Bittu
Word Count: 9,237
Thank you for inviting me to this ceremony. My regards to everyone who’s watching me live and the ones who’ll be watching this later. I hope all of you are safe and doing well. My name is Dr. Bhaskar Narayan Singh. I’m a surgeon and have spent almost three decades in this practice. I’ve worked with hundreds of institutes and have been a guest lecturer for several medical colleges. Currently, I’m serving as Deputy Superintendent at the VBIMS, Mumbai.
The world is in a healthcare crisis. This pandemic has taken lives, damaged infrastructural capabilities worldwide, and has forced us all to witness our biggest fear. The fear of losing a sense of community. My condolences to the ones who lost their lives battling this virus. Our fraternity is fighting this pandemic at the forefront. In my village, people used to say, ‘A doctor is God reincarnated’. I’m proud our fraternity has been strengthening such belief.
All of you deserve your share of applause. You’ve not only completed your degrees but have also been frontline warriors in the final months of your graduation. I’m honored to be a part of your graduation ceremony. I know we have limited time, as you and I need to get back to our duties. So, I would like to use my time to share a story with all of you.
As you continue henceforth, I’m sure you’ll focus on gaining experience, expertise, and reputation. After all, these are the success parameters traditionally defined for us, right? And they indeed are. I believe you’ll turn out to be best at these. But there’s an additional parameter that I want you all to focus on. And that is what this story is concerned with. The story of Laxmi.
Laxmi is the strangest person I’ve ever come across. I’ve worked with hundreds of professionals till now, but the variety of experiences I’ve had with her are nothing short of a journey. It’s been eight years for her in VBIMS and I’m glad that we have developed as individuals in these years. I remember that call from 2012, after which she’d joined at my reference.
My friend—another fellow surgeon—from Ahmedabad calls me one day and asks if I have a vacancy for a nurse. He tells me that there’s this one nurse whom the State Hospital Staff Association has barred from working. He says that she’s very good at her work, always obedient, hard-working, honest, etc., etc. So, then why did she get barred, I ask. To which he says, she has one major problem. She’s a total stickler for rules. If there are rules set out for something, she will follow them till the last alphabet. As anyone would, I too wondered as to why this could be a problem. He then narrated the incident that got her thrown out of the hospital that she used to work for before joining him.
Once she was assisting a high-profile surgeon in a bypass. The surgeon enters the theatre and wears his gloves and mask. Just before taking over the equipment, he pulls out a handkerchief from his pocket and wipes his forehead. As you must know, there are strict rules about what could be taken inside the theater. I’ve seen surgeons often carrying their personal masks and towels—with all precautions and responsibility, of course—because they are particular about a few things. But ideally, one should not carry personal cloth inside. Laxmi had read the manual carefully. So, she didn’t allow the surgeon to continue. The surgeon and others tried to explain, but she remained adamant. The surgeon left the room vexed. As a result, the surgery got postponed and she lost her job.
At this friend’s hospital, nurses and ward boys had called for a 15-minute symbolic strike against the district authorities. They planned to conduct a full-time strike with their family members and the ones who were off shift. Just for those 15 minutes, they’d asked everyone to assemble outside. But Laxmi being herself, refused. She said her duty is till 7 PM and before that she won’t go out. So, they barred her from working in the entire state. He said he can still employ her, but he won’t be able to control the bullying and negativity.
She sounded problematic, so I asked him to give me one good reason to employ her. He sent me a newspaper cutting with a picture of Laxmi carrying a patient in her arms. I can never forget that image. The news piece said: In a road accident, a truck ran over three guys. One of the three guys was so badly injured that the flesh was seeping out his stomach like pulp from a ripe tomato. Each person on the spot was terrified to even touch him. And when even the ambulance guys refused to pick him—calling him a police case—a brave nurse single-handedly carried and placed him on the ambulance stretcher. The image had Laxmi—plump physique, powerful demeanor, round stern face—in dull blue hospital uniform, appearing to be knackered by carrying an adult almost her weight. Her uniform blotted in red, and so her face with the pressure. That image exuded sheer power. Her comments to the reporter were, ‘This is my work’. My friend told me that she was demoted to ambulance duty as part of a punishment.
We are in a tough profession. I’ve seen the most courageous of people surrendering to pressure at times. That act stood unparalleled for me. My friend said she’s one of a kind. She’s either admirable or intolerable. There is no in-between. She caught my curiosity. I had one position open. So, I employed her.
On her joining day, she takes time to understand the system. And the next day, she asks for employee rulebook and general procedural guidelines. She’s the only nurse in my experience of over 30 years who have asked for the rulebook. She finishes reading it in a few days and then intimates me that our fire drill equipment is not in place. I assure her that I’ll get it fixed. As she moves out of my cabin that day, our adventure starts.
Since that day, she begins to give glimpses of the reason for my friend’s strange description of her. I started hearing about her every other day. One day the chief nurse tells me that she’s the most disciplined of the lot, and the other day she complains that she’s rude and stubborn. Some patients especially ask for her saying only she can control their patient, and others object her strict nature. Her behavior towards patients looks responsible but feels utterly cold. She operates as a paradox. The types you want to keep along but cannot tolerate once they’re with you. Like an engaging riddle that one wishes to solve but doesn’t want to be stuck with.
