The smell of the wards was hard to describe. It was the odorous outcome of a
perpetual battle between diseases and drugs, one vying to conquer the battlefield that was the
human body, the other, mercenaries trying to successfully complete the duty
they were manufactured for. One striving for existence, the other trying to
fulfil its destiny. It was difficult to get used to. Even Dr. Sayid Ahmed, who
had been walking in and out of the wards for more than twenty years now,
crinkled up his nose, just that little bit, every time he walked into one of
the six wards in the hospital. An eternity ago, he had begun as a student in
that very hospital. Slowly he had clawed his way through school, through an
internship, through his masters in a foreign nation and though it had taken him
long he finally stood where he wanted, where he deserved: the head surgeon of
the same institution that had initially equipped him to be a significant
soldier in the fight against diseases. He had saved innumerable lives, he had lost a few but there are always casualties in war. He
had gained a reputation for taking on even the most difficult of cases and more often than
not succeeding.
People came to him from distant corners of the country, pleading for a way to
postpone death and a fortnight or so later profusely thanking him but he didn’t listen
to the gratitude, not anymore. Just like years of practice had inured him to
tears and sorrow, he was now also accustomed to the profuse appreciation which
he believed wasn’t necessary. He was, in the end, just doing his job.
His
daily routine was pretty set. A nine o’ clock visit to the wards, then the
three hour long stay at the outpatient department except on Saturdays and Wednesdays, which were surgery
days. Today was a Thursday. So like every other Thursday he was ready for his ward
rounds at nine. Dressed in a light blue shirt, black pants and the white apron
he was followed by an entourage of junior doctors and interns eager to listen to
everything he said and prepared to answer every question he asked. The first
ward was S.M.-1 or surgery male-1. He crinkled up his nose as he entered and
then like a well-oiled machine got to work. An auscultation here, a x-ray
report interpretation there, this was his work, this was his domain, amongst
medical terms and stethoscope voices, this was where he belonged, in the truest sense of the word, this was his home. Nothing else
mattered, the huddle of third year students giggling in a corner, three
attendants wasting their time in fruitless gossip, none of them mattered. If there
weren’t lives at stake he could have confessed to himself he even enjoyed these
daily skirmishes with fluid imbalances, bacterial invasions and malignant
wanderers.
“Present the case
Dr.Nadim.” he said and the intern did so. His sentences were commands. “And the
blood test reports, what do they say?”
“Sir, his CBC and differential count
have dropped to normal levels. The electrolytes are normal too … … Sir. The
electrolytes are normal too, sir.” Dr. Nadim replied.
He then faced towards the
patient and told him he could go home today.
Bed 14, S.M.-1 ward. “I don’t feel
that well. I would like to stay for a few more days.” The patient meekly
protested.
“I’m sorry but there is no
need for you to be admitted anymore, so please you should go home today.” He
explained to the patient. “But doctor, I don’t…”
“Do you understand me?” Dr. Sayid raised his voice, just a little and the room
felt silent, the
students, the attendants, everyone except for the ceiling fan squeaking
oblivious to the rare sight that was unfolding right beneath it. For Doctor
Sayid was always restrained, always very professional in his behavior. It was
just for a moment but he had lost his cool. His interns were shocked and now
even more afraid than before.
“You will be discharged today.” And just like that he was back. The professional tone restored.
That was the final bed in the ward. He exited ward -1 and entered ward -2, crinkled
up his
nose, just that little bit and got down to work. Lost in the moment of Dr.
Sayid unusual outburst Dr. Nadim had forgotten to leave behind the case report
on the bed which was the normal practice, so the nurses could collect them and properly store them.
He returned to the ward to leave the report where he should have and he heard the attendants
discussing what they had just seen. He wasn’t accustomed to the culture of medical profession
as his teacher, so unable to avoid people talking about someone he respected he
listened.
