Code Blue

Something’s not right

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“I don’t feel a pulse.” Instantly, I feel my own double. I know what I have to do, but only if I can focus on what matters the most right now: keep the blood flowing enough to keep the heart and brain alive. I glance at the monitor and take a deep breath, trying to block out the mother’s terrified screams while swallowing my own horror at the unsightly shade of purple my patient is turning. I look directly at the nurse practitioner standing opposite me and say, “Start compressions.” Then I turn to the bedside nurse and say, “Call a code, and get the crash cart and defibrillator.” I put my finger on the child’s femoral pulse and feel the steady thump-thump-thump of blood flow with each compression, three times the rate of the push-pause-push rhythm of the mechanical ventilator.

This is the job: facing the worst of situations with the calmest of demeanors. Forcing your brain to remember what you know when all your body wants to do is stay frozen. We are trained, through endless repetition, to overcome the urge to succumb to the panic of adrenaline, and instead channel its rush into productivity.

Seconds later, the room is filled with people rushing in to help. Someone helps me get a backboard under the child. Someone cracks open the emergency drug box and begins drawing up code doses. Someone disconnects the ventilator and takes over the child’s breathing. Someone sets up the defibrillator and places the pads on that little lifeless body. Someone leads the mother outside and stays with her to give her updates. Then another wave of people floods the room; this time, an incredible team of pediatric critical care providers I work with on a daily basis. With one glance at the patient, one of my PICU nurses turns to me in dismay and gasps, “Oh my God, that’s our baby!”

Yes. That’s our baby. They are all our babies. We may not share their DNA, but we know what music makes them happy, what position they find most comfortable and how they like to be held. Even the older ones are our babies; we know which superhero they emulate, what food they get excited about and what books make them forget their pain. Yet somehow, in overwhelming moments like these, we must efficiently control our emotions to be able to save these babies we’ve spent countless hours caring for.

As our PICU attending takes over leading the code, I cycle into the short line of chest compressors and place my hands on that tiny chest: unnaturally cold against my fingertips, yet still soft enough to spark dread that I might break its bones if I use too much force. With every compression, I am acutely aware of the bruise my thumbs leave on that small sternum and the trickle of blood that has begun to blossom at one nostril. I choke back tears and remind myself of the goal of all our efforts: whatever it takes to keep the heart and brain alive. Several rounds of compressions and emergency drugs later, our efforts have proved to be in vain; there is clearly no heart or brain function left, and we are now left with the task of delivering this news to the distraught family sobbing outside the room.

How are we to do this? How do we grieve with our patients’ families without breaking down, but also without appearing to not care at all? How do we create the most comforting environment for families to share a few final private moments of grief on the worst day of their lives? How do we suppress our own emotions enough to be able to get on with our day but still acknowledge the loss we feel? And then there’s the next challenge to face: did we miss something? Could we have prevented this disaster? I am fortunate enough to be part of such a fantastic team of critical care providers that the answer to that question has always been “No” so far. And though this fact does provide some consolation, it doesn’t take away the pain. Not just because we’ve all spent countless hours of tireless physical and mental labor trying to keep them alive, but because, like I said, they are all our babies too, and we have loved each and every one of them.

Rising from Ashes

Last week, I had the privilege of attending a support group for burn survivors. I got to spend the morning with a bunch of people who had been through unimaginable pain and then fought against their own bodies to stay alive before emerging victorious. These were people who had been left severely scarred – both physically and psychologically – and probably relive their trauma every single time a candle is lit or electricity is used. Somehow, instead of wallowing in self-pity, they found it in themselves to come together to see other people through similar experiences.

I bore witness to the bond amongst survivors of similar trauma, and between patients and their caregivers, but what really stood out was the bond this group shared on a raw, emotional level simply by virtue of being human. All morning, I only heard words of wisdom about conquering fears and overcoming hardship, and only saw tears of gratitude about heroism and survival. The room was brimming with encouragement and support, not just amongst themselves, but even for me – a young physician who had no business attending this meeting other than as someone who occasionally cares for patients with burn injuries.

To say that I haven’t met a more inspiring set of people would be a gross understatement. While I swore to maintain confidentiality about the details of this meeting, I would like to thank them for sharing their stories with me, and more importantly, for showing me that even the most intense pain can be temporary, that the worst scars can be reminders of immeasurable courage, and that we can all make it through what seems impossible – if we only have the desire to achieve, the grit to sustain, and a little help from our friends.