I never saw her with anyone. She even had her food alone. And this behavior, as it usually does, filled the staff with curiosity. I heard all sorts of gossip and speculations about her. And she stayed amidst all of this like a drunkard in a noisy bar; on her own trip, completed unfazed by any of it. She entered and left at fixed timings. Signed the registers with her left hand. Kept her uniform always neat. And unlike other nurses, never engaged with any sort of accessories. Her cold behavior, one-word answers, stern tone, and non-participative attitude became well known to everyone. Some found her repelling, some intriguing, some strange, and some mad. But all of them wanted to know about her. I found even the senior doctors discussing her at times. They all knew what was already provided. She’s an orphan and a widow. Lost her parents at an early age. Her husband died after the initial few years of marriage. She’s been working since she was a young age and has spent more than 20 years working as a nurse. Her records say she’s born in Satna and has completed her diploma from some local college. But all this wasn’t what everyone wanted to know. Why is she so silent? Whom she lives with? Does she have an affair? Why can’t she let anyone breathe? Such questions filled our lunch spaces over all these years. Isn’t it funny that when we’re asked what we’re interested in, we say facts. But in reality, facts interest us the least. People want to know what cannot be registered. They want to know your behavioral patterns and idiosyncrasies. And the day they get to know that, you’re not interesting anymore. That’s why so many of us weren’t interesting for each other, while she was.
Personally, I admired her. She always treated me like a mentor, like other junior subordinates of the staff. She gave me the authority to educate, correct, and challenge her. She took the liberty to question me whenever appropriate. What’s special about her was this uncompromising aura that she had. It troubled anyone in her company. Even I felt on toes whenever she assisted me in surgery. But I liked it. The life of a surgeon is an extended saga of a lover. For the initial few years, there’s challenge and you love it. Then for the next few, there’s the joy of knowing and repeatedly acing at doing it. And afterward, a plain dichotomic existence; some days involved to the degree of indulgence, other days seeking for a challenge, an opportunity to discover something new. She was this challenge for me. In all these years, we experienced so much—tragic events, health emergencies, natural hazards. We witnessed the bravest of souls breaking down. But she never did. She remained emotionally unmoved.
As months passed, I started enjoying her presence even more. I discovered her to be a person of unknown limits. I understood that apart from being a stickler for rules, she’s quite generous at helping the people she works with. Though any sort of emotional outpour remained missing, she compensated for it with her acts. So, once she did double shifts for a week because two of our nurses met with some emergency. She gave up half of her one month’s salary when the staff collected money for ambulance driver Anantram’s operation. Multiple such acts of her kept me wondering as to what is the base of her courage and generosity?
When you spend lifetime opening bodies, you realize that this system of ours is driven by an unknown intelligence: an incomprehensible soul. And this soul finds its own sources of courage and hope which operate beyond our consciousness. When the mind is silent, anesthetized, this soul remains awake. And operation theatre is the place where you witness it in action. That is why sometimes the patients with the meekest possibility of staying alive get saved, and the ones supposedly safe couldn’t. Because it’s the soul that fights. That’s why for me, this profession is sacred and the operation theatre’s a holy place, because that’s where I witness fragments of God. That’s where I act to the best of my capabilities and then submit to their will. That’s where I observe moments in which life generously kicks in, and the moment in which it truly surrenders. For me, this courage, this generosity, their sources, they can only be developed by living a life full of true emotional experiences. Good or bad, doesn’t matter. But true experiences. I wanted to know about Laxmi’s experiences.
So, one day I asked if she follows a religion. She said no. If she has any family or relatives? No. Is she living here with someone? No, alone. Is she in need of anything? No. Is she angry or sad about something? No. Clearly, I couldn’t gather much. Her limited responses left me further intrigued. And out of curiosity, I decided that no matter what I will find her emotional base. I started thinking of ways through which I could discover her modes of interaction. I observed that there were no ways to help her through technology or assets, as since the day she got her new phone, she spent most alone time watching some videos, and because of her scooty, she directly left the campus after duty and traveled to her place alone, unlike other nurses who traveled together through hospital transport. Even the home she had rented was in a faraway colony—mostly uninhabited—at the other side of a town. I couldn’t decide if it’s her choice to prefer 2 hours of commute every day just for the sake of living away from people, or she couldn’t find any place nearby.
Also, due to her obsession with rules, most matters became a ‘this OR that’ choice for her. They made it impossible for her to be in any situation of emotional dilemma. I learned that this is going to be tricky. She won’t reveal anything by herself. I’ll have to place her in situations that would allow her to be express.
I assigned her the duty at maternity and labor sections. I thought children, the joy that a new life brings, the grief that the loss of one life causes, might evoke some emotion in her. After a week, I saw no change. I got multiple complaints from new parents stating that Laxmi prevented them from cuddling own child because they were not following some minor sanitation protocol. I had to move her.
I sent her for training along with other nurses to get trained on emotional responsibility and self-care. She learned everything but showed no effect. Her behavior continued to be cold. Nurses need to act as caregivers also. She surely was one, but care for her remained only a series of trained responsibilities.
