November 12, 2011
The night that never ended dawned. All three of us, Achan, Amma and I had precious little shut eye. I am given the first dose of antibiotics promptly at 6am. The fixed injection needle starts to turn sore after 24 hours. But I have bigger worries on my mind.
By 7pm, Divya sister arrives and panics to find me still lying down.
"Ezhunelku Arun. Ingane thanne kidakunathu kanda doctor sherikkum njangale chadikkum. ennittu nadaku" (Get up, Arun. If the doctor sees you lying down like this he will scold us. Get up and walk).
As she comes by the left side of the bed to help me up, I remind her of the urine bag that is fastened there.
"Ithum pidichondu nadakanam. Medical collegile okke patients ithum thooki roadil nadakunathu kanditille" (You should carry this and walk around. Haven't you seen the patients of the Trivandrum Medical College walk around on the roads carrying these?)
As I try to get up, I am given instruction of how to do it. "Turn to your right, press your left palm down on the bed frame for support and lift yourself up." It is an impossible instruction to follow when your abdominal muscles are out of commission. Two sisters and both parents help me sit up. A violent cough ensues. It feels like my entire intestine is tossing up and down inside. "Hold your stomach firmly when coughing". I obey.
"Rathri muzhuvan bhayankara pain aayirunnu sistere. Avan urangittila" (There was major pain for the whole night. He hasn't slept) Amma reports remorsefully. "Catheter mattatte? Pakshe poyilengil pinneyum idendi varum. Athukondu oru 24 hours athu idunatha nallathu" (Shall we remove the catheter? But then if urine doesnt go, we'll have to reinsert. So it is better to leave it on for 24 hours) That same mantra repeated the umpteenth time. I look tearfully towards Amma. 24 hours of this would be unbearable.
Amma goes downstairs to find Dr. Haridas as soon as he arrives. He comes to the room by 8:30am. By then I have managed to walk couple of times up and down the room carrying the bag like 'patients of the Medical College'. The doctor finds me drained and seated on the chair. He is accompanied by the two junior docs, Shyam and Manoj, and Divya sister.
I lie down. He takes one look at the catheter and asks, "Who did this?"
"Duty doctor" answers Divya sister.
"Dr. Raj" I remember.
"Who is he?" doctor asks his juniors.
"new appointment"
Dr. Haridas asks for a syringe. He proceeds towards the removal. "there was no need even for a 10ml catheter, why is he given 30ml, oh god, these people" he exclaims as he deflates the bubble inside.
Then in one quick motion the tube is yanked out of me.
It feels like a snake slithered out of me.
Quick intense irritation.
I let out a very vocal "aaaah".
"He is very sensitive" remarks the doctor.
For him these daily morning patient rounds are instructional sessions for the juniors.As he hands the removed catheter to Divya sister, she hesitates to accept it and then does it unwillingly with two fingers of her left hand. Granted it is a recently removed catheter, but her faltering infuriates the doc. "Accept it with both hands," he orders in stern voice, "you are committed to a service. That is your profession. Junior nurses are supposed to learn by looking at you."
"And look, the bandage has also been displaced, it needs to be tight" he examines me. "This needs to be tightly bandaged, give me bandage" Divya sister realizes that there is no bandage in the cart. She runs out of the room to get some. "Enthu cheyyana?!" (What to do!) Dr. Haridas throws up his arms annoyed.
"What is her name?" he asks the junior doctors. Both of them don't know.
"You don't know the name of the nurse who comes on rounds with you. Do you think that is how it should be?" he scolds them.
I don't have the energy to tell him her name. I am limp.
Divya sister returns in a minute with a roll of cloth bandage and the senior-most nurse in tow. Dr. Haridas takes the roll from her and begins to unroll it.
"Where is this from?"
"From D block Sir, we are out of bandage in C Block"
"You know that this needs to be 10cm. How much is this? This is hardly 5cm. Are you teaching them this?" he asks the senior nurse.
She stands speechless.
"Where did you work before this?" he asks Divya sister. She mentions two hospitals in the city.
"Look, I can give you all these instructions in the privacy of a room. You don't have to feel ashamed. I am saying all this now so that it will be effective and do your future good."
He bandages me very tightly. Because the bandage is only half the requisite width, it virtually becomes a twain running tightly around my hip. This would make standing up and walking difficult for me for the next 48 hours. But it works out great to reduce the swelling.
Dr. Haridas asks me to cough after turning my head to the right and left. "Perfect, perfect" he remarks. "Did you have bowel movement?"
"Not yet"
"Do you need a small enema? It will make you very comfortable"
"No doctor"
I am terrified of another tube going inside me. He sees the fear on my face.
