False Spins Wove Curious Plots Till The Last Breath

When J. Jayalalitha’s last days finally get written about, at least one chapter would be devoted to questions about the late Tamil Nadu chief minister’s final leg of medical treatment and the secr­ecy surrounding it. The state government did eventually release a detailed note from Chennai’s Apollo Hospitals and about the remedial measures adm­inistered to the AIADMK supr­emo by an expert team with the All Ind­ia Institute of Medical Sciences in Delhi. That was after the Opposition DMK and former CM O. Pann­eerselvam sought a probe into the details of illne­sses that plagued the 68-year-old leader and the therapeutics prescribed till her death on December 5 last year.

The 12-page discharge summary has turned out to be a double-edged wea­pon. It not only revealed the extent of Jayalalitha’s illness with very poor prognosis, but also showed up how Apollo had concealed the real picture from the eyes of the public. “There is a huge gap between what Apollo said in its bulletins when Jayalalitha was adm­itted and the medical summary released after three months,” says AIADMK MP V. Maithreyan, an oncologist, close to the party’s Panneerselvam camp. “Both the hospital and the government owe an exp­lanation on why Jayalalitha’s true condition was not disclosed.”

The government’s report came out on March 6 as both Jayalalitha’s political opponents and die-hard loyalists dema­nded an inquiry into her illness, treatment and circumstances of the death. The demands had public resonance: there was a big turnout acr­oss the state when Pan­neer­se­lvam and his rebel AIA­DMK group’s leaders observed fast on March 8, wanting a CBI investigation into “the mystery surrounding Amma’s unti­mely death”. The OPS faction is keeping up the heat on the issue, believing it will help increase its support base, especially among women, and sustain a ‘negative’ mood against V.K. Sasi­kala, the jailed former aide of Jayalalitha, ahead of a byelection next month.

It is now clear that the health bulletins were an exercise in brevity and vagueness. They stand in naked contrast to the details mentioned in the summary document. On September 23 last year, the day after Jayalalitha’s admission, the bulletin stated the CM was admitted for fever and dehydration. “She has no fever now and is taking normal diet.” But look what the summary says:  “She was suffering from infection and dehydration, accompanied by respiratory distress and altered sensorium (being drowsy and not responding to verbal commands.) She was admitted in a very critical condition to the Multi Disciplinary Critical Care Unit (MDCCU). She had second degree AV (heart) block and severe bradycardia (slow heart beat) and hypotension (low BP).”

Could a patient in ICU with such complications consume a normal diet? “Very difficult,” admits a senior physician of the 1983-founded hospital, headquartered in the Tamil Nadu capital. “No doctor would risk putting any additional strain on the patient.”

On the third day, Jayalalitha “held discussions” with officials on a Supreme Court hearing on Cauvery, claimed a state government release. But she continued to be in ICU, was barely conscious and struggling to breathe without support, according to the health summary. What’s more, further investigations rev­ealed she was suffering from septic shock and a serious heart ailment affecting her mitral valve. Barring doctors and medical staff no one had any access to her.

“Her clinical course deteriorated later during the ICU stay (day 4 of hospital stay) when she started to develop significant audible wheeze and significant tachypnea (abnormal rapid breathing.) As “her respiratory dynamics worsened” Jayalalitha was put on a ventilator on September 28. But this development was communicated through the bulletin only on October 3, which finally talked of “respiratory support”.

Similarly, a bulletin issued on October 2—after London-based expert Richard Beale first visited the CM on September 30—concluded she was “responding well” and “has been advised a few more days stay in the hospital for treatment”. The medical summary gives a totally different picture: “Dr Beale counselled the family and government officials about the nature of the problems, need for prolonged ICU and hospital stay and guarded prognosis. He was of the opinion that considering her overall condition she carries a mortality of 40 per cent.”

Only on October 6, in its two-page bulletin that lists various experts treating Jayalalitha, does Apollo finally acknowledge that the CM will require a longer stay in the hospital. And, by inference, it confirms what Dr Beale had counselled six days earlier.

The Apollo bulletins came to a sudden halt after October 8. Three weeks later, doctors went on to claim that Jayalalitha was conscious. That was on October 28, when she “affixed her thumb impression to the forms to allot her party’s symbols to candidates of three byelections”. The Apollo summary is silent about her condition on that particular day, adding to speculations that the patient was not aware of the procedure.

The hospital issued no bulletin in Nov­ember. Instead only its chairman, Pratap C. Reddy claimed on different days that Jayalalitha was recovering well, aware of her surroundings, removed of ventilator and would decide when to return home. On November 19, the AIADMK spokesperson revealed that she had been moved to a private room—a step down from the ICU. It was here that she suffered a card­iac arrest on December 4 and was rushed back to the MDCCU, where she died the next day—after 75 days in hospital.

The Apollo summary also stated that Jayalalitha’s “past medical history was significant for multiple medical problems including obesity, hypertension, poorly controlled diabetes, hypo­thyroidism, irritable bowel syndr­ome with chronic diarrhoea and chronic seasonal bronchitis”. The state health secretary’s clarification further nails the fact that Jayalalitha had refused to take insulin shots for her uncontrolled diabetes. “Except for corticosteroids administered for atopic dermatitis,” she was “only taking oral hypoglycemic and anti-­hypertensive drugs to control pre-existing diabetes mellitus and hyper tension.”