Occasionally, I tried training her myself. I explained, ‘Humans are emotional beings. Yes, it is our duty to ensure safety and maintain certain restrictions. But when the situation is harmless, we should be flexible enough to break a rule on human consideration. We need to put people first. Let’s not forget, the rules are made for them. If a rule doesn’t serve them, it serves no use. We need to think emotionally and serve them with empathy.’ Her behavior afterward left me unsure of my articulation abilities.
Lastly, I deployed her on morgue duty, as death is said to be an emotional elicitor. Also, there weren’t many people there to mess with. Her coldest—and the most irritating—side appeared there. She spent days sitting alone outside the morgue engrossed in her phone. She occasionally moved only to get bodies identified and transferred. Even the severe crying and wailing of a late person’s relatives didn’t move her at all.
At that point, I felt hopeless. I even asked myself why am I doing this? Some of my answers strongly opposed my actions but remained meek in comparison to my urge of finding her emotional core. I decided I’ll stop this adventure. The next day, I tried my best to not focus on it but failed. I knew I was obsessed, and I couldn’t do anything about it. Over the next few days, the frustration led to disappointment. Even though I wanted to know, I couldn’t think of a way to go forward.
When you support someone emotionally in rough times, in a way, you give them the courage to fight through. You give them hope of a supportive world. A hospital is a place filled with people looking for these. Many patients come here not to get medicines; that they can get through a phone call. They come here seeking hope. They want me to assure them that everything’s going to be fine. They want emotional support from a trusted source. Why Laxmi, a person with such courage cannot give anyone else hope? I couldn’t get this question out of my head.
My curiosity felt like a blazing flame in my head. Initially, it gave me warmth, but now, it was burning me. I had to decide to drop it. So, I assigned her usual duties and tried to avoid her. I overloaded myself with work for the next few days. I visited friends and engaged in recreational activities after work. But still, I couldn’t extinguish the flame. It kept burning, faintly and incessantly. A few weeks passed, and I felt I had overcome it. It should’ve relieved me, but instead, I felt discontent. I accepted it this way and hoped to overcome it with time.
I might have. But then, one afternoon, matron Fatima met me. She informed that Aparna—one of our new nurses—has come from Pune and has not been able to find any place to live. She needs to move in urgently. She asked for my help. As I assured her of arranging something, the idea of a new plan filled me with joy and put the flame ablaze. I thought of stopping myself, but I couldn’t. And for one more time, I decided to let hope drive me.
I met Aparna. A usual chirpy young Puneri 1 girl. I felt the possibility of companionship building between the two. Especially because when one has an inexperienced new-to-the-real-world kind of person along, there are chances of developing a sisterly or mentor-mentee bond.
I called Laxmi to ask if she can accommodate Aparna until she finds a new place. I said, she’ll share rent and all other expenses too. I admit I didn’t know if she had any place to keep one more person along, but I knew she’s generous. And as I’d expected, my bet played out well. She agreed. I called in Aparna and introduced her to Laxmi. That evening, she moved in.
The next day, I placed them on the same shift. I even placed them in the same ward. That evening Laxmi took her along to the home. From then on, Aparna tagged along with her. They used to travel together. Aparna used to assist her, sometimes even asked her doubts. Even though Laxmi remained the same, Aparna looked happy. I was happy. I hoped for this bet to play out well.
This happiness didn’t last too long. I soon noticed that apart from Aparna asking her questions, they never really talked. Aparna tagged along for lunch some days. But later she started going with other girls. I gave her small assignments hoping she’ll seek Laxmi’s help, but instead, she preferred asking someone else. Laxmi never—never—reached out to her. I saw my plan getting failed, yet again.
My wife passed away some 15 years ago. Later I lost my parents too. I’ve been living alone since then. In all these years, I’ve become mostly self-sufficient. Engaged, engrossed in my world, in my learning. There’s work—a lot of it, mostly—along with some developed learning hobbies. Then there are friends and a few relatives. While most of the time is spent on these, there are still times when I’m sitting alone in the room seeking companionship. From what I observed and understood, Laxmi had her work and mobile phone, that’s all. Doesn’t she feel the need for having a conversation?
I started tagging Aparna with me. She was fun to be around. We had general conversations about life. Every day she asks me, how’re things going, sir? I would tell her about the last evening. Then I ask her the same. And when she answers, I try to smartly place questions that could help me get info on Laxmi, and their equation. Her responses usually reflect coldness. She tells me how Laxmi refuses to hang out with other girls. How Laxmi never comes out to watch a movie with them. How they spend almost the whole day together but still rarely talk. Sometimes she wonders how one can remain so quiet, so lonely. Sometimes she appreciates her for preparing all the food alone. She speaks so much, but words like laugh, smile, cry, sad, lonely, never get linked to Laxmi.
