I was hastily walking through the corridor of the hospital.I might have been looking odd from the glances I received from the passers-by.There were some sputters of morning wishes as I brisked along.I kept looking at the watch which read 8.40 AM.The unbuttoned white coat swayed from side to side with the stethoscope perched around my neck.I entered the male ward and not surprisingly,it was packed after yesterday’s admission day.Patients were lying on the bed and on the floor hardly giving space to walk through.
I was late and was just hoping that my professor hasn’t reached yet.I was already in the habit of making excuses daily but a part of me was embarrassed to make any more of them.I made a brisk observation of the ward and could not see signs of ongoing rounds.Relieved,I proceeded to the doctors' room.As expected,my juniors had already arrived and were both watching something on their smartphones.They stood up with a start as I entered.
“Good morning,Sir!"Anette was quick to voice while Robin just stood up mouthing something faintly which I took for a muffled “Morning”.
“Sir hasn’t reached?”I asked without concealing my happiness.
“Not yet,Sir!”Anette retorted,with a small smile.
“How many admissions yesterday?Any ICU patients?”I wanted to know.
“22 in the male ward,9 in the female ward with one patient in the ICU” Robin said enthusiastically.
My phone rang at the moment.The name of my Professor flashed on the screen.I cleared my throat as I swiped over the screen.
“Hi Danie,I called to say that I would take atleast an hour to reach.Its that my daughter is having a slight fever.So I need to settle some things before I leave.You may start the rounds,I shall join in.”
“Its fine Sir; I am in the ward...”I wanted to let him know that I was already here as I continued,“...there are a total of 31 admissions of which one patient is in the ICU.I shall start straightaway Sir.”
Just then, Annette’s phone rang and she picked it up and answered:
“Oh is it? We shall reach straight away.”
“What is it,Anette?”I had to ask.
“Sir,it’s our ICU patient-the staff nurse just called to inform that she had gone for desaturation twice in the last half an hour.Her Covid results are negative.”Anette told as she picked up her sling bag.
“What brought her to be admitted though? Her presenting complaints?” I asked them as we started moving out. “Lets move to ICU then,if there are no critical patients here".
“Yes sir; she was having vague symptoms,chest pain and exertional dyspnoea,though I didn’t get any positive clinical signs.She had a history of MI(heart attack) 3 years back though we are not sure if it was a documented one.She was eventually shifted to MICU late night following desaturation.”Anette said.
The situation was such that most patients nowadays are hesitant to reveal their travel history and contact history in the wake of skepticisms surrounding the pandemic.So most often than not,it is upto the clinician to ask leading questions.
We reached the ICU.We entered one by one after seeing to sterile precautions.Anette guided me to the bed in the right extreme corner.I looked around while I followed her and not surprisingly,all the beds were full and there was a lot of bustling around since multiple departments had come in for the morning rounds.
As I reached the bed,I could see a woman probably in her early forties,being given oxygen support through a face mask.There were multiple IV lines with a pulse oximeter probe clinging onto her right index finger to assess the oxygen saturation in her blood.A nurse was standing by the side of the bed.I took the case sheet which was kept on the table by the footend of her bed which read ‘Shalini Menon,43/F’.I quickly went through the records and meticulously noted the investigation reports.I went by the side of patient and called her by name.She slowly opened her eyes and mumbled something.She raised her hand as if to free herself from the chain of IV lines that held her captivated to the bed.I asked the nurse to remove the mask temporarily after ensuring that her Oxygen saturation readings were normal.The nurse did so and took a step backwards.I asked the patient her name to which she replied feebly yet promptly.I asked her to take a deep breath as I placed my stethoscope on her chest.
“Seems like she has got features of pneumonia”I turned to the JRs as I said this after auscultation.Anette opened her mouth clearly wanting to say something but she quickly prevented herself from the same almost immediately, simply nodding her head sideways in agreement.
