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.

Advertisements

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.

Lament of the Indian Resident Doctor

While the media paints a sorry picture of the innocent patient denied elective services during a resident strike, the voice of the protesting medical resident goes unheard.

Most of us went through a “When I go grow up, I’m going to be a doctor” phase during childhood. Mine began at age 7, and I never outgrew it. It seemed so magical, how my doctor could listen to things that were going wrong, piece together important bits of information to explain why it was happening, and better yet, offer a solution to make everything better. I was amazed that those hands that felt my pulse had once touched every part of a human body, memorizing the locations of all the different organs that make us function on a minute-to-minute basis. Those eyes that looked at the back of my throat had spent hours upon hours reading gigantic texts with miniscule fonts, learning to recognize disease from incidental