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I met Zhou Qisi and her husband at their home in Shanghai. Unlike the bedridden patient I had imagined, she appeared just like any other lady of the house -- slim, cheerful, bustling about to make her guests comfortable, pouring Chinese tea, offering fruit.
Zhou's life changed markedly twenty years ago. In 1986, when she was more than five months pregnant, she experienced severe cramping pain in her abdomen. Doctors thought it was premature labor, but actually her intestines were all knotted up, a life-threatening condition called volvulus.
The blood supply to the intestine gets blocked because of twisting, and if not "un" twisted in time, there is permanent damage. The gut soon "dies" and afterwards, gangrene sets in. Infection spreads rapidly through the blood and the patient loses his life if the infected organ is not cut off in time.
Zhou underwent an emergency operation. Her intestines were already gangrenous. Doctors saved her life but Qisi lost a large part of her intestines and also her unborn baby.
Zhou's life hung by a thread after this complicated surgery and doctors had few hopes for her. She would never be able to digest food.
Normally, the food we eat is digested in the intestines and the simplified food products enter the blood. But as Zhou lost almost all of her intestines, any food she ate would simply pass out of the body, undigested, depriving her of any nutrition.
This event occurred more than twenty years ago in Shanghai, a time when medical technology in China was in its infancy. Rubber tubes used for injecting saline and other fluids used to be recycled, as also were the steel needles, which are now discarded after a single use.
Zhou and Cai prayed for a miracle because only that could save her life. Their prayers were answered. Dr. Staffan Bark and Hugo Thelin, from a Swedish pharmaceutical company called Kabi, were visiting Zhongshan hospital at the same time that Zhou was admitted there. They were messengers from the messiah.
Kabi manufactured all sorts of nutritional products that can be injected directly into the veins of a person. This technology, called total parenteral nutrition, or TPN, is especially designed for patients who cannot eat or digest any food taken by mouth. In short, for patients just like Zhou.
The timing could not have been more perfect. At the time that Zhou was lying in the surgical ward hanging on to dear life, Bark was having a chat with her surgeon, Professor Wu Sou and his student Professor Wu Zhaohan, about introducing TPN in Shanghai.
TPN was not a new concept in the developed West, but in 1986 in Asia, it was an alien technology.
Important decisions were made rapidly and TPN products were flown to Shanghai immediately, at the cost of Kabi, to start Zhou on the therapy. Wu had trained in the United States and had the know-how of this technology, but all his students had to undergo training about using these products.
Zhou survived and became the first TPN patient in China. Today, more than two decades later, she is the longest survivor on TPN in Asia.
Kabi started a company called Sino Swed Pharmaceutical Corporation, which then took over the sponsorship of TPN for Zhou. By 1987, SSPC started manufacturing the products in the Chinese town of Wuxi, after erecting a state-of-the-art production plant.
Cai was taught how to mix the products and administer TPN at home.
All the surgeons were put on high alert for this first patient in China on TPN. Nobody knew what complications to anticipate or what could go wrong. But nothing went wrong and the wonder continued.
A thin PVC tube, called a catheter, was fixed permanently to Zhou's skin that would carry nutrition into her blood. This way, there was no need to puncture her skin everyday with a needle.
Every night, Zhou receives a mixture of amino acids, fats and carbohydrates through a slow drip that lasts 10 hours. During the day, she is independent and mobile; she can cook, clean, shop and shower regularly and even go around cycling.
"When the miracle lasted two years, we became more greedy and wanted it to last for a few years more," Zhou says, smiling. By 1991, the couple was ready for a baby.
Pregnancy during TPN! The whole team took up the challenge although they had much anxiety about the physical and mental health of this baby-to-be.
On April 8, 1992, Zhou delivered a healthy baby girl -- a jewel in the crown. The world saw the first baby born to a patient on TPN. Zhou decided to call her Kabi, after the Swedish company that saved her life with their products.
SSPC executives then helped the family to relocate into a bigger house where they could be more comfortable and also decided to sponsor Kabi's education. The baby Kabi, like their firstborn, deserved only the best, they felt.
With the mega success of this first case of TPN in the country, Zhou and Kabi became a showcase for SSPC. She and her husband are often invited for seminars and symposia to promote TPN products. Her presence makes a big impact on surgeons all over the country and has given a huge impetus to the business of SSPC in times of tough competition.
This medical miracle is the fruit of timely intervention by Staffan Bark and Hugo Thelin, the dedicated team of doctors at the Zhongshan hospital, and the executives of SSPC, who have made a lifetime commitment to sponsoring TPN products. The daily cost of TPN, about 500 RMB (US$69), is a big sum for a modest family to bear.
The courage and optimism of Cai and Zhou is unparalleled.
In a circumstance when any ordinary person would give up in despair, Zhou fought her way through with a smile on her face. Today, she is the champion of patients with short guts and meets patients on TPN to inspire and encourage them.
Cai has mastered the science of TPN so well that a single glance at his wife tells him which vitamin or electrolyte needs a dose adjustment. "All because of love!" Zhou says
Kabi is a perfectly normal 16-year-old teenager, who recently won a trophy in a piano recital contest. Her proud mother is grateful for the life she has and for this child, who has brought sunshine into her life.
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(Dr. Pradnya Kulkarni is a clinical pathologist from India. She worked as a consultant pathologist in a private laboratory in Pune before moving to Hong Kong with her husband and young daughter. She is also a freelance writer, focusing on medical issues of public concern. ©Copyright Pradnya Kulkarni.)
