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Sunday, August 25, 2013

A Saga Of Love

Internship, in a way to put it, is in itself an independent phase of life. An era in itself. You are no longer a student, but aren't a doctor either; you are somewhere in between, and sometimes you wonder, if even that is where you belong? There are many a trials and tribulations in the intern's life, frustrated housemen, frustrating schedules, depressing backlogs and demotivating Government Resolutions.

And yet, just somewhere in between, someone comes around, whose pain supersedes your pain, whose confusion makes you realize how lucky you are, that you at least have a rough idea of what you want in life, someone who you just cant pass off as just another incidence......

It was my 4 th night shift on the trot in the EMS - I can boast of it and I will, but I wasn't particularly comfortable or happy doing it! The three of us were chatting with each other as we mechanically cannulated IVs in the que of patients lined up ahead of us..... a que which had no end till so far as the eye could see...., simultaneous collecting blood samples 2 EDTA, 2 Heparin and 3 Plain bulbs, filling out forms and pausing our conversations briefly as we shouted out the instructions, simultaneously surveying the arms of the next patient for a good vein. This whole routine was so intense that it occurred almost at a spinal level, the only higher function involved was in our conversations.

In this din, trolleyed in a patient- not an occurrence of significance in our part of the world. He was a typical patient, cachexic, dehydrated, semiconscious and accompanied by two cash-strapped relatives. I got up and proceeded to his trolley holding a cannula, a spirit soaked cotton swab in my double gloved right hand and a 3-way attached to a syringe in the left, collection bulbs and a strip of dynaplast in the pockets of my apron. The man seemed to be in his late 60s, was bare chested and only a bermuda covered him below the waist. As I set out to do my job  I was interrupted rather annoyed by his wife who asked me, "Will he die?"

This was annoying for two reasons, one, relatives usually asked if patients will survive, not the other way round and two, for the tone of her voice and the way she kept aloof from the patient. But, ours is a profession where personal beliefs and emotions and prejudices are kept in the locker as the white coat is retrieved from it. I did what I had come to do, and directed her to the registrar for ant further queries..... no intern knows how much his involvement in patient care is supposed to be, so prophylactically, it s safe to keep it at a bare minimum.

The registrar asked her for the history, she annoyed him by her attitude, her obsession with the patient's death and her ever changing answers. No one could afford to spend so much time on one patient, there were 50 others waiting in the que. So, after initiating preliminary treatment the Reg moved on to others, leaving minute intricacies of his history for such later time as would be possible.

For the next three hours that followed, the female ensured that she was noticed by everyone in the EMS by her mannerisms and high pitched quarrels with a semi-conscious husband. It was becoming very irritating for all present..... when we were racing against time to save lives, she was one we could do without.

Finally, at around 5 am the que ended, the reg began interrogating her. She enjoyed every bit of feeding us mis-information and backtracking on her previous statements. By now it was clear that the patient has acute renal failure and would require dialysis for the near foreseeable future. Even if we are a government set-up, procedures such as these cost money, howsoever less that it may be. And she replied, "I don't have the money. If you don't give him dialysis, will he die?" We left it at that, your patient, your decision.

With that had to be asked asked, with all that had to be explained explained, the reg moved on to covering up other formalities. "What is your relation with him?" the Reg asked. The obvious two answers could be sister or wife. And this is where the mystery unfolded. She answered, "Wife...."

And then after a few seconds, glanced back at the patient, her eyes lit up with a resolution and she murmured  as she tried to control a sort of a wicked smile..... "Friend...."

With a startle, the Reg asked, "Wife or friend? Make up your mind."
"Friend" she confirmed.

"Is he married?"
"His wife stays here only, In Elphinstone...." she answered, "but he come to me when ever he is sick."

"Give us his family's address".
"Why? Why do you want his family's address? I have brought him here, I have given my address..."

"If he dies, we have to inform his family."

"Ah.....!" That wicked smile smile finally broke through. 'He dies' - this is what she was waiting to hear for so long.... this is why she was pestering us since the time they has wheeled in.
I think, she had received  a very straight forward answer for her question, no element for ambiguity. But may be, she had some other calculations in her mind. "One minute..." she said. And walked to the trolley which was barely a meter away. I thought, she wanted to whisper something into the patient's ear. But, she echoed, "Doctor is telling you will die. Who will take your body?"
"My wife" he answered, with a smug.
"Why? She does not take care of you. Who will take your body?" she echoed again.
"My uncle's son" he answered in the same demeanor.

At this point, our irritation had been blown away so beyond the roof- added with the exhaustion- that this whole incidence started appearing entertaining, so to say. Both of them were past 60, yet they quarreled like newbies in love exchanging sweet little nothings. The question was not of life-death-suffering, it was of establishing authority.

It was 8am and the next intern came to relieve me. As much as I wanted to stay back and audience this conversation till its end, all my senses were overwhelmed by the prospect of a good shower and the much deprived sleep that would follow.

On my way home I thought over the conversation and the female's obsession with death. It was a very Barbarian emotion that she harboured. Greed - to get what she wanted, at what ever cost it came or closure, that she finally got the recognition she deserved?.

His dead body, a trophy symbolizing her victory in the war, where she had lost every battle or, a conquest over what had been stolen from her? Till death did others apart, but he would be her's even after his death!

This is the beauty of medicine, it isnt just disease and treatment and minting money out of it, it is taking the understanding life and its various aspects to a completely different level. It is understanding the human behaviour- Human behaviour with all its simplicity, with all its complexities, with all its benevolence and malevolence. An opportunity to understand human psyches and emotions.

A skeptic like me will describe her emotions as extreme possessiveness, at it lowest, sickest level.
A die-hard romantic may counter it as eternal love, an epic romantic tragedy  - A Saga Of Love !