'Maybe it wasn’t worth it, bro.' I sighed, exhaling the white smoke of the half-burnt cigarette.
'Yeah man, I know it sucks at times', Sid exclaimed on the other end of the line. 'But this was your decision, buddy. You wanted to become a doc.'
I took another puff and checked my watch. I was still on duty and I had sneaked out for a cig asking the junior intern to attend the patient who had just been wheeled in a while ago.
'At eighteen we all think we will change the world, Sid.' I was half expecting the intern to call me anytime now.
Sid laughed. 'I’d told you a thousand times back then to go for IIT. You had even qualified for it. I hadn't! I had to settle for a NIT. But you opted for Medicine after qualifying for medical and that was by choice. I repeat "your choice". And you were enjoying it in your initial years. That's what you wanted to do. I know times are worse. People are so impulsive, arrogant; they don't even think twice before suing anybody. They raise fingers, throw stones. But this is just a few handfuls. Don't let a single incident ruin your week, man.'
'It is not about one incident. These are frequent now. Imbeciles with absolutely no idea about medicine think that they know it all after reading something abstract from the internet. You save their kin a hundred times, they will thank God. You fail once and they will curse you because somehow that's your fault. A man aged 82 cannot die naturally, he is immortal! We are the ones who kill for fun.'
'Calm down, bro.'
'...because', I cut him short, 'they think we just get up in the morning and wonder "Oh, this is such a fine day, let's go put some people to the grave." Bloody rascals! Why don’t they vandalize temples and mosques when their prayers aren’t answered? Accountability shall go both ways, isn’t it?'
'What actually happened? I mean did the patient have a condition?' Sid asked.
'He had a fucking CHB. A type 3 heart block. He expired before we could take him to the cardio ER for a cardio-version.'
'Okay now that is Greek to me.'
I continued to fume as if I hadn't heard him. 'Their claim was that his condition only deteriorated after they got him to the hospital and they vandalized the place shouting we should've at least given him a "saline". Can you believe that? They fucking think he died because we didn't put a fluid bottle I.V. How ridiculous! Fluids to an impending cardiac failure patient! Morons!'
'I understand. Just drop it. Don't think so much about it. That was a week ago. Don’t let it bother you so much.'
'Yeah, says the man who works from a desk inside an air-conditioned office in MIT! Funny.' I rubbed my boot on the ground over the cigarette butt.
‘Come over here, practice here. Trust me it’s far better. At least the working environment is.’
‘Yup, like that’s so easy.’ I smirked.
'You could have been in my place as well, Arpan. Besides, why are you in the hospital today? Who works on Sundays?'
I was going to hurl a fresh set of abuses at him when almost instantaneously he corrected himself. 'Oops! sorry, bro, really sorry. Don't speak another word. No! Stop right there. I forgot you are an Emergency doctor now. Sorry. No offense.'
I couldn't help but grin.
'You should take a break and just chill for a few days,' he continued. 'Go to a beach. Maldives. Mauritius. Miami. Somewhere. Just go.'
'I don't get a six figure salary like you do, sweetheart. In case you've forgotten, I am an Indian doctor. We don't get paid like in the West. Though our honourable politicians are promising to turn this country into Europe, it hasn't been quite the case in reality, yet.'
There was a beep on the phone. I asked Sid to hold up to check the screen. It was the intern calling.
'I'll catch up with you later Sid. Got to go.'
'Hey, just take a second. Breathe. Head up, you got this. Take it easy. And we are meeting next week. The booze is on me.'
'Oh, that's wonderful motivation!' I smirked again as I disconnected the line hurrying back towards the ward.
I almost ran inside, straightening my collar, unfolding the stethoscope in my hand.
'Doctor Mukherjee, this is the patient file.' The staff nurse handed me some ruffled papers as the intern quickly started explaining to me the signs and symptoms he had observed.
'Another case of poisoning.' I remarked, now shifting my gaze to my left.
