November 11, 2011
The 100th day of my stay in India. The date 11.11.11. Friday. Surgery. I was up by 4:30 am. Ensured bowel movement...twice. Achan was my bystander for the previous night. Exactly 11 years ago on the 11th of November, 2000, the same doctor had performed an open unilateral hernia surgery on him. At that time, Achan and Amma had inaugurated room 101 of the hospital.
By 6am, Sheela sister (nurse) arrived with a glucometer. My 'ouch' was a little too loud when she pricked the left ring finger tip for a drop of blood. "Ingane karayano?" (Should you cry so much?) mix of surprise and sarcasm in her voice. I grinned sheepishly. RBS 143. I would be given insulin during the surgery.
Sheela sister speaks excellent Malayalam, but doesn't look like a Malayalee. Later, on Sunday, when Achan met her at the newspaper stand outside the hospital, she would tell him that she is from Nepal and they had settled in Kerala 10 years ago. She wore a badge over her blue uniform that said "III Year GNM". On the following Monday, when two sisters, both named Soorya, were busy taking my blood pressure, I would learn from them that GNM stood for General Nursing and Midwifery.
Aneesha sister came by 7am to perform the all important task of inserting the drip/injection needle that would be a fixture to my left palm for the next couple of days. Achan had been all praise for this system that prevents multiple prickly injections. Just like hernia, I have certainly inherited a mild case of hyperalgesic trypanophobia (thanks wikipedia!) from Achan.
Aneesha sister carefully shaved the back of my palm with a handheld disposable shaving blade. I wondered why this had never occurred to the overzealous Murugan. "kuthum munpe parayane sistere" (please tell me before you insert) I tell her while looking away. "aadyam vein kittate" (first let me find a vein) she quips. Unfortunately I hadn't inherited exceptionally visible veins from Achan. In his case, it is possible to check his wrist pulse simply by looking at the throbbing.
Well, as part of full disclosure or may be TMI (whichever way you want to look at it), I do have visible veins somewhere in my body, but definitely definitely, I never want any needle anywhere near there.
The 'II Year GNM' assistant ties a clear tube on my wrist in an attempt to coax the vein out. Aneesha sister gets sterner at the elusive vein. She starts slapping the back of my palm. "kitti kitti" (got it, got it) she exclaims after half a minute. "Kuthukane" (Inserting) she announces immediately and goes in before the vein disappears. A stopper and cap come on the tube. All my antibiotics and fluids for the next couple of days will pass through this needle. Obviously they must be biblically not rich at all.
I sit up and notice the tiny air bubble between the miniscule amount of blood that had accumulated in the injector. I am not allowed to drink even water except half a glass that was used to wash down a couple of tablets. Amma arrives looking fresh. Her sight is always a relief. Dressed in white mundu, I wait.
8:30am, Divya sister knocks on the door. "Pokamo, Arune?" (Shall we go, Arun?) I head bob, smile. Wave my needle infused palm to my parents and walk to the operation theater, shirtless, flaunting my hairless belly.
Behind the dark glass doors firmly warning of "restricted access" to the operation theater and labor rooms, is a dark corridor. To the left as soon as one enters is the intensive care unit. I am asked to wait outside there on a bench. I see patients fresh out of yesterday's surgery lying on the elevated beds of the ICU separated by curtains. Some have oxygen masks on. Some are sleeping.
"Cleaning onnu examine cheyyane" (we need to examine your cleaning) Divya sister says as she brings me the gown and another white 'dhoti' to wear. The gown is back open and only extends till the hips. I had expected a longer one that would go down till the knees. Damn them misleading Hollywood movies! I hand over the 'mundu' I was wearing to the sister. An attendant takes me to the tiny bathroom at the corner of the corridor to examine Murugan's good work. Completely satisfactory.
I am led onto a section buzzing with activity. Men and women in green scrubs and masks walking briskly, dutifully. "Sorry about the construction noise, Arun" I hear a familiar voice. It is Dr. Ashwathy. Unmistakable sparkle of her eyes even though the rest of the that pretty face are hidden by the green cap and green mask. "Oru bed kodukku. Fluidsum" (Give him a bed and fluids) she orders a younger scrubs-wearer.