Gradually, I started growing weary of these mundane conversations. And I guess, Aparna also sensed it. So, our conversations automatically shifted to other topics. Now she mentions her only as a glimpse in other grand stories. I too never ask her about Laxmi. Although, her mention does make me curious and gives me discontent, but I never go in detail. I thought, maybe I should stop attempting to steer someone else’s life just for my curiosity and let her live the way she wants to. Until the day I had this thought, somewhere inside, I always hoped for a miracle. But that day, I lost all hope. I realized I am wrong. She is just built this way. There is no source or reason behind it. I allowed the flame to burn itself. And after it sufficiently did, I allowed it to burn down. There were moments when I felt pulled by the urge to rekindle it, but I restrained myself and did not surrender. I allowed myself to fail. I allowed myself to admit my mistake.
Months passed and life moved on. I remained occupied with other engagements. Laxmi, well, she remained the same. She assisted me on a few surgeries, met me for weekly roundups, and during all of this, showed the exact same behavior. The idea of disengagement was going well from my end. But fate hadn’t decided to end the story yet. One day, as I came back from round, Aparna greeted me with excitement. I couldn’t ask her the reason as I had to quickly leave for another round, but when we met for lunch, she started by herself.
"Sir, you won’t believe what happened yesterday. I’d never imagined something like this ever happening", she says animatedly.
"You completed one month without breaking any equipment?", I teased her and smiled. Others also laughed.
"No, sir…", she replied in her extended girly tone. "This is way more interesting than that. There’s one dog that chases us every day on our way home. The moment we reach the cross near home, he gets up, barks madly, and follows us till home. Laxmi tai* 2 usually doesn’t bother much, but I get scared like hell. Yesterday, he didn’t bark. But for some reason, just appeared in front of the scooty. Luckily, tai managed to save us from falling, but the poor thing got his leg injured. There was blood dripping from his feet, and he howled in agony. I got so scared; I couldn’t think of going near him. But tai went near him as if it’s not a dog but a child. As she bent down, he stopped howling! She held his leg and examined it, and he sat there quietly letting her examine. And then…", she takes a dramatic pause, "…the unbelievable happens. She picks him, places him on the scooty, and gets him home. She hasn’t got anyone home in all these weeks. She doesn’t allow me to get anyone home. But she gets him, a street dog"*.
All of us heard in silence. This news picked everyone’s interest.
"She gives him first aid. Serves him food. Then sits by his side until he finishes eating. And once done, tells me, ‘I think he should stay here until he gets well. Is it fine with you?’ What problem can I have? I’m happy that she’s talking and finally we have some excitement in our home. This morning, before leaving, she baths him and serves him food".
She continued for a while afterward. Everyone added their comments. I too praised this progress. What I really wanted to say was that I know this isn’t going to change anything. I’ve done enough trials and have already seen a lot. But I stayed quiet. I thought, let the kid learn in her own way.
Since that day, I kept hearing the adventures of Laxmi and the dog. One day, she gets him vaccinated. The other day she starts training him. One evening she decides that she’ll take him every night for a walk. One day, he tickles her while training, and she smiles. Another day she names him Bittu. Then she handles him with mother-like care. People started talking about them so much that even the news of the latest couples got sidelined. Though it wasn’t all happy. Some called her a maniac who couldn’t tolerate humans but sits well with dogs. Some called her attention seeker and treated Aparna as her agent. But negativity kept aside, most people loved hearing about Laxmi. Speculations filled the discussions and Aparna kept coming with more to speculate every day.
For me, it didn’t bring much excitement and I remained unperturbed by most of it. Our minds are such strange creatures. The same thing that once fills us with joy, becomes mundane after a while, just because of one event. As if there’s a switch that goes off. We notice this, we try changing it, but the switch doesn’t move. It moves at its own will. The will of the subconscious; that which observes, records, and recalls everything.
Their adventures continued and we kept hearing about them. She even brought him to one of our picnics this February. He was a usual INDog—Indian Pariah dog; the street dogs we see—but bright, young, and healthy. During the picnic, she mostly remained seated in one place and stayed quiet. But Bittu had a lot of fun. He shined in the sunlight and amazed everyone with his stamina. He played frisbee and ate all sorts of things. Meeting him was like meeting some colleague’s family member, the one you’ve heard so many good things about that you admire them and wish to meet one day. Everyone was happy for Laxmi, except me. How can I? Yes, she surely is reflecting some motherly elements. But she’s still the same person; stony, cold, unresponsive, and actively passive. What good did a relationship serve if it didn’t change you positively?
Soon, Aparna moved out of her place and started living with a few other nurses in a place near to the hospital, and whatever information she used to feed us, stopped. People also lost interest in Laxmi and soon picked another person, and then some other story.
Months passed and we reached closer to that historic day in history because of which we’re having this seminar through web conferencing. It was mid of March and we were on high alert due to the rising coronavirus pandemic. The virus, it’s impact, treatment, safety procedures, guidelines, we were still learning and finalizing on a lot many of these things. There were umpteen factors to be considered, arrangements to be made, and actual human lives on stake. With the information coming in, there was definite fear in the staff too. I held multiple meetings to educate and inform them in advance. We made plans. We decided that members of our staff who could be on risk will be sent on paid leaves. And staff members who live alone or with some other staff will be primarily and preferentially trained as they do not risk anyone else’s life and can safely visit home and come back or can even stay in the hospital.
