होता है। अनेकों बार इलाज और इसकी प्रक्रिया इतनी दुरूह और जटिल होती है कि शत प्रतिशत अच्छे परिणाम का आश्वासन देना संभव नहीं होता है।
मानव शरीर के अंग हर व्यक्ति में अलग-अलग ढंग से दवाई और शल्यक्रिया के विरुद्ध प्रतिक्रिया करते हैं। इसी कारण परिणाम हर व्यक्ति में अलग होता है। गर्दन और रीढ़ की हड्डी में तो अनेक बार जटिलता और रचनात्मक भेदों के कारण अच्छी और सफल शल्यक्रिया के बावजूद मरीज के लिए परिणाम अच्छा नहीं होता है।
आजकल की व्यस्तता भरी जिंदगी में हममें से अनेक समय पर भोजन, व्यायाम और यथोचित नींद पर ध्यान नहीं देते हैं। इस कारण ह्रदय रोग बहुत ज्यादा लोगों में और कम उम्र में ही हो रहे हैं। बड़ी शल्यक्रिया शरीर के सभी अंगों को विचलित कर सकती है, यह हमें समझना जरूरी है।
एक शल्य चिकित्सक को सदैव इन सभी बातों को मरीज को स्पष्ट रूप से बताकर लिखित संमति लेना चाहिए। ग्राहक संरक्षण नियमों के कारण वैद्यकीय सेवा एक व्यवसाय ही समझी जाती है और उचित सावधानी के बिना अनेक चिकित्सक बड़ी आर्थिक और सामाजिक परेशानी में फंसे जाते हैं।
डॉ नितिन को सुखद और सफल भविष्य हेतु बहुत मंगलकामनाएं और बधाइयां
Translated in English:
The piece written on this special occasion with a beautiful memoir for seeking forgiveness is truly worth reading. In the life of a doctor, there are many instances where difficult decisions must be made after consulting with the patient and their family members. Often, the treatment and its procedures are so complex and challenging that it’s impossible to guarantee a 100% positive outcome.
Every human body reacts differently to medication and surgery, which is why the results vary from person to person. In cases involving the cervical spine, due to the inherent complexity and structural differences, the outcome may not always be favorable for the patient, even after a successful surgery.
In today’s busy lives, many of us neglect proper food, exercise, and sufficient sleep, which is leading to heart diseases becoming more common at a younger age. It’s important to understand that major surgeries can disturb all organs in the body.
A surgeon should always clearly explain these aspects to the patient and take written consent. Due to consumer protection laws, medical practice is often viewed as a business, and without proper caution, many doctors find themselves in significant financial and social difficulties.
Wishing Dr. Nitin all the very best for a prosperous and successful future.
Dear Nitin,
I admire your unique and innovative style of asking Kshama from the patients you touched or operated.
We all know our limitations, despite our best of efforts we may not achieve the desirable outcome. Despite all this we have to continue our journey with due precautions.
Very kind of you to ask for forgiveness. May god bless you
Very well conceptualised Nitin…the emotions that flow during the surgery make us more strong to face all the consequences post surgery when you already know the dark side of our human body. A bitter fact of Neurosurgeon s life… loss or gain… Micchami Dukkadam
Dr. Nitin is one of the best Neurosurgeons I have seen. He takes full responsibilities of all the outcome of his patients, whether or not it’s his doing. Rate to see such human emotions!!!! It’s often tough being a doctor and carry this deep emotions together. Have personally witnessed such emotions for one of my patients too. Hats off
“whether in thought, word, or deed. It is a reminder that life is fleeting, that our actions have consequences, and that we must take responsibility for them.” These words are with so deep meaning.
“Every surgeon carries within himself a small cemetery, where from time to time he goes to pray—a place of bitterness and regret, where he must look for an explanation for his failures”
Really heart touching sir, Excellent
Forces beyond our control give us reminder of the limits of our doings and life.
Paryushan Parv gives us a teaching to ask for forgiveness from whom we had hurt, made feel bad knowingly or Unknowingly.
Sir, it’s humbleness n kindness of yours to write down feelings. You are always been there at day/night for us on a single call. Thank you.
Micchami Dukkadam!!
Excellent
God bless you doctor
Keep up the good work
Nicely penned
A scenario every Neurosurgeon faces often in his life☹️
Well written sir.
Heart touching
Great writing. I can understand the pressure.
Dear Dr. Nitin,
Please accept my heartfelt gratitude for the work you do and for the reflection you’ve shared. It is a powerful reminder of the importance of forgiveness, both towards others and ourselves. May this Paryushan Parv bring you peace and comfort, and may you continue to inspire those around you with your wisdom and compassion.
Micchami Dukkadam.
Excellent Nitin . Well written and has great meaning . May God bless you all time
Life is short and we learn a lot as neurosurgeons and that may be reason why many neurosurgeons are so humble and down to earth.
Michammi Dukkadam
You are really Great. The greatest warrior is the one who accepts his pitfalls strives hard and overcones it. Patients are blessed to be in your hands. All the best.
Dear Nitin. It is an article written from your heart reflecting the emotions of all we Neurosurgeons. It makes us humble yet resilient and guides us to continue to strive to bring out the best in us and try to provide a meaningful purpose for our lives in our journey as a Neurosurgeon.
My warm regards to you. Looking forward to a long and vibrant Association with you as a colleague Neurosurgeon!
Micchami Dukkadam.
Very well written Dr. Nitin.
You are doing a great work by saving life. Not all things are in human control.. some things are Divine n are written to happen.
Nitin I have read your note written in all humility and coming directly from your heart. Thank you for sharing your thoughts and experience which are universally applicable. Your deep analysis and narration goes to show your sensitive nature and your resolve to do the best not only for your patients but also for all humanity. The story of your friend and his operation is truly heart touching. You did your very best for him and with his consent. There is no reason why you should be carrying any weight or guilt on your shoulder. Every step in life is predestined and every breath is already accounted for. We are just instruments of His service. Our past actions bring us together but it is He who decides the ultimate result. Only our thoughts are within our control and if they are good, honest and compassionate, that is all that matters because neither our destiny nor that of others is in our hands. Asking for forgiveness is in itself a very humble gesture. I am also much wiser now after having read your truly thought provoking note. Thanks for sharing. Please forgive me if I have overshot my jurisdiction .
Best wishes!
Great emotional wrteup. You are borne to serve the humanity. Regards
Hello Dr..thank u for ur inspiring write ups ..feel so proud to meet a doctor ,whom I admire not only for his skill ,but a being who is so humble and caring even after achieving great heights in his chosen profession. Once again I salute u for the great work and sincerity.