The Sound of Silence

Awake in a city that never sleeps,

With blinding lights and busy streets,

Surrounded by people, yet lonely inside:

A fact I put on pretences in order to hide.

 

A blur of faces, a haze of familiarity …

Still my void deepens into a bottomless cavity,

Because no one pays attention as I weep—

Lonely, deserted in the City of Dreams.

 

I desperately shout out for a little concern

And begin the endless wait for some care in return.

A sound finally penetrates the veils of indifference,

But it’s only the deafening sound of silence.

 

My silver lining dissolves into an ocean of tears,

Marooning me on an island of countless fears.

Right in the middle of the crowd I stand,

Yet no one bothers to lend a helping hand.

 

People I call friends blindly hurry past.

Nobody cares … but no … at last …

A concerned silhouette gently approaches me

And it’s not just a shadow from my dreams!

 

He wipes my tears and tenderly says,

‘I can’t be around all the time, everyday.

So wait for me when you think no one cares …

It may take some time, but I will be there.

 

‘And during your wait don’t let your faith elope

With the essence of your existence— your ray of hope.’

Touched, I asked,  ‘But why do you care?’

‘I am the true friend you thought was not there.

 

‘I know that lonely feeling— I’ve felt it too;

And the one person who stood by me was you.

No, I haven’t forgotten that, my dear friend.

You have both you and me until the end.’

 

Now the sound of silence suffocates me no longer.

It signifies your approach and makes me feel stronger.

Thank you, my friend, for making me see

That I not only have you— I also have me.

Bloodbath

Disclaimer: This is a fictional account set against the backdrop of a true event of violence, and contains graphic details in accordance.

Tall and thin, with cascading golden hair. It amazed me just how much she resembled my daughter … well, except for the fact that this one had the city stamped all over her. She was wearing a loose black top that had been cropped to bare her midriff. The light caught a glint of a bright blue butterfly-shaped bellybutton piercing above the waistband of her tiny denim shorts. Beaded slippers adorned her delicate feet, and I noticed a small heart tattooed on the inside of her right ankle. Each nail on her left hand was painted a different neon colour, and the ends of her hair were dyed a bright shade of purple. I decided to call her Angela, for obvious reasons (yes, even with the clear rebellious streak). Despite the blood, the half-melted face, and the missing right arm, I could tell that Angela had been a beautiful young girl.

I must have stood there observing her for a few seconds (although it felt like an hour at least) before my own beautiful blonde girl burst through the door, screaming. As I turned to face Anya, she caught sight of Angela and screamed, if possible, louder than before. Eyes wide with terror, her gaze shifted to the person-shaped hole in our kitchen ceiling. This was when I noticed that Anya was covered in blood. I could only assume that there were more people that had somehow been blown up in the sky.

Suddenly, time seemed to double its speed as the shock wore off and panic kicked in. I felt an overwhelming urge to run, although I had no idea what I would be running from. I only knew that corpses were falling from the heavens and we had to get away. I grabbed a howling Anya by the wrist and stepped outside our cottage, only to slip in what must have been Angela’s blood, because her other arm, with its neon-coloured nails, cushioned my fall. Apart from this arm that I had ended up sitting on, my yard was now home to two unmatched dismembered legs and what looked like a severed head, all in a large pool of gore. I felt my vision grow bleary as tears— of fear and horror more than anything else— flooded down my face too. It had quite literally rained blood on us that morning. And we couldn’t fathom why.

***

Nobody survived it. How could they, when it was not a crash landing but a deliberate act of mindless violence? A commercial airplane had been shot down by militants. Who would ever have thought? There was to be an investigation, of course, and rightly so. But until then, our fields were to be fertilized by the decaying flesh of those unfortunate passengers on that doomed flight. I could tell that none of us was going to partake of this year’s harvest.

***

I want to look beyond the horror we faced; to see that all around the globe, hundreds of people’s lives have been devastated by the loss of the persons whose mangled remains now lie scattered in our fields. Yet I want to explain to the world somehow that although we did not lose family or friends in this catastrophe, we are no less shattered than them. I want to be able to step out of the house without collapsing into tears at the doorstep. I want my Anya to stop having hourly flashbacks of bloody rain. I want to stop waking up, drenched in sweat, from nightmares of a maimed Angela lying dead on my kitchen floor. Most of all, I want to pack my things and move— far enough from this place that the faint smell of burnt flesh no longer lingers in the air, but not far enough to have to board an airplane.

