A night

During the course of our life there are certain events which are of such profound significance that they tend to shape us as a person, they go on to define who we are. They may not be very important to the rest of the world but their significance lies in the intense personal emotions they invoke in the handful of persons who are the actors and spectators of such incidents. Often we do not realize the impact of the event when it is actually taking place, only when we look back and reflect we realize how indelibly such events have altered us.

It was my first night in the department of medicine as an intern. We were in our unit room, a stuffy little room adjacent to the ward. There were four of us, me, my co-intern and two of my seniors, one was the house staff and the other post graduate trainee. I was the greenhorn. It was a summer night. Those of you, who have been to Kolkata, or any other tropical city, can imagine how a summer night is here. Even at night, the air was still hot from the merciless frown of the day time Sun, humid and stale, laced with the invisible agents of tuberculosis and perhaps a host off other bacteria, viruses and may be some fungi all jostling for a suitable host to plant their seed. The state of the room didn’t improve the conditions much. There was a small window but without any effective ventilation it sat there mocking us, its rusted iron bars grinning at us like carious teeth. There was a small table scattered with the tools of our trade and the four of us sat around it, administering to the assorted ills, aches and pains of the 200 patients in the ward and all those who might get admitted during the night.

There was a steady trickle of patients being admitted through the night, the usual sample of chronic kidney disease, asthma attack, heart failure, organophosphate poisoning and so on. There were no patients of myocardial infarction, they get directly admitted to the cardiology department from the ER. I had not realized how time flew by, there was always some thing or the other that needed to be done – a blood work, a ryle’s tube insertion, so on and so forth. And then it happened. A call, the nurse asking me to have an urgent look at a patient who the nurse thought was not doing quite so well. Off I went with my stetho to the ward. If you have gone to any old government hospital, built before independence, you can see buildings have high ceilings with huge doors and the fans hang from the ceiling on long metallic poles. This was one such ward. When I entered, it was silent except for the metallic clangs of the old ceiling fans which were perhaps even older than me.

As I approached I saw that the patient was a young boy, not quite so young to be in the pediatrics ward yet not old enough to be called a man. His face conveyed a lot. It was typical of Down’s syndrome. He was propped up with an oxygen mask strapped to his face. He was covered with cold sweat, the fluorescent light gleamed off him. His eyes were fixed in a dead stare. All these told me he was in shock, possibly cardiogenic. Putting the stetho there was no heart sound, nor any breath sound. I began CPR and the related procedures of ACLS. Time ticked away, with each press of the chest a little bit of hope passed away. His ribs cracked under pressure, I could feel it in my hands. The breath of death hit me. With every press of the chest froth emanated from his mouth, telling me of pulmonary edema, that he had drowned in his own body fluids, sitting there in his bed. The resuscitation was unsuccessful.

The father was inconsolable. He kept telling, “I did everything I could, why didn’t he get a few more years?”  It is in moments like these you realize the absurdity the world, the absurdity of the molecular gamble that results in having the a young boy an extra chromosome 21, that results in his untimely death. It is in moments like these you question your faith, perhaps even loose them.