"Don't worry about it. It is perfectly alright even if you go only tomorrow. You have hardly eaten anything. Now on eat proper solid food. All that I have done inside you is a mechanical fixing. There was nothing biological about it. So there is no need to make any changes to your food habits. But I will send a dietitian over to discuss the blood sugar issue with you. Usually I let people go after 24 hours of surgery, but Arun you stay another day. You will clearly feel the benefits later."
I fold my palms and bow to thank him. Without question, I owe the rest of my life to this good doc.
By 9am, a sister comes to inquire if I have passed urine. I look helplessly towards Amma. Amma transforms into a tigress and storms out of the room to the nurses' office. Apparently she gave them a piece of her mind about how idiotic it is to expect a human being completely drained of all urine just half an hour to urinate again.
I drift off to sleep to make up for the lost hours of the night. By 11am, I wake up. I need to use the restroom. I call out to Achan. Baby steps towards the commode. The extra spacious bathroom doesn't look so appealing now.
Walking slowly, naked, with a tight white bandage around my scrotum that is supported by a twain like thread around my hips and a clean shaven bulging belly, I must have resembled a senescent ancient Hindu Advaitha sanyasi.
A burning sensation rises.
10, 20, 30 seconds pass.
The first drop of urine comes out.
"Achaaaa" I yell in agony.
It feels like acid.
I lean onto the wall.
Achan holds my shoulder and gently pats my back. "onnumila, onnumila" (it's ok, it's ok) he says with a quivering tenderness.
I don't have the guts to pass more urine. But I have no option. The fear of catheter reinsertion outstrips the stunning pain.
I relax the muscles.
Urine drips out like molten lava.
My legs go weak.
I continue wailing. A minute that felt like a lifetime.
It is obvious that I have severe inflammation in the tract.
I walk back from the bathroom much relieved. "Ini catheter vendalo, alle Acha?" (No need of catheter anymore, right Acha?) I seek confirmation. "Enthinu? Ini vende venda" (For what? There is absolutely no need anymore) he tries to cheer me up.
I sink back onto the bed. Breathing heavily in relief. Amma had been sitting across from me, on the bystanders bed. She had heard my weeping inside the bathroom.
One look at her and I get reduced to a weeping baby. Tears flow profusely down my cheeks. A lump chokes my throat. She rushes over and hugs me tightly. She kisses me on my forehead. "Potte, potte, saramila, saramila" (Let it go, let it go, it's fine, it's fine) she says. "Ninakku ee mupathimoonnu vayasu samayam kollila" (Your time at this age is not good) she tries to provide an astrological explanation as if superstitious logic could reduce my suffering.
I don't need it.
Just her presence near me does me good.
"Come on, nephew, let us get up and play some football" my second youngest uncle tries to lighten the mood.
"I could have, but my balls are tied up" I reply.
Everyone laughs. I think they are relieved that my grumpy, worried self of the last 12 hours is disappearing.
The insulin injections from the previous day drop my RBS to 87, so they are stopped. I have wheat gruel for breakfast, oats for lunch.
I urinate 4 more times during the rest of the day. Incremental reduction in the pain each time. Achan was there each time encouraging and consoling me. The second time I rested my head on his shoulders through out.
By the third time, the flow is more forceful but this returned the pain to initial levels with more inflammed regions getting touched by the stream on its way out.
After the last time, Achan tells me, "You didn't cry this time. Tomorrow you will be absolutely fine"
In the evening Dr. Suresh Babu stops by. I tell him the catheter crisis. "It was unnecessary," he says apologetically, "30ml was absolutely not needed. The inflammation will go away soon. Don't worry". The mistakes during the move from ICU to the room are also recalled. "I am sorry," he says genuinely, "but there are such people anywhere you go." Amma promises to call Vijayalakshmi aunty as soon as she gets home so that the doctor's daughter can have a local guardian in Mumbai. He invites us to visit him home. We extend him the same invitation.
By the time I finished dinner of wheat dosa and scrambled egg white, Seenu came with her dad, Kurien uncle. I hadn't seen her in person for 6 years though we have been close friends very much in touch. She had just returned from a semi-spiritual trip with her parents to Jordan, Israel, Palestine and Egypt. "You look as young as you did in 2004," Kurien uncle compliments me. He recalls the case of a relative who had multiple hernia attacks. "He used to say his body is like an old torn tshirt with new holes appearing every now and then." Achan, Kurien uncle and my youngest uncle embark on a discussion about corruption. Seenu had a 5 am flight to catch back to Delhi, so they leave in half an hour.
The delivery of the last dose of antibiotics for the day becomes tougher as I begin to have swelling around the needle in the palm. Dr. Haridas had ordered a dose of valium for the night to let me sleep well. Also two heavy duty fiber tablets to move those bowels.
"Call me whenever you need in the night," Achan tells me as he lies down on the bystander bed. Amma goes back home.
I sleep as soon as my head hits the pillow at 10pm.
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