The construction of a new floor is taking place in the hospital. The whirring of the concrete cutters, stabbing of rivets and electric drills penetrate the centrally air-conditioned facility. I watch the fluid drip into me slowly. I feel sleepy. A portable curtain is to my right. 3-4 beds to my left are empty. Steel almirahs with glass doors line the wall facing me, stocking gloves, masks, hairnets. Two of them have fading labels of "mens cap" and "womens cap" written with black markers on white duct tape.
Couple of nursing students, I presume, play a little quiz ignoring my presence. From a thick pocket book, she asks him something. He 'hmms' and 'aaa's for some time and then answers correctly. Somewhere in the corridor a radio is tuned to an FM station that is playing some of my favorite Mohanlal songs from the late 80s and early 90s. "Paadam pootha kalam" followed by "alimalarkaavil pooram kanan". I take it as a good sign for the day's start.
"Pokam" (Lets go) I open my eyes hearing a male nurse. He carries the fluids bottle. "bathroomil pono?" (Do you want to use the restroom?) he asks as we pass it. I head bob: no.
The operation theater was nothing like I had expected. Again, double damn you misleading Hollywood and Indian movies!
First of all, the room was enormous. 20ft by 25 ft, I guess. The entire wall across from the door was a glass window that flooded sunlight into the room. At the center was a t-shaped bed. I was to assume Jesus pose horizontally on it. I counted at least 5 doctors in the room before I lied down. Near the two side walls where 36" LCD monitors on roller tables. A single round arc lamp hung on top of the bed. I spread my arms onto the side extensions of the bed.
"Did you sleep well, Arun?" Dr. Ashwathy asks as she approaches my left palm ready with a syringe. Dr. Haridas arrives. I smile at him. From the shine in his eyes behind the glasses, I gather that he smiled back too. I look at the clock on the wall. 9:09.
Black out.
"Arun...." I hear a faint voice I haven't heard before.
I try to open my eyes.
Hazy.
I see a female figure in sari walking away.
My brain tells me the man walking towards me is Achan.
My eyes close.
Open again.
Blur.
I can make out the form of my youngest uncle. "Maama" (uncle) I try to call. Throat is dry.
The next figure who comes near me is more recognizable. "Valiyamma" (Amma's elder sister) I hadnt expected her to come to the hospital. I was happy that I recognized her.
I tried to fold my palms into a Namaste but the fluids tube made it difficult.
"Rest edutho, urangikko" (Take rest, sleep) Valiyamma said.
I realize that the first figure I hadn't recognized was Amma. Achan told me later that she complained that I hadn't recognized her.
"Samayam enthayi sistere?" (What is the time, sister?) I turn my head and can see clearely the spectacled nurse with braces. She wasn't wearing a mask. "1:15" she tells me. "Operation success aayirunno?" I ask."Valare nannayirunnu. ippo urangikolu" (It went very well. Sleep now)
I drift back to sleep. For the next hour, I wake up intermittently. I have dreams about the urgent need of getting surgery done to fix my hernia. Then I would wake up to realize with relief that it is over. Years ago I used to get similar scary dreams about missing examination dates and waking up to realize that it was already vacation time.
I felt happy. Just a little soreness in my tummy and abs. I was even borderline arrogant about my painless condition.
Sister dutifully changes the fluids bottles every time they empty. I need some adjustment of my palm to make the drip smoother. The needle insertion wasn't perfect. My lips and mouth are dry. A junior sister presses a few drops of water into my mouth from a bubble type bottle.
Since mine was the first operation of the day, I occupy the first bed in the ICU. Right across from the door which opens and closes every few seconds with the busy-ness an ICU naturally has. A huge violet thick cloth curtain with floral pattern hanging from the rod near the ceiling separates me from the next bed. A tube light shines brightly on me.
Around 3pm, I feel like urinating but dismiss it and drift back to some more sleep. HUGE mistake as I would realize in a few hours. Occasionally the window of the ICU is opened for bystanders to see the patients. Amma was always there. She would gesture me to sleep.