Not everyone can afford the luxury of running away, so we must steel ourselves and resume our daily routines in the midst of the carnage. And of course, get the hole in our roof fixed … but the hole in our souls? That’s another thing altogether.

Appreciate

All it takes is a few moments of your time

I’ve always wondered what it is about random compliments that have the power to make your day. They rarely extend beyond your appearance or say anything substantial about your character, but they still leave you feeling warm and happy.

Today, I realized why: they are given freely, without hidden intentions or expectations. A stranger recognized something beautiful in you, and it was important to them that you be made aware of it. It is a wonderful act of emotional kindness we could all stand to practice more. All it takes is a few moments of your time, and a tiny bit of courage.

A Cold November Afternoon

Something was wrong.

Amelia shivered as a gust of wind swept across the deserted yard. She rubbed her hands up and down her bare arms in a vain attempt to trick her body into believing she was warm and comfortable. She stood on to her tiptoes and craned her neck in the direction of the tiny gate. Still no sign of Chris. No sign of anyone, actually. Not even the priest. You’d think at least the man of God officiating the wedding ceremony would show up at the venue on time. She found it absurd how quiet the place was, when in fact it should have been filled with the sound of music as Chris’ brother walked her down the aisle.

Admittedly, the chapel was far flung, to say the least. But everyone had been given precise directions. And Chris knew. Yet there she was: a young girl standing all alone at the doorsteps of a locked chapel in her wedding dress, waiting for her groom, guests and minister to arrive.

She took off her veil and wrapped the flimsy material around herself— once again, not a very helpful attempt at keeping the cold from raising gooseflesh down her arms. “They’ll be here any minute.” She whispered herself as her teeth chattered. “It’s not possible for everyone to forget, or lose their way and give up. And Chris will definitely come.”

Her legs began to ache. She considered sitting down but quashed the idea almost instantly— the steps she stood on were mysteriously dusty, as if nobody had bothered to sweep them for the wedding, and they would most certainly ruin her pristine white gown. So she slipped off her heels, held her gown above her ankles and walked about a little, glancing eagerly toward the gate every now and then.

‘What kind of wedding planner doesn’t get the venue decorated?’ She thought to herself angrily as she surveyed the untidy yard. Autumn leaves were strewn all over the place, and while they lent a lovely orange-red hue to the atmosphere, it simply wouldn’t do to have them flying in everyone’s faces once the ceremony began. And she saw no sign of the standard arrangements any sane person would expect at any simple gathering: no chairs or tables, no food or drinks … and certainly none of the beautiful flowers and drapes she had picked out to liven up her cold November “I do” afternoon. And then there were the steps. Those bothered her the most. Was she expected to get married to the love of her life with dust flying into both their eyes?

Suddenly, she felt the hair on the nape of her neck stand. A chill ran down her spine. Clearly, something was wrong. Everyone couldn’t have forgotten. No wedding planner would let a client get married in such a state of disrepair. No minister would fail to reach a wedding ceremony he was to officiate. And Chris would definitely never abandon her.

Confused and frightened as she was, she couldn’t shake off her strong feeling of déjà vu. She strode towards the gate she’d been eyeing all afternoon, pushed it open and walked down the overgrown lane. She wondered how such obvious absence of any signs of life hadn’t struck her as odd when she had arrived 4 hours ago. Suddenly, without knowing exactly why, she broke into a run. Somehow her heels and gown and veil getting dirty and torn seemed inconsequential. Something was wrong.

It was well past dusk when she reached the main road. And still, she found herself alone. In the dark. Fear gripped her like never before, and she let out a scream. Nobody came. Silence. And then suddenly, “Amelia?”

Amelia spun around, her heart pounding. She knew that voice. “Aaron?” She gasped and stumbled backwards. Clearly, she was hallucinating. Her younger brother had been dead for ten years. She had buried his mangled remains, with the rest of her mutilated family. Her statement had sent the drunk driver that killed them all to prison. She blinked multiple times, hoping for this vision to disappear. He got blurry, but that was probably because she was tearing up. When they spilled out from her eyes, hot against her cheeks, he still stood there, two feet away from her, as clear as day, and surprisingly unmarked and unscarred.

“Amelia …” Aaron approached her slowly. “What are you doing here?”

“What are you doing here?” Amelia blurted out, catching herself unawares.

Aaron raised one eyebrow.

