I looked up as the ward bell rang. She was wearing a saree today and that simply added to the elegance. Her long braided hair still retained the last drops of a morning shower. If I had met her at a place other than the hospital, I would never have guessed that this tiny person was one of the best Pediatricians around. The consultant placed her bag on the table and smiled my way as I wished her a good morning. It is simply beautiful to see her smile, full of love and concern for you. But today,something was missing in it. I couldn’t quite put my finger to it. But I knew. Something was on her mind. She had returned after two days leave. ” Sister, please bring me V’s chart,” She requested the head nurse. And suddenly I had a glance at the shadow looming over her thoughts.
From here on let’s call “V” as Vinay, though that was not his name. He got admitted one evening from the OPD. A thirteen year old, he was slightly on the heavier side of the weighing scales. He had Type 1 Diabetes Mellitus and was admitted with ascites and pleural effusion. Treatment was started as per clinical and laboratory judgements. He was with us for two weeks. It is an undrrstatement to say that the place grew quite fond of him and his mother. His condition improved initially but after a week, he started on a downhill course. Alternative diagnoses were considered. More tests were sent. Medications were changed. Doses were adjusted. His parents were informed about the limitations of the set up we were working in and were advised to take him to a higher center. But they decided to continue in faith. I had watched as the consultant tried to make the best decision for the boy. She would come by the ward even when she was off duty to help with his treatment. She had discussed the case with specialists and was doing all that was in her power. How come I never thought of that! I would often wonder as she pulled out more and more tricks from her goody bag of knowledge. But in the end nothing could trick the disease to surrender. By one Saturday evening his condition had deteriorated and his parents decided to take him to a higher center. We were in contact with the center he was taken to. And after two days we received the news that he had succumbed to his illness.
I watched in silence as she went through his file. I was sure the thoughts of Vinay had troubled her the last two days she was on leave.What was going on in her head now?,I wondered as she flipped the pages. Maybe we could have done more? Maybe that one investigation we wanted to do but decided against would have clinched the diagnosis? What if he had come a few more days earlier for treatment? What if he was taken to the higher center as soon as advised? These were some of the thoughts in my mind. And somehow I could find them resonating in her mind too as she gave the file back to the nurse. Her head was slightly bowed low as she proceeded towards the first bed for the morning rounds. I wanted to give her a hug and tell her that she had done her best. I watched as she tactfully placed the stethoscope over the chest of a playful 3 year old. She listened to his heartbeat as he tried to grab it with his tiny hands. She gave him a pat and smiled. And we continued the morning rounds. Like nothing had ever happened.
Sometimes, this is the hardest part of being a doctor. People die. That is the natural order of life. But every doctor wishes he or she could have done just that one thing…just any thing to make that heart beat again. You get involved with the patient and his family as they fight death. And when they lose the battle, you feel the pain of the loss too. I remember the first time I faced the death of a patient during internship. I was inconsolable for hours. The second time, I shed fewer tears. By the third, my eyes were dry and so was my heart. But even now, the contact with death sends a chill down my spine and my soul. And yes. Then there are all those doubts of what more could have done …those doubts loom over you and try to engulf you till your eyes and mind are filled with the face of the next person who needs your help. And ofcourse,the inferno of death gives you a glimpse of your dependence on the Greater physician.