"urakkam ellam poyo?" (Are you done sleeping?) sister asked me around 3:30. "kidannu sheelam illa sister" (I am not used to lying down for extended periods, sister) I tell her. "nadakanno?" she asks ready to remove the side railings of the bed. I thought she was joking. Very painfully, I realized later that she wasn't. I should have walked then. I ask her if I can get something to read.
"Bharathaparyadanam, kutty krishnamarainte. roomil und" (Bharathaparyadanam by Kutty Krishnamarar. It is in our room) I tell her. She telephones. In a couple of minutes, Achan comes with the book. I tell him I feel fine.
I couldn't read more than two paragraphs though of the heavy duty Yudhishtira versus Arjuna mudslinging after Yudhishtira's shameful defeat at the hands of Karna. My eyes are too tired.
5pm. The atmosphere in the ICU reflects that of any regular office closing time. Duty nurses are changing. The braced-spectacled one leaves. I never got to ask her name. May be I did and then forgot in my general stupor. The slender, fair sister Pratibha takes over. There are at least 5 more post-surgery patients in the ICU. A young man who had come for some minor procedure was let off earlier in the afternoon after an hour of observation. Through the window his relatives had talked about catching a 4pm train.
3-4 doctors are in the ICU looking at the patients they had operated on earlier in the day.
"Aruninte lips valare dry aayalo" I recognize Dr. Ashwathy behind the mask.
"drip mathrame ullalo doctore. vellam kudichila" (It has only been fluid drip all day, I haven't had any water) I explain.
"Urine poyo?" (Did you pass urine?) she asks.
"Illa" (No).
"5-6 hours aayalo. urine pokan try cheyyane" (It's been 5-6 hours. Try to urinate)
Pratibha sister brings me a urinal bottle. Dr. Manoj and Dr. Shyam who are the junior docs who sit on either side of Dr. Haridas to form the holy trinity at the Out Patient room are also around.
"ithoru hostile environment aanu, Arun. tube light off cheyyano. relax and try" (This is a hostile environment, Arun. Shall we turn off the tube light? Relax and try" Dr. Manoj instructs.
It was indeed a hostile environment with perpetually opening door facing me, a bright tube light and no curtain to go around my bed. I position the urinal and try to think about all the waterfalls in the world. For the first time I realize that my scrotal sac is heavily and tightly bandaged. Just when it looks like the trick is done, some new person opens the door. All the waterfalls dry up. Global drought.
"Aara ee ICU-il bharathaparyadanam vayikunathu?" (Who is reading a book in the ICU?" An unfamiliar voice. The owner of the voice comes to my bedside. I don't recognize him. "I am Suresh Babu. Anesthesiologist. Any pain?" he asks. I tell him I just have minor aches but my major worry is about urination now. I heard the word catheter mentioned. I am sure that raised my blood pressure.
The genial Dr. Suresh Babu engages me in a relaxing conversation. I tell him my brief bio. He was working in Muscat and Ireland before coming back to India.
His elder daughter is studying at IIT Powai. I get upbeat about my alma mater. He is worried about not having any relatives in Mumbai to act as her local guardians. I tell him I know the best people for that job. I promise him the contacts of Vijayalakshmi aunty and Rajan uncle as soon as I am out of the ICU. We talk for 15 minutes or so. No sign of urine. "Relax and have a black coffee. Don't stress about the urine. You don't need a catheter. It is not good." he consoles as he leaves.
I was sure I made a new good friend.
My bed is raised. Amma brings me a tumbler of black coffee. I enjoy a few sips before I get a vomiting sensation. Pratibha sister rushes in with an injection. Sensation subsides. Sweet coffee.
By 8pm, Dr. Manoj checks on me again. "There shouldn't be any pressure on your bladder today. That is why we might resort to the catheter. But don't worry about it now. Keep trying."
I am not relaxed anymore. I curse myself for not finding out about this urination criteria area. For some vague reason my mind keeps repeating the word catheter. I stare long and hard at the urinal. Even in the healthiest of times, I haven't paid this much attention to my penis. May be that's a lie!
A gnawing worry grows in the back of my mind....but nothing could have prepared me for what turned out to be an unending, excruciating 100th night back home in India.
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