Sunday, February 26, 2012

The Unfair Affair


The best efforts have been made to keep the following narrative in the realms of fiction and should there be any transgression into anything in real life to anyone, it is to be regarded as remarkably co-incidental! 

There are two important characters in this story- Tom and Penelope! Their names appear oddly Hollywood-like by virtue of being changed hastily. The scene is set somewhere in a trauma centre. It is thus implicated that the two protagonists are medical folks. Tom is senior to Penelope. Only in this particular night, the two of them have duties together therein. The storyline requires that the lady intern be enthusiastic about learning practical work from the also mentioned surgery first year postgraduate trainee. One such task is the insertion of a chest tube and that becomes central to all that is going to be written about.
It is 10 PM when the Patient comes into the thick of things, brought in by four hustling attendants, one in each corner of his stretcher, where he lay down, absolutely miserable, somehow holding on to his life. When he is being carried along to the examination cubicle, he raises his head slightly to look at half a dozen doctors seated behind one big table and his imploring eyes stop with an earnest gaze at Penelope as if he comes to know, that very moment, that this lady will be his savior.
Tom does not observe any part of this because he has too many things at the back of his mind at that moment. On the other hand, Penelope becomes spontaneously aware of some strange feeling growing within her after she has eye contact with the moribund soul. She looks around at Tom to see if he shares the feeling that the patient has more chances of living than of dying. Tom merely raises his eyebrows, not in response to the question that was not put in words, but because he is wont to do so when words fail him. Penelope only understands that she has to follow Tom as he moves towards the Patient to examine him.
The Patient was at that moment restless, breathing with great difficulty and he looked too weak to fight for survival. The double impact by two bulls, one from front and one from back, to his chest, twelve hours ago caused him to be in this pitiable condition. Tom was murmuring technical terms to himself. “Absent breath sounds on the right side of the chest!” “Dull percussion note here”. “Hmmm! This is blood aspirated out”. “Hemopneumothorax!”. “Chest X ray shows that too!” He then turned to Penelope, “You need to put in a chest tube in the right side if this fellow has to breathe to live”.
Penelope: “But I have never put one”.
Tom just rubs his chin and thinks about a smile that he does not execute. He is positive about getting it done by her. In the next few minutes, he makes everything ready, all by himself. The kidney tray, the artery forceps, the needle holder, the suture material, the surgical blade, the local anesthetic, the betadine swabs, the dressing pads, the adhesive plaster, the scissors, the 32 F chest tube and the water-seal drainage bag with water filled to the initial level are all in place in double quick time.
Tom: “So, put it in now”.
Penelope does not hesitate at any time after that. As Tom kept on describing the steps, she did each of them as well as it could be done. The skin incision caused no pain to the Patient. He merely chanted “Allah!” a couple of times and then remained quietly reassured that “Madam is going to make it all right”.
She gently dissected the fasciae underneath and Tom could not help but be amazed at her skill of maintaining such meticulous tissue care. She demonstrated the musculature of the rib space and then made her way through it till it gave way in a matter of thirteen long minutes! A gush of blood spurted out as she punctured the pleura. She expectantly looked at Tom and only saw him vacantly staring at her hands. Both the gloved hands were totally covered in blood and along with the pool of blood that was steadily forming, drop by drop, underneath the dressing table, altogether presented a gory picture. In another second, when Tom looked at her, she just gravely shook her head intending to shake him off his thoughts; the ones that were in the back of his mind and had at that time come to forefront as well. This was because she needed further directions and Tom had stopped talking. Tom understood the growing rebuke. “Now put that tube in through the opening, tighten the U suture, close the remaining defect with mattress sutures, fix the tube, clamp the tube, cut the end, connect it to the drainage bag with the connector and release the clamp”
It took Penelope only eight more minutes to complete these eight swift steps! She remarked “Blood is in the bag. The swing is there. It is functioning well”