“The counts are also elevated and chest x-ray is also suggestive of an early infection.” I continued.I always liked to take classes which was something my juniors were also quiet fond of-well atleast that's what i thought!.
“How are you feeling now?” I turned to face the patient as I smiled gently at her.
“I think I am slightly better doctor, though I feel nauseated being in here!”-she replied.
It was quite natural for a patient to feel suffocated in the ICU setup.Some people even develop psychological issues on prolonged stay.
“You are having a chest infection which is possibly a pneumonia-early stage.Coupled with the heart attack history you had previously,it might land you in trouble if not properly cared for. Hence the reason for ICU observation.So I’m afraid you might be here for atleast 48 hours!” I replied as softly as I could.
She didn’t speak anything but just closed her eyes and sighed.And as I looked,tears started rolling down her cheeks.I really felt sorry for her but there was nothing much we could do.I patted her shoulder mildly and assured her its going to be alright.
“Who do you have with you here,Mrs.Shalini?Husband or father to whom we might speak to?” I gently enquired.
“My husband is not here.I have only a distant relative of mine waiting outside.I don’t have any family now..I.. don’t…know..!” she was sobbing uncontrollably now.
“One of you please go and prepare the bystander in the briefing room.I shall follow.” I told my juniors.Robin nodded and walked back while Anette looked on.
“It’s totally fine.May I know your spouse’s or father’s whereabouts because it’s important that they also understand the procedures and treatment you undergo”- I told her.
“I haven’t spoken to my father for around fifteen years now doctor; for the sake of someone I loved and trusted back then,who left me when he thought he could have no future with me.” She replied amidst the wailing.
“You have to stay calm madam.Please!” the nurse was by her left hand side by now.
“What happened?!” I enquired.
“I am sorry doctor for saying all these.I…I shouldn’t have bothered you with my personal story and worries.”
“No..no..its totally fine.We are also humans and we all have our personal worries too. So don’t feel bad!” I reassured her.
“My dad calls me every single day over all these years but I never attended the call.Initially,I was angry at him for not approving my love life and I detached myself from him.But now that I understand what he said was right and I can’t bring myself to speak to him as I feel humiliated.Now I don’t even know if I can make it out from here”. She wiped her eyes as she said this.
I looked at her.Something in the depths of those weary eyes troubled me as I imagined how it would be to be in her shoes.
I patted her again and turned to Anette.
“Continue the same medications.We shall review with Sir once he joins us”.
And I walked towards the briefing room.
I spoke with the patient's bystander.She was a second degree cousin of hers who told me regarding Shalini's family rift.I understood that Shalini was angry at her father for not allowing her to marry the person she loved and eloped with him.Although initially angry and agitated with the disgrace she brought upon the family,her father who was a retired Colonel, gradually did forgive her and wanted her to come back to them but she never ever returned the calls.
I discussed with the relative the treatment plan and that she was still in the danger zone and that we would need atleast 24 hours more to gauge her condition.
We proceeded to the wards and by the time we completed the male ward rounds,Sir joined us and we did a quick review of all the patients.
I was at unease with myself for the rest of the day.I just felt terribly sorry for the patient and her parents.I remembered how my uncle went through a similar deal when my cousin did the same a few months back.That picture just never left my mind.As I went to meet her for the evening rounds,she timidly asked me if she could use a phone to call her father.I told it was not permissible to use cellphones in the ICU but that I would do the needful and inform him on her behalf.She thanked me and laid back with her eyes shut.I took the case sheet from the bedside,went through the pending reports.Before I replaced it back,I made a quick mental note of her permanent address as enlisted there.It was not that far away.
I looked at my watch as I got out of the hospital.It was half-past five.I took out my phone and looked at the address.I turned the GPS on and peeped into the map.It was hardly an hour’s drive.I called my wife and told that I would be bit late than usual.I drove in the direction indicated by Google Maps.I reached the place at which time it was 6.30PM.I got out of the car and asked an autodriver whether he knew Colonel Menon Sir’s house.As expected,he gave me the direction to his house which was about 500 metres from where I was.
