Death: And Beyond

I was 3 days old, professionally, when death slapped me on the face for the first time and made me realize, what life is all about. So far I had seen the death from a distance, in terminally ill patients in the ICCU of our school's hospital, who were destined to die. And I didn't treat them, somebody senior, more experienced one, was managing the show of which, I was a distant spectator, hardly making any impression of black tragedy on my psyche.

Around 40 years ago, fresh from the medical school bursting at seams with theoretical knowledge, I was made to treat a 17 years lad, hardly 17 with a faint trace of masculinity on his upper lip gasping for his last breath. He was caught between the two vehicles plying in opposite directions twisting his torso. Far away from the era of MRIs, CTs, USGs we, in that ill-equipped [Very Very mild word!] Civil Hospital in the permanently drought-stricken area of Maharashtra could hardly lay our hands on single ECG machine that too after a lot of perusal and permissions, forget about modalities like Pulse oximeter or ventilator. I trembling with anxiety was trying to memorize the CRP and was doing my level best. The nurses brought up with typical government attitude were of no help either. After demanding one life-saving injection, they used to run around in all the directions without any result even after wasting precious minutes. So if for Inj. Adrenaline I had to wait for 10 minutes, which are very, very crucial, I had to wait for Inj. Effcorline for another 15 minutes. After struggling for 15 minutes or so, his body lay calm in front of my eyes. The life that was struggling to live gave up and went cold leaving me colder. Though not devastated in any melodramatic way I nonetheless was very shaken to the core after seeing the frugality of life from the close quarters. 2 days after the incident senior medical officer who performed PM on him, told me as if to reassure, 'My lad, I was 23 then, there was nothing you could have done to save him. He had so many internal injuries that it was impossible to save him at our level. So don't take it to the heart! '. So easily said for a life that did not get a chance to bloom.

So many deaths I had to certify thereafter, that though did not ask for it, unknowingly heart and mind started taking it, 'THE Death', more casually. Harsh words to digest but every doctor has to face this reality to preserve his sanctity to treat the next one in the line. 

Though I went through this routine more mechanically, unwillingly, some deaths lingered in the mind for long, long enough to make a dent somewhere inside.

Death is such a final statement, which can not be rewritten come what may, makes people around, react in such a complex manner that at times it becomes extremely difficult to handle the situation.

One spouse coming from extremely well settled middle class family was suffering from end-stage AIDS, and I was treating the patient right from the detection of positivity for HIV. Around the turn of the century when situations varied from total non-availability of Antiretroviral drugs to very expensive ones coming from abroad, leaving the relatives bankrupt after the death of the loved ones. It was extremely difficult to face the family day in and day out when death was certain. Though I had explained every detail to the near and dear ones I was pressurized from not so near ones, say uncle or brother in law, hinting at times about my incompetency bordering on to the negligence, to come out with the diagnosis. l was not allowed to disclose it medico legally. And there was furore after the death, which was inevitable. But I was not prepared to take the flack from the relatives including the near and dear ones, whom I have explained every detail about the disease painstakingly. After taking the crap for long, in desperation, I had to take the reasonable one aside and had to tell him in firm words that if the chaos does not stop at once I am going to declare the cause of the death and disease his father suffered from. It struck hard very hard. And within minutes the loud howling and wailing stopped along with finger pointing at the hospital and me. That was social stigma then and even now but I had to use it to save the situation and bring senses to the unruly family.

But the sincerity always percolates. So when the other spouse detected positive, the family rushed to me for the treatment. By then as the drugs were made available, the living spouse has completed more than 12 years of life fruitfully, seeing all the daughters getting married and grandchild from son. And I am grateful to the family who had immense faith in me to allow me to treat every member of their family thereafter, even when the first one succumbed to AIDS under my surveillance.

That's only one experience and there are many more. 

Over the years after every death, I sink a little more and at the same time brace myself to face the next one. Death of young one leaves a deep scar though it was destined, at times when octogenarian takes his last breath and family runs amok I don't get it. Just don't get it. They say and it's nature's rule that everyone has to face death some time or the other and other such blah blah, but when it confronts them in the face they behave as if everyone is immortal especially their very very old parents and death can not touch them. I feel, rather than the death they are afraid of the life they have to face after the void, that's more painful! Life IS a bigger challenge than death, which is a one-time affair and life.... it goes on and on and on.....