The sweat in her forehead was now slowly disappearing to leave a glow which could compare to that of her eyes that showed such great pleasure at the accomplishment of the task that Tom could feel equally satisfied about it. One affirmative nod from him said it all. And at the back of his mind, random noises all changed to a series of claps in applause.
The Patient reflexly coughed a couple of times to draw the attention of the two. Penelope, on one hand, was cheering within herself, intoxicated by the joy of success and Tom, on the other hand, was absorbed “in appreciating every frame of the dynamic change of expressions in her countenance, the movement of every fascicle of her facial muscles in creating those emotions, the dance of her eyebrows in synchrony with that of her eyes” and the whole thing looked very nice.
At 12 midnight, the inrush of patients had ceased. The half a dozen doctors were finally all seated together again, behind that big table. Tom took his seat beside Penelope. He had to muse upon the performance of the day and somehow convince Penelope to give him a treat for being a helping hand for all the joy that was an accompaniment with the “first time ever stuff”.
That singular process was proving much too difficult for him. It was his turn for a “first time ever stuff”.
Tom: “But I have never before asked you for one”.
Penelope rubs her chin and thinks of a smile and guffaws loud. In the next few minutes she is busy in disposing off every request from him for that treat, much unlike the way he laboured to gather things for her disposal earlier that night.
Penelope: “Tut! You will not get it from me at any time!”
Interrupted by hesitations, Tom kept on persevering to meet his end. He is one fellow who just hates to fail in his missions. Maybe Penelope was fully aware of this fact that she kept on saying “no” every time to the point of frustrating him to the end of his tether.
The unrelenting standpoint of Penelope was not understandable and required analysis. Tom began to wonder if it was simply for the sake of denial.
Saying “no” is so much more meaningful than saying “yes”, possibly because it leads on to so many more questions centering “why?”. The saying of “yes” raises no further questions. The former is an unfathomable phenomenon. The more you think of it, the deeper you enter until relevance may be lost of the original proposition. A “no” is never a simple “no”. Probably, it is preferable just for the sake of this. It coufounds! It is profound! It elevates the person’s importance in his or her own eyes.  A “yes” is only routine!
The sweat grows in his forehead with the solemn disappointment of having failed after trying so hard for as many times as to lose count. At 2AM, he gives up and rises to retire to the Doctor’s room to have a nap. As he leaves, he gives Penelope a wry smile.
            The events of the night set in motion the language processing domain in a hereto silent observer, Rov, who also happened to be doing duty in the same place. The usually inarticulate Rov suddenly transforms into his alter ego and begins to spin a web of words. In two hours, he has written a story about things that he felt were unjust due to their incompleteness and in doing so, he seeks to highlight the skewed balance of interactions suffered by Tom as rendered by fate. He calls it “The Unfair Affair


Dr.Mayurakshi said...

-He merely chanted “Allah!” a couple of times and then remained quietly reassured that “Madam is going to make it all right”.

That was hilarious! The chapter headings are as imaginative as they come. And I've a nagging suspicion that the Penelope in the story has a name that ends in 'O', since we interns heard the surgery residents everywhere gushing about her chest tube insertion ability! :)

I too got to insert a chest tube in the ward in a boy who was recovering from chicken pox too! So, Ema da told me to do it, trying to mask his reluctance to do the job and encouraging me in learning surgical skills. I did it despite profuse sweating, hand tremors, mutinous looks from the boy's father and Ema da's sermons of "Don't ever show the patient that you are nervous!" (which I'm sure the boy understood). But it went well, and I felt a sense of accomplishment. That was worth the risk of chickenpox!

Rov said...

Ema cherishes high political ambitions and this is one good example of his skill level! He is quite an affable guy however...As regards your guess, Azho Kezo must be the name in your mind but if that it so, you may make another try with possibly a more correct name! ;)

Dr.Mayurakshi said...

I don't know any one else except for the above mentioned, so my curiosity will have to be settled with the Hollywood pseudonyms!