There laid a girl of about fifteen on the dilapidated hospital stretcher. Her tarnished skirt, anaemic eyes, unclean nails screamed poverty from every point. There were about five people accompanying her. One of them was a woman about forty in a pale, cotton sari wiping her eyes with a corner of her cloth.
'That must be the mother' I observed to myself.
Beside her stood a grim looking man of about the same age staring at me.
'Must be the father' I thought. He was clad in a lungi and an oversized shirt. The other three were nonchalantly observing the hospital walls and patients on other beds -probably the neighbours or distant relatives who had volunteered to accompany them.
I was already quite exhausted. My trained mind told my tongue to utter the words necessary to get rid of unimportant people in the already clumsy room. It's become a norm by now and the words don't even need permission from my mind to do so. It's almost a reflex.
The next minute I found myself observing the girl closely and monitoring her vitals.
I started writing on a paper that would soon turn into a bed ticket which in the following hours would serve as a guidebook for drugs and injections to follow.
Halfway, I looked up at the girl's father. 'Suicidal, I suppose.'
He lowered his gaze.
I continued writing. I explained to the parents the risks and the course of treatment and gestured the nurse to get the consent forms signed.
While the man dipped his left thumb in the inkpad, his wife sobbed with a corner of her sari covering her mouth.
The blue thumbprint was on paper and the father hurried back towards his daughter's bed as his wife continued to wipe her face. Her cry was audible now.
'Hey, Vikram, please check on that patient on bed number seven. His nebulisation should be over by now.'
The intern nodded in agreement and followed my instructions.
Just as I was about to get up from my creaky chair, the woman now fell on her knees.
'Please Doctorsaab, please. Save my child. She is our only daughter. She was planning to elope with a man in the neighbourhood...’
‘I don’t want the details.’
‘We won't scold her ever again. Please I beg you...' She was reaching for my feet.
'Don't do that.' I almost jumped out of my chair. 'We will do whatever necessary. Now, please stop crying and wait outside. I will call you back.'
I had hardly finished my final words when the father came back running. 'Doctorsaab please come. My daughter is... my daughter...' he stammered.
Flipping the stethoscope around my neck, I rushed out. The girl's parents followed on my heels.
The girl was gasping for breath.
I checked on her and instructed the nurse to put on the oxygen mask and nebulise her. My colleague had just arrived and he looked me in the eye and nodded to say that he will be monitoring her. I returned to my chair.
I was doing some pending paperwork while occasionally staring out of the door at the mother who continued to wail at the entrance to my small chamber. The swaying green curtains partially obstructed my view. From experience I knew that it wasn't worth telling her to calm down as that usually aggravates things and so I decided against wasting my energy. It had already been twenty two hours for me in the ER and energy was barely something I could afford. I was literally dragging my sleep-deprived body around the place for quite sometime. My replacement had arrived, yet I lingered on for a few more seconds for no good reason that I can think of, now.
'Arpan! Come out. We need help.' Rahul, my colleague, yelled.
Situations change here in seconds. Patients with pensive disorders survive while futile symptoms deteriorate faster than the blink of an eye.
Perhaps I was waiting for this. But how on earth could I’ve known!
I rushed out half-contemplating the next step.
'She's choking. We need to intubate her, now. Hold her.' Rahul said as he rushed to fetch the tube and the scopes.
The parents seemed struck by lightning. I asked the father to come ahead and hold down his daughter's legs so that I could take a closer look but he didn't move. He mumbled something inaudible. The place was starting to get crowded as people accompanying other patients drew closer in excitement, open mouthed.
‘She’s frothing’, ‘don’t think she will live...’, ‘Poisoning I heard...’ ‘Are those the parents?’, ‘Must be hard...’, ‘...was the girl’s fault, she drank the poison...’ Whispers were getting louder and that irritated me beyond limits. ‘Such a little girl drank poison! Oh my God!’, ‘Do you know what poison?’, ‘Fertilizers, some sort of insecticide.’ ‘...No, no. Rat-killer.’, ‘Tut-tut, Carbolic acid...’, ‘...I think she’s dead.’