We got our first set of PPE kits and central level guidelines on the 21st of March. We prepared special wards and ensured the safety of our existing patients. Mask and hand sanitizers gained essential status. Laxmi played a key role in this whole preparatory phase. She followed each guideline and made sure others follow it too. Her vigilant nature that usually irked many, suddenly appeared inspiring and got recognized as care. She took the toughest of duties, the ones with maximum risk, and did them with conviction.
Specialties lost importance and as doctors we all took duties. As I was the senior-most among the ones to be primarily trained, I formed a crisis team with few others. This team was expected to do double shifts occasionally. Laxmi and Aparna were two of the twelve nurses in the team.
On the 25th, lockdown got imposed. All of us were provided with passes to travel back and forth from the hospital, but most of us preferred hospital vehicles, as it was safe and hassle-free. Laxmi didn’t. As per her logic, she was following all the rules so there wasn’t any need of restricting one’s personal vehicle’s use. At times, she got questioned at police postings. But she remained adamant and used her scooty.
On the 27th, we got our first COVID infected case. Soon, our hospital became one of the hotspot zones. By the 2nd of April, we had around 12 positive patients. There were other usual cases too, which either had to be diverted, delayed, or admitted at risk. The cacophony of coughs filled our heads. It was everywhere; in the wards, at the reception, emergency, even the telephone calls. The situation was tense, but luckily, most of our staff were operating fine. Except for those who felt weary and nauseated while wearing the PPE suit.
One of our nurses, Sulochana, vomited after being in the kit for a continuous 8 hours. She was advised to go home and discontinue for the day. But she insisted on continuing as that day was her turn to do a double shift. I decided to meet her as I too had just finished one shift of duty. I disrobed the kit and met her near the reception. As I was convincing her, Laxmi came to rescue. She was moving out after finishing her shift. She understood the situation and offered to do the double shift on her behalf. Sulochana still resisted as she knew that Laxmi had her double shift the next day, but after Laxmi’s reassurance, she finally went home. I thanked Laxmi and continued with my work.
I was in the hospital until late that night, going through some latest test reports, when all hell broke loose. We got the news that Sulochana’s husband has called for an ambulance as she’s feeling breathlessness and is gaining fever. I was shocked and deeply concerned.
There are moments in life when you’re forced to act everything out as if you’re playing a role. This profession offers many such moments. There are days when I’m terrified after reading a case’s details and not very sure as to how it will go. But I play the role of a confident, know-it-all, can-fix-it-all surgeon. When I enter that room, I cannot have doubts, I cannot be afraid. So, I prepare myself for it. I think half a surgeon’s job is to perfect this act because when things don’t go well, others feed off your confidence and competence. And the ones who continuously manage to hold themselves well, get qualified to be called excellent.
Sulochana’s case was one such moment for me. I was terrified not just for myself, but for my staff, and millions of others outside. Here’s a nurse, operating with a PPE kit, trained to follow all the measures and guidelines; if she gets infected, what confidence will the normal public have? I held these thoughts and moved out to receive her at the emergency. Laxmi was already there. Staff members in masks and gloves surrounded Sulochana. I screamed at them for standing closely and called for more nurses in the PPE suit.
We moved her to the testing ward to get the tests done. By the time the testing got completed, I was close to ticking 23 hours in the hospital, and Laxmi, 17. The test results were supposed to come the next day, but since her symptoms showed a clear case of infection, we started preparing for the following steps. As per the guidelines, people from the staff who attended the patient without proper equipment should not be allowed to move out of the hospital campus. Which meant Laxmi, Suparna—another nurse—and I will have to move directly to the staff isolation, as we attended her without our kits. This guideline was prepared considering the health of staff and their families. All of us had kept extra pairs of clothing in the hospital lockers as part of the preparation.
As we waited outside the testing ward, I called Dr. Subhash— the one supposed to lead the team after me—and asked him to report ASAP. I was disappointed. Even though I was mentally prepared for the situation, I hadn’t expected to go down this soon. My team, my staff, that looked up to me for guidance, I sorely disappointed them all. I spent the next few minutes cursing myself for not taking proper precautions, and then the other few attempting to list down everything that I need to hand over to Subhash.
I looked at the tiled floor, neat and checkered like a chessboard. It appeared surreal at the time. We all walk over these squares every day making our little plans. We decide our moves and try to predict how others will play out. We forget we aren’t the players, but merely the pawns. Provided with the liberty to make a move or two, but ultimately, out of control. We remain unaware of the one who moves; until, they decide to make us informed of their existence. Who are they? We don’t know… Often, we never get to know.
That thought released some of my angst and I felt surprisingly calm. I looked around. Suparna—to my surprise—was also calm. She sat on the bench, peacefully awaiting instructions. I couldn’t think of her reason to be so still. Is she in such a shock that she has lost her senses? Or is she happy that she won’t have to serve her duty for the next 15 days? Is she praying to her God? I don’t know…
While Suparna’s reaction was strange, Laxmi’s was unfathomable. Laxmi—who usually remains unperturbed by any event—looks tense. A frown sits on her forehead, while she paces across the corridor, captivated by an unmistakable sense of urgency. I try looking at her face—mostly covered because of the PPE suit. Suddenly she turns towards me and looks directly in my eyes. I’ve seen her for so many years that I know these aren’t the eyes of the casually stoic Laxmi. She comes near and sits beside me.
