The Circumstance of Time

Raghav was by the counter, half standing half falling over it. Passively he took out his phone from the pocket of his crinkled and unwashed jeans- now smothered with latex glove powder in amusing places. He pressed the home button. It was 9.54 AM already. He’d been awake for almost 29 hours now. Up and in constant motion, much like clockwork. Tall, thin and gliding- akin to the seconds hand.  If not for him, time came to a standstill in Ward- 8B of Baba Saheb Hospital. After all Raghav was the junior resident. The adjectives genius and hardworking shied in front of him. Long hours were the norm rather than the exception, but the previous night in the emergency had been particularly outrageous. 86 admissions in a ward with 40 beds.  With three patients on a single bed, foot in the mouth no longer remained just an idiom.

Raghav did a mental round of the ward. A dozen files to be made, histories to be taken and treatments entered- all that had to be done before the consultants came, which could be anytime, depending on when their kids had to be dropped to school and when the morning news began to bore them. Raghav sighed and shifted to full gear. He was writing down his notes for a patient he faintly remembered from the last afternoon. Diabetic, hypertensive, ST elevation, the works, when a thin thirty something suit clad woman with a dupatta covering most of her face came to him. “Doctor sahib, inki haalat kaisi hai”. Raghav shrugged. He put down his pen and asked “Kaun hai aapke patient”. “Rajesh” she replied. “Kaun Rajesh”. “Bed 22” came the answer. Aah, CLD Rajesh.  This was a 38 year old mechanic who’d drunk enough to rot his liver and then some to let his damaged liver addle his brains. Raghav had already started all the routine treatment for CLD, which he could recite without giving half a thought to it. “Aapke pati ne sharab pee ke sharir kharab kar liya hai, jiske karan yeh gafflat mein hain. Khane ke liye  naak mein tube daalni hogi “. From under the cloth, he saw the expression tighten on her fairly pretty face. Her lips curled which made the scars near the angle of her mouth and on her cheek conspicuous. “Chemist se leke aao jaldi” Raghav ordered her while handling a torn slip of paper with Ryle’s Tube (18 Fr) written on it. A quick glance to the cheap MR gifted wall clock - 10.10 AM. With so much work pending, he however was far from perfection.  

Rounds were a little more cluttered than on other post-em days. The nursing staff had slumbered on and the most basic drugs were out of stock. To get the relatives to comprehend this was a PR nightmare. The consultants were blind and deaf to the chaos of it all. Time had wiped the memories of their junior years.  Their two minutes at a patient translated into twenty for the resident.  Lab tests, imaging, referrals. “This patient is clearly in hepatic enceph. He’ll aspirate. Why does he not have a NG tube? Why has he not been transfused yet? This is irresponsible behavior on your part Dr Raghav” started their tirade at bed 22.  When it came to annihilation, time had proven to be an effective vaccine.

Raghav lugged on. He called for CLD Rajesh’s wife. Finding out about the lack of  progress with the tube, Raghav lost his usual cool. “Tumhe parwah nahi hai apne patient ki? Tube dalni zaroori hai” he ranted. The woman quivered, and began to explain how she alone and clueless she was, how she’d left her two young kids at home. Raghav knew that for CLD Rajesh, the measure of time left was not by the rising and setting of the sun but by the sandglass, sand slipping away. “Mujhe nahi pata. Aap arrange karo.  Har ghanta keemti hai.” He wasn’t unkind but empathy took up too much time and in medicine time was currency.

Two days passed by. Distress calls were made, some rather futile. Patients who’d come solely for respite from the harsh summer sent away.  Samples taken and sent. Vitals noted, corrections done.  By now, the bedlam had subsided. Time took a deep breath. Such was the malleability of it.

Around eight at night, Raghav was asked to attend to a patient who wasn’t moving. Bed 22 CLD Rajesh. Raghav put his stethoscope to his chest. The darned sound. Patient had grossly aspirated. “Brotherji, Em tray.” He knew intubation and chest compressions were merely a formality. His hand on the pulse and eyes looking into the wife’s scarred face, he shook his head- gently but definitively. He knew the patient had died because of the lack of the feeding tube, but what was the point of saying it now. Why burden someone with the guilt of having aided in their own husband’s death. He walked back to the counter without a word, signed the death certificate and went on. When you’re in the wards long enough, life comes to resemble a circus, packing up and moving away.

The Earth went on rotating, the days passed. Raghav was attending to a newly transferred-in patient when he spotted CLD Rajesh’s wife. For some unknown reason, he remembered her face of the hundreds he saw everyday. “Kya hua?” he asked.  She told him how the death certificate had been signed for the wrong date, a day after the day of death. Raghav knew how much of an inconvenience that must’ve been to the woman and was immediately apologetic. She stopped him midway and said “Aapki galti ki wajah se mujhe apne pati ke sath ek aur din mila, jo meri shaadi ka sabse acha din tha”.  Glancing at her face one last time, Raghav paused at her scars.