When Outlook asked Subbiah Viswa­nathan, the Apollo COO who had signed most of the bulletins, why there was such a discrepancy between the bulletins and the summary, he passed on the question to Mohan Dass, the hospital’s media relations manager. He had this to say: “There is so much happening; so better to keep quiet for a while. If at all we talk to the media, we will call you. We will put you on to the doctors at the appropriate time.”

According to a senior doctor in the Apollo team that treated Jayalalitha, the health bulletins were always vetted by plastic surgeon K.S. Sivakumar, a relative of Sasikala. “If the public and the press got to see only the barest minimum in the bulletins, the hospital is not to be blamed. The flow of information was controlled by someone else,” says the doctor who doesn’t want to reveal his identity.

Even when the specialists met the media finally in February 6, there was no full disclosure. Today, the medical summary finally reveals that Jayalalitha was seriously ill from the day she got adm­itted for “fever and dehydration”.

Former Assembly speaker P.H. Pandian says Tamils did not anyway believe whatever was “doled out” about Jayalalithaa being given the “best” of treatment. A senior police officer cla­ims most women are “averse” to Sasikala. Reason: they believe she and her relatives deliberately failed to take care of Jaya­lalitha when it was apparent that the actress-turned-politician was in poor health ever since she was jailed in a wealth case in September 2014.

With the bypoll to Jayalalitha’s cons­tituency RK Nagar to be held on April 12, “Amma’s mysterious death and Sasikala’s role in it” could become integral to the  OPS faction’s campaign. The voters seem to echo a similar sentiment. “We elected Amma from here and it became a VIP constituency,” says Kalai Selvi, a fruit vendor opposite the Tondiarpet branch of Apollo. “But we do not trust Sasikala and cannot be expected to support a candidate she selects. First Sasikala has to answer our doubts over Amma’s death.”

It was to counter such suspicion and snowballing propaganda the Edapadi Palanisami administration released the discharge summary. The exercise is pro­ving to be counter-productive. What’s more, AIADMK deputy general secretary T.T.V. Dinakaran and the ruling faction face ano­ther hurdle, as the OPS group has challenged Sasikala’s continuance as the party general secretary and all her acti­ons subsequent to the intra-party revolt. This move is to highlight the temporary nature of her appointment and thus und­ermine Sasikala’s authority to sign the election papers of the AIADMK’s official contestant for the bypoll allotting him the party symbol.

“OPS and his friends want to freeze the ‘two leaves’ symbol on the one hand even while swearing loyalty to Amma,” says senior AIADMK legislator P. Vetrivel, who had vacated the RK Nagar seat for Jayalalithaa to fight the 2015 byelection. “If the Election Commission applies the Samajwadi Party formula to decide on which is the real AIADMK, we are confident that the one led by Chinamma (Sasikala) will earn that recognition in view of the number of MLAs, MPs and district secretaries who have accepted her leadership.”

The byelection will turn out to be a fight for Jayalalitha’s political legacy as her niece Deepa Jayakumar has also thrown her hat into the ring. Obviously, there is more drama left in the story.

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Hide & Seek

What the public was fed about Jaya’s health turns out untrue

Claim: J. Jayalalitha admitted on September 22 for fever and hydration

Fact: The Apollo summary says she was very critical. And was suffering from infection and dehydration, accompanied by respiratory distress and altered sensorium (being drowsy and not responding to verbal commands).

Claim: On the third day she held discussions with officials on Supreme Court hearing on Cauvery

Fact: She continued to be in ICU, was barely conscious and struggling to breathe without support. Further investigations reveal she was suffering from septic shock and a serious heart ailment affecting her mitral valve.

Claim: Denying that she was ill, Jayalalithaa had sued Tamil biweekly Nakkeeran and Rediff.com for publishing reports about her poor health and possibility of going abroad for treatment.

Fact: The Apollo summary stated that “past medical history was significant for multiple medical problems including obesity, hypertension, poorly controlled diabetes, hypothyroidism, irritable bowel syndrome with chronic diarrhoea and chronic seasonal bronchitis.”

Claim: The Apollo bulletins issued during her hospital stay and after London-based expert Richard Beale’s first visit had claimed that she was responding to treatment.

Fact: The Apollo summary now reveals that Dr Beale had given Jayalalithaa only a sixty per cent chance of surviving.

Claim: Doctors had claimed that Jayalalithaa was conscious on Oct 28 when she affixed her thumb impression to the forms to allot her party’s symbols to candidates of three bypolls.

Fact: The Apollo report is silent about her condition on that particular day, adding to speculations that she was not aware of the procedure.

Claim: In late November, Apollo Chairman Prathap C. Reddy claimed that Jayalalitha had completely recovered and the timing of her going home would be at her choosing

Fact: Her heart condition was nowhere near normal for a discharge. That came true when she suffered a cardiac arrest on Dec 4, leading to her death next day.