"Doctor, I cannot stay here. I need to go home", she says in a cautionary tone. I ask her what the matter is. "My dog is alone at home. I’m here since yesterday evening. Since it was a double shift, I’d kept extra food for him. But now I’ll have to go. I need to feed him". I spend the next few minutes enquiring about the case with her. Apparently, she had tried finding a person who could keep Bittu, but couldn’t. Going by her social skills, that wasn’t surprising. Her concern was genuine, but the circumstances, grave. She asks me if there is any way she could go home once every day just to feed him or if a person could be arranged for the same. I assure her to make some arrangements and pull out my phone again.
During the conversation, I discovered a new Laxmi. A sensitive, caring, openly emotional, needy person. I don’t know if it would’ve been tough for her to come out like this or she would’ve done it without thinking. But one thing was for sure. What my planning and tricks couldn’t do, life had done that. I can see emotion flowing through a crack in the usual rock-solid Laxmi. This left my conscience pulling opposite-ways in the moral tug of war. A side of me was happy to see Laxmi open up. And the other side was sad and concerned at the grave situation that she was into. I looked at the phone that reminded me of its dying battery, which at the time felt unimportant. I ignored it and dialed Dr. Subhash. He couldn’t confirm anything and asked for some time.
Meanwhile, we followed the process as instructed. We all got dressed in hospital clothing and moved to a separate isolation ward. Within the first hour itself, our preliminary check-up and scans were done, and we were provided with the first set of precautionary medicines. We moved through the same wards that we’d set up for someone else and interacted as patients with our colleagues. If any of us turn out to be positive or show any symptom, we might even be placed among those who looked up to us for help. It felt unreal, like an uncomfortable dream. I wish I could wake up.
One can always educate oneself to the best of capabilities about the experience of something, but that will still fall secondary in comparison to the actual experience of it. I’d thought that the whole process we’d designed for patients was full proof. The patient would feel that they are in safe hands. But going through the process in person totally changed my perception. I understood that in our planning, we forgot one of the most important aspects of wellbeing; emotional health. There was no checkpoint to ensure that we’ve provided any sort of emotional support. A patient struggling to be healthy, one who’s going through a life-altering process, with fear for their future, their family, fear of losing life itself, about to be placed in a room full of strangers when they need their loved ones the most, needs to be provided with emotional support. I learned that there is so much yet to learn. We need to transform empathy into a habit, that can translate into processes and tools to support the humane needs of fellow humans.
I kept checking on Laxmi as we went through the process. Her sudden vulnerability felt like a fresh wound to me. One that is exposed and needs to be treated with caution and care. She looked constantly anxious; her body language that of a decrepit woman. Even though I never saw her checking the time, but it felt as if she was counting hours. In between, she once reminded me that it’s been 20 hours since she’s at the hospital and checked on the status of her request. I had to ask her to be patient, as even our phones weren’t with us at that time. Watching her go back gave me a huge disappointment. At that moment, all my happiness, musings, and learnings stopped. I just felt bad. For her, for Bittu, and his state of hunger.
We were on our beds in a separate ward prepared for members of the staff. We were left mostly unsupervised— considering we knew the guidelines and symptoms well enough—with just one nurse for communication. Also, the constant dearth of PPE kits demanded less consumption on people who’re aware of the drill. As soon as I got my phone back, I noticed the battery level at a mere 2 percent. I looked around to search for a charger which could help my phone, but couldn’t. So, I requested the nurse to get my charger from the cabin.
I dialed Dr. Subhash. Each ring operating as a ticking clock for the pertaining emergency. As he attended the call, his tone reminded me of my loss of authority and the pressure that he might be operating under. He hurriedly stated that there is no resource to fulfill any such request. I nudged him further asking him to consider the dog as a member of the family. He responded with numbers from the latest cluster of cases and the pressure he’s receiving from the local leadership and media. I understood that in addition to the lockdown, a curfew is imposed in the city. Also, the hospital is under tight scrutiny, as members of staff got infected. I felt dejected at my absence. There wasn’t anything that I could’ve asked afterward, so I wished him luck and disconnected the call.
The moment I placed my phone down, I saw Laxmi approaching me. For a fleet second, I wished for the possibility of never having to face her again. The next second I felt guilt. And then, fear followed. It’s been 22 hours since she’s out. What if the poor animal died of hunger? Laxmi came to my bed and stood at a distance. She knew there isn’t any need of asking a question. It’s easier for an ice cube to melt, but for a glacier to crack, takes a lot. She looked alarmed. Her gait was apprehensive. I told her we couldn’t arrange anything. There is no one available to be sent home. I asked her if she has any neighbors who could help. She said she does not have anyone’s contact and anyhow, no one would like to enter a nurse’s house in such risky times. She asked me if I knew someone who could visit her home. I thought for a moment and realized that I don’t know many people outside the healthcare circle. Most of my friends whom I can rely on are either people of the staff, other doctors, or relatives.