The house was by the roadside itself.It was a two-storeyed well-kept house at first glance as I slowly brought myself to the front door.I pressed the calling bell and waited.Moments later,an elderly lady,probably in her 70s opened the door for me.She was expressionless and stared at my face.
“Hi Ma’m,I am Dr Danie...”I said,“...Is it a good time to speak?”
The woman kept looking quizzically at my face.So I had to continue “...I am the treating doctor of your daughter Shalini.Err…she sent me to meet you both”.
The old woman’s face suddenly brightened up as color rushed onto her face.
“Please come in Sir!” she said and led me to a chair in the living room.I sat while she stood by.The room was neatly kept with a few framed photographs adorning the wall opposite.I could spot a younger version of their daughter in all the frames.Her mother noticed that I was looking at the photographs intently when she spoke up.And when she did,I could see tears welling up in her eyes.
“It’s been nearly fifteen years since she left us; I hope you know that already,don’t you?” -her face looking from one photograph to another while she said so. “She is our only daughter and we loved her so much.We never restricted anything and allowed her to follow her passion.Never did we think even once that she would break our hearts one day.Most parents would not be able to accept their children’s relationships initially.All we asked her was to reconsider her decision because we didn’t feel she made a right one.But she just hurled some improper accusations and stormed out of the house.We couldn’t just bear it.It took a long time for us to accept her choice.We were ready to invite her back.But she could never forgive us.Was it so difficult a decision doctor? To forgive her parents who brought her till then? Did she think we would be least concerned about her well-being?”
She paused for a minute before continuing.
“We were literally shattered when she rejected our calls.We tried everything we could to contact her.But she wouldn’t budge.And this denial was too much for her poor father.He did suffer from a massive stroke a couple of months back.I honestly didn’t expect that he would survive but he did.He loved his daughter more than he ever loved me”. She was whimpering bitterly between words.
“She is obviously sorry for all that and wanted to contact you.But I offered to inform you on her behalf.” I didn’t know what else to say.
“Come with me doctor!”
The woman asked me to follow her.She led me to an adjoining room where I could see her husband lying on the bed.He had something that looked like a photo frame clutched between his hands.
“He doesn’t speak a word after the incident.Today morning he just took her picture in his hands and wouldn’t let it go as much as I asked him to” she walked upto him while saying it to me.
“See,Shalini is going to come back to us,that’s what her doctor says.” She told him caressing his forehead.There was no response.He just opened his eyes and closed again.
The woman led me outside and asked me in hushed voice : “She is going to be fine,I presume? I am sorry I forgot to ask the details of her illness once I heard we got a response from her even if not directly”.She was smiling.
I didn’t know what to say.I could not tell her that it’s too early to comment on anything at present given her significant medical history but I didn’t want to extinguish the flame I just saw in her eyes.Probably they didn't even know what happened to her years back as well.I simply nodded as I kept my left hand over her right shoulder.
“I shall leave then mother.I mean I have to go a long way.I just couldn’t let you people not informed of her whereabouts because I know what something like this inflicts upon the near ones.I understand it may not be possible for you to pay a visit to the hospital in these conditions,but rest assured she would come here after discharge!”I told her as I walked out of the door.
Exactly at that moment,my phone rang and I saw it was Anette.
I ignored the call.
“Thank you so much for going the extra mile,son.You have indeed instilled a new life in us!” ;she beemed at me as I said farewell.
As I slowly walked back to the gate,I took out my phone to call back Anette.I nearly reached the car when I saw her message notification flashing across the screen.
I opened the message to see these words: “Sir tried calling you...Shalini had a massive MI minutes back.They couldn’t revive her.”
I waved to the lady as I entered the car.Both of us were wiping our cheeks-she out of glee and me out of grief.