‘Nurse!’ I cried louder than required. Honestly, I wanted to scare the whispers away.
Momentarily the buzz stopped. The nurse hurried to my help and held the girl steady. I took a closer look- the airway was collapsing fast.
I got rid of the apron, rolled up my sleeves and adjusted my spectacles as Dr. Rahul rushed back.
'Doctorsaab, please do something.' Both the parents burst out in tears. 'She is our only daughter...'
'Shut up, and step back'. I yelled craning my neck in their direction, rather rudely, and then immediately regretted it. I felt horrible.
Rahul was already trying to go in with the laryngoscope but to minimum effect.
Time was running out. More people peeped in. The ward boy hovered nearby with files in his hand. He was headed somewhere but had stayed on to watch the drama.
Seconds seemed like hours.
After a few more attempts, Rahul looked up at me. He was soaked in sweat. The girl was still dying. The scope hadn’t yet gone in. It was going out of our hands.
We exchanged positions and now I held the scope.
Rahul held the AMBU as I tried to get the scope inside her mouth. Secretions were blocking my view.
Failure. More seconds rolled out. Even without looking I knew there was at least a dozen pair of anxious eyes beating down on my back.
My ears turned hot, my legs ached. Suddenly the cacophony of the hospital had vanished. I heard nothing but the clicking of the scope blades, the brushing of the girl’s clothes on the green sheet and the thud of my heart beating against the chest wall. Almost holding my breath I hoped, rather prayed, for a single chance - a glimpse of white of the vocal cords. There was none.
The patient had collapsed. Eyes closed, limbs flaccid, she barely breathed. From the corner of my eye, I could see her parents throwing their arms up in despair though their wails didn't reach my ears. It was almost over.
Sometimes you can only hope against hope. I breathed heavily.
And then like a silver lining, a faint white, one last gasp. There was the little slit I was looking for. My heart skipped a beat. My fingers responded fast as if they were possessed, the tube got in and almost in no time Rahul was pressing the bag to fill her lungs up with air. Soon, I fastened the tube at the angle of her mouth.
The chaos of the place returned, I could hear again.
I checked her vitals a couple of minutes later. Dr.Rahul was still pumping the bag with his hands and I knew from the look on his face, his finger pulps ached badly.
Another day, another battle won. I have treaded this fine line before but each time the rush, the adrenaline doesn’t disappoint me. Maybe I love this heat. Maybe I am selfish. I dare to say I love this race against the odds, at other’s expense. I win on some days, lose on the others. The little spike on the flat-line, the unconscious soul gasping back to life – the joy of it, the thrill of it is unparalleled.
The parents were leaning onto their daughter's bed; they had probably run out of tears by now.
I gave the nurse a few instructions and then turning on to the parents said, 'Don't worry, she will probably live.'
It took them a moment to let the words sink in and they exchanged a few puzzled looks. Their eyes lit up once again.
Flipping the stethoscope back over my neck, I pulled the harness of my bag onto my shoulder and with an air of authority began to head out of the ward.
'Doctorsaab,' the mother began, 'I do not know how to thank you... what to say... God’s mercy... forever in debt...'
I wanted to respond but didn't have the strength to do so. I felt drained out.
I tapped her shoulder on my way out. I am not sure she understood how I felt but she fell quiet.
The crowd dispersed as if I were some star. I couldn't help but smile. Cherishing my little celebrity moment I gingerly came out in the open.
'Yes!' I whispered to myself clenching my teeth and fists at the same time making sure that no one was watching. That was a strange feeling amidst all that chaos, sweat and hunger - a familiar one, but unparalleled.
I lit up a cigarette and took out my phone from the pocket.
'Sid, have you ever infused hope back in someone? Have you watched their eyes change colour?
‘What?’ Sid sounded completely lost.
‘Guess what, you were right. It’s not so bad after all. Maybe it "was" worth it.'
'What are you saying? I think you are turning crazy...'
'...about the booze...I have a plan...' I walked briskly through the crowd out of the hospital gate to catch a rickshaw.
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