I started calling them one by one. Laxmi stood there awaiting my response. Her face projected panic and eyes demanded hope. Emotions that never appeared even while handling patients in their last moments. Most of my contacts were either serving their duty or stuck in an emergency of their own. Also, because of the curfew, not all of them had the authority to move across the city. I started dialing people outside the healthcare circle; my newspaper vendor, colony guard, part-time driver. And just as I was dialing one of my neighbors, my phone switched off. I looked at Laxmi, and then my phone. I shouted for the nurse with such alarming intensity that jolted Suparna out of her nap for a few seconds.
The nurse came running and informed me that my cabin is sealed for disinfection. I asked her to arrange an I-phone charger as soon as she can. She nodded and left. Laxmi kept standing there as I indulged in all means of saving grace. A person whom I pushed for years to get vocal, asked me one thing. And what did I do? Showed her a switched off phone. Her face went blank. It appeared as if she’s gone back to be her normal self. But her eyes, moist and red, told a different story. She asked, "Is there any way I can leave for just an hour, Doctor?"
"No!", I said. "There are strict regulations, Laxmi. We need to comply. But I’ll arrange something", I tried reassuring her.
"Even if he howls, no one will be able to come to his rescue. He’ll die of hunger", she stated as a matter of fact.
"He won’t, Laxmi. Dogs can easily survive 24hrs without food", I said, only to feel guilty after a moment. She served me with a flaming gaze. Yes, they can survive. Even humans can. But will I leave a kid hungry for so long? Will I ever take that risk?
"‘I’m sorry. But for now, we’ll have to abide by the rules. Spare me some time and I’ll make arrangements", I added guiltily. I expected a reply thrashing my delays and requests at once.
But strangely, "Okay. I’ll wait", she said and went back to her place. Instead of calming down, I felt annoyed. I knew a lot of it was my fault. But I realized that I wanted her to protest. I wanted her to speak out and fight for her need, speak against me, against all of us, even if it’s none of our faults. Fight for someone she loves. But she didn’t. How can she still be calm? Is all her concern only a farce? Or just another responsibility that she’s religiously serving.
Before my mind could find ways to detest Laxmi, I engaged myself in looking for the nurse. I found her casually chatting outside the ward. Sadly, her carelessness got the best of my annoyance. I rebuked her for not reporting to my cause. She said she cannot move from this ward until someone else takes over the duty. So, she has asked some other nurses, but even they couldn’t find the charger anywhere. I asked her to inform me as soon as the work at my cabin is done.
Inside, Laxmi sat rigidly on her bed, facing the other side. I wanted to shout, but for whose fault. It is me who couldn’t get her help; the one to be damned. I went to my bed and crashed like a meteor. With eyes closed, I damned the moment when I’d begun taking so much interest in her life. I damned my decision to intrude her ways. I damned my over-inquisitiveness that got us to this point. If I wouldn’t have interfered, this dog might have never appeared in her life. I tried but couldn’t manage to find a way out for my anger. I decided to go out and find help myself. Just because the situations aren’t favorable, and Laxmi isn’t courageous enough, I couldn’t let the life die. As I got up, I noticed Laxmi peeping out of the ward door.
I called her asking for what she’s trying to do. "Doctor, if the situation is harmless, we should be flexible enough to break a rule on human consideration, right? I need to go home. My scooty is in the parking", she said with fearful inhibition.
I understood her intention and tried my best to hide my excitement. She’s really going to do this! I repeated in mind to make myself believe. "But this isn’t a harmless situation. We could be infected. This can put someone at risk", I said.
"I’m wearing a mask. I won’t touch anything. I’ll make sure I don’t put anyone in danger", she said with commitment. "I believe you’ll trust me on this".
"But how will you go out? You’ll be caught. And if you did, then I don’t know what they’ll do", I tried putting my pragmatic act together.
"I don’t know how I’ll escape, but I’ll have to. There are extra pairs of clothes and my travel pass in the scooty. I’ll take the lift and directly go to the basement", she added with the confidence of an efficient con artist.
"I cannot approve of this, Laxmi. I cannot", I said, but I actually approved of it. I wanted her to run away and disobey me for once.
"You always tried your best, doctor. But I didn’t. Today when I am, please help me", she pleaded with urgency.
I was shocked. What was that? Did she know? I understood I don’t have much time to spare. I asked her what she wants me to do. She needed me to engage the nurse for at least 15 minutes. Meanwhile, she’ll go out. I thought her plan is poor and childish, but I still agreed. I could’ve asked her to stop and gave it a try myself, but I didn’t. A part of me disapproved of all of this and asked me to grow up. But I chose to be silly and went with it. We looked at Suparna who was sleeping since she entered the ward and hoped for her to remain that way. I asked Laxmi to pretend to sleep on her bed, while I call the nurse inside. I needed to engage her with something. So, as she arrived, I asked her to sit on the chair, her back towards Laxmi’s bed, and started to apologize for my misbehavior some time ago.
Laxmi peeped out of her blanket and found the nurse to be engrossed with me. She left her place cautiously. She pulled the door as slowly as possible, but it still made a screechy sound. The nurse was about to turn but I engaged her with my explosive panting. Usually, a senior doctor would’ve been called in such a situation. But since I am quite senior, I took command and asked her to check my BP. Meanwhile, Laxmi stepped out. From the small window in the door, I noticed her taking a turn. I wished for her to successfully reach home. In those hopeful moments, I forgot the silliness and danger of this plan. I forgot the nurse trying to keep her calm. I smiled and kept staring at the window. She came back after a few moments and looked inside. I saw her masked face; her eyes met mine, and she smiled the way I’d never seen her smile before.