There were three of them; all waiting on their loved ones. The worry
of the first day of emergency where every word their loved one spoke was
accepted with care as if it were a treasure had vanished and had been replaced by
boredom, a vacant space that they were trying to fill with idle gossip.
“That’s what doctors have become these days. Did you see that?” one of them
said. He was
an elderly man of about sixty.
“They do not respect us. Do they understand that
without patients there would be no doctors? They need us just as much as we need
them.” The second man joined in.
The third man, a middle aged man, with a strong
moustache and receding hairline couldn’t keep quiet for long. “What was the need
to humiliate the man like that? He is paying for his stay. He says he doesn’t
feel well. Do doctors kick out patients as they wish now?”
Dr. Nadim stood with the case report in his hand. He hated each one of them.
“It’s a free bed. The doctor doesn’t get paid for it.” He defended the doctor.
It seemed the
men had been defeated, for a while at least, till the middle aged man spoke again,
almost in a confrontational voice, “Just because he doesn’t get paid doesn’t
mean he gets to treat patient anyway he wants. Is the health of a patient not
worth a few minutes of his day? He just wants the patient to get discharged so he doesn’t have to waste his time doing free work. It’s all about
the money these days. Even for the people that save lives.”
Dr. Nadim was angry but he
was also late. He left the file and walked out. He couldn’t concentrate from then on. Dr. Sayid
was his idol. When he thought about how his life wanted to be he looked at Dr. Sayid’s
life for guidance but what he had seen today disturbed him. It couldn’t be the
reason the men were talking about but if that wasn’t the reason, what was? Why
the sudden outburst? Why the unprofessional manner of disapproval? Why would he
do that?
Dr. Sayid didn’t know any of the things that weighed down Dr. Nadim’s mind that day and even if he did he wouldn’t have
cared. He couldn’t stop to pick up every little child that fell down. There were things
that one had to learn by experience. And also, it was 11 o’ clock and time to move to the
outpatient department. The OPD was always hectic. Doctors, patients, students,
attendants, laboratory workers, peons, everyone gathered under a single roof.
The examination room was more organized. The peon admitted one patient at a
time. The
doctor examined the patient made a provisional diagnosis and either prescribed
the patient some medication, told him certain investigation that needed to be
done or that he needed to be admitted. Dr. Sayid was proficient as always,
ignoring the tears and the gratitude, just doing his job. One after another
patients came and went. Tears, smiles, sorrow, joy. Every day the examination room
was filled plethora of emotions, every color displayed in a vivid rainbow.
After about fifteen or so patients an elderly man walked in. He looked anaemic,
malnourished and poor. He found it difficult to put steps together. His every
bone was prominent; his sub-cutaneous fat was non-existent. He was a picture of
poverty. The very thing that was wrong with this country, people living on meagre
morsels that accidently overflow from cups of content rich gods. The news was
not good either, of course it wouldn’t be. Dr. Sayid didn’t betray his
emotions. “You’re going to have to be admitted.” he said; nothing more, nothing
less.
The old man looked
crestfallen. Everyone in that room could have guessed what thoughts were haunting
his mind then. Money; a hospital meant bills. How could a man barely able to
feed and clothe himself afford a hospital stay? With the dejected look, which had
now become a fixture, the poor old man stood and before turning around to walk
away remembered to thank the good doctor. Before he reached the door Dr. Sayid
called out to him, “Excuse me sir,” he said, “I don’t know if you need it but a
free bed is available which I can keep reserved for you if you can come by this
evening.” He then nodded to one of his junior doctors. “Yes sir. Bed 14 of S.M.
-1 should be available by this evening.” The junior doctor replied. The poor
old man stood for a moment, powerless to move and then unable to control his emotions
turned around and walked out with tears moistening his faded shirt. Dr. Nadim,
an intern, still an amateur in the fine art of professional restraint, had a
wide smile spread across his face. Dr. Sayid in his calmest voice asked for the
next patient to be sent in.