“You’re dead.” Amelia said to him, though she was obviously trying to remind herself of the fact.

“Yes. That’s why you need to come with me.”

Amelia felt a stab of pain as everything came rushing back to her— the week before her wedding … the final alteration of her wedding dress … the shop caving in … bricks upon bricks crushing her body, squeezing the air out of her lungs and agonizing pain through every fiber of her being …

Amelia’s knees gave way and she felt a thud as she sat on the road. Tears streaming down her face, she saw fire-fighters pull her lifeless body from the debris and Chris sob over her for half the night. She gave a start as she felt Aaron’s gentle touch on her forearm.

“Chris buried you today. Right next to me.”

“So … instead of a wedding … I had a funeral?”

Aaron nodded sadly as Amelia rocked back and forth, sobbing into her veil.

After what felt like eternity, she looked up. Aaron was sitting beside her cross-legged, waiting patiently as she came to terms with the tragedy.

“Now what?”

“Now,” said Aaron, getting to his feet and beckoning her to follow suit, “you come with me.”

“Where are we going?”

“To Mom and Dad.”

“Heaven?”

Aaron smiled. “Well we don’t call it that … but yeah, sure.”

“But— I need to … I need Chris to know that … that I loved him till the very end.”

“But there is no end.” Aaron said simply. “Chris will join us when his time comes. And you will still love him. And he knows.”

***

“Amelia!”

Amelia rushed into his embrace. It had been years since she had felt his comforting arms hold her against his strong chest … since she’d breathed in the sweet scent of his body and felt his breath on her neck …

“Chris!”

“We have unfinished business.” He said to her with a grin.

“Yes we do!” Amelia nodded happily.

“I’m so glad you have everything ready, Amelia. I will not lose this chance again.”

Amelia smiled, intertwined her fingers in his and led him down the path to the chapel.

And so, on another cold November afternoon, many years down the line, in a chapel infinitely more special than the one whose gate they’d met at, Chris and Amelia finally had their “I do” moment in the company of their families in the tranquility of the afterlife, where there was no death to do them part …

Letter to a Friend

You had no business just dying on us

Dearest Jui,

I realize, of course, that now that you are free to know and see so many things, you will probably not be checking your Facebook page (and is there a computer in the afterlife?), but my concept of death is that once you cross that point, you just KNOW things. But I’m still gonna go ahead and say some stuff that’s all bottled up inside because I really need to let it out.

First off, you shocked everyone. My first reaction was that that you had no business just dying on us like that because it was too soon. Because you had so much left to do: turn 20 and then 21 and … well you get the point, get that boyfriend, recruit more people to AISEC, get your degree … Because you had your whole life ahead of you. Because I just assumed you would get better and be here to giggle on forever. Because. Just because.
But I knew before I got the final call.

I still can’t believe I didn’t meet you during your ordeal. I don’t even know how to feel about it: whether I should feel bad that I couldn’t be there to show you my love and support, or relieved that I only have happy memories of you and didn’t see you suffer.
But I know you did. And I’m glad you’re no longer in pain. I just wish there was a way for that to be true and for you to be with us.

But I’m not going to bind you here. You have a lot to do now as well … like always.

You know that it is human nature to move on. Time is a good healer. Some things do leave scars though. And perhaps a few years down the line, we will get used to this. But you must know that we will still always love you.

I still remember one of your birthday parties when we were in primary school and how we were all fighting for a seat on that swing you had then in your balcony. And how you were giggling ALL the time. Seriously! ALL. THE. TIME. And how we would share a joke and giggle (see!) and only you would get caught for your explosive laughter. And how we would count the seconds of tuition torture left until freedom. And ‘Fuzzy Duck!’ And … the memories just keep coming. And only happy ones.

Know always that we will miss you more than it is possible to convey through words. Who will share the only vegetarian dish with me at the table now? And fight with Anupama like you’re an old married couple? And constantly tell Miti to chill? And call up Kruttika and insist on everyone meeting? And cheer Pooja on with undying enthusiasm? And click one million photos? And … so many things, Jui, so many things. Our group hug will never be complete without you. (That’s why I’m sure you’ll be with us in spirit at least, whenever we meet.)

I only hope you are happy and at peace now. And that you’ve met your dad.

Love you always.
Until we meet again (because we WILL. You WILL have to be reborn someday, you know. And when one of us has an uncontrollably giggly kid, we’ll know it’s you.),

Take care
And keep smiling as always.