Her eyes shined, appearing to be victorious. I don’t know why she came back. Maybe to inform me that all my years of mentorship hasn’t gone waste. Or maybe just to drop a thank you smile. I’m not sure if she’ll be able to rescue Bittu, but Bittu clearly rescued her. I was content. It felt as if I had a victory. And from that day onwards, Laxmi became a story for me to drive an important point home.
I’m sure all of you will gain immense experience, expertise, and reputation in this profession. But as you’ll spend some years, many among you will realize that a job in the healthcare domain is like an extended saga of a lover. If not, then you’ll surely have some days—God forbid, but maybe even months, just like the current situation—where you’ll lose all hope. Where your emotions will be tested, and you’ll be asked to remain rock solid even when the world around will be falling apart. I should remind you, ours is the profession that demands one to decide when to switch a ventilator off. As dreadful it may sound, many of you might have to switch it off.
You’ll open bodies and operate disfigured parts. You’ll save some and will see some losing lives. You’ll come out of an operation theatre, not being able to save a child, and the question, ‘Did I do my best?’ will haunt you for days. You’ll lose and regain your trust in life, in God—if you believe in one. And this will happen again and again. And when all of this happens, you’ll need emotional support. You’ll need those pillars that you can cling to in times of need. You will have to ensure that you have something or someone to go back to.
Some of you must be thinking, what if I didn’t feel any of that? What if it didn’t affect me at all? Well, you might still have a great career and get recognized and renowned for your work. But tell me, will that be a worthwhile life? I don’t think so. I think it will be a loss of life experience. A life with immense opportunities of interacting with people in the most private moments of their life, of being part of uncountable emotional experiences, of developing oneself on a front that is at the core of one’s life. It will be a loss. Yes, you’ll live a supposedly ‘safe’ life. But you’ll miss out on actually ‘living a life’.
I can assure you that those who’ll choose ‘living a life’ will be the ones realizing the pleasure of immense joy and a fulfilled existence. But trust me, they’ll also have to occasionally go through immense pain. And when that happens, your pillars will support and guide you. So, find a teacher, or a lover, or a mentor, or a family, and involve with them passionately. Allow them to move you and be ready to move mountains for them. Because god forbid if life turned out like Laxmi for you, you will need a Bittu to rescue you.
Going back to the story, some of you might be thinking of me as a crazy stalker. Just to clarify, I’m not one. I am a mentor for tens of staff in my hospital, and I can narrate similar stories about each of them for you. But those for some other day.
As for Laxmi, she got caught in the parking itself. Sadly, that too because of my fault. After she left, I was so overwhelmed that I couldn’t control myself. I didn’t realize when my acting came to a halt and my eyes begin to shed tears. When I think of it now, I feel I was in a delirium induced by the medicines. Otherwise, how can you expect a senior surgeon to explain any logic behind this tomfoolery?
The nurse caught me faking and sensed Laxmi’s absence. She quickly reported and got her caught. Laxmi was brought back to the ward and we were questioned for our behavior. Dr. Subhash and other senior faculty joined in the questioning. This was serious offence. We could’ve faced legal repercussions for it. But I managed to convince them that there wasn’t any option left for her. And I had to help her on humanitarian ground. The discussion went long, our reputations came to our rescue, and they finally got convinced that it was a matter of saving another life. They asked Laxmi to stay within the ward and arranged for a special ambulance to carry Bittu to an animal care center. Well, that’s all it takes to save a life: timely response.
Laxmi changed since that day. I saw her crying when she saw Bittu through a video call. I don’t know what all she cried for, but she did, for long. It was heartwarming to see her smile after the call. Luckily our reports came negative, but we had to spend a full 14 days in isolation. A few others joined us during our stay. We all learned a great deal about each other. On the 15th day, we came out of isolation and joined the duty.
Now whenever I met Laxmi, she met with charming enthusiasm. She went back to be the same strict, courageous person. But this time she talked. She understood and explained. She smiled and allowed others to cry. She became a caregiver that patients would dream for. I am certainly proud of her.
Our hospital has enforced a rule specific to the COVID situation. In a room, we allow only one attendant with the patient at a time. Yesterday, an elderly couple came to get their son treated. Their son was showing a few symptoms of COVID infection and had to be tested. He was an adult with an intellectual disability and special needs. They were the ones responsible for carrying out every activity required for his daily functioning.
Laxmi came to my cabin and explained the case. Then she asked, "Doctor, they both want to be with their son at all times. Should I allow them?"
"What do you think?", I asked curiously.
"It is our duty to ensure safety and maintain certain restrictions. We’ll do that. But when the situation is harmless, we should be flexible enough to break a rule on human consideration. Right?"
I smiled contently and nodded. I saw her eyes smiling radiantly as she left the cabin. Thank you for being with me throughout the story. I wish you great health and the best for your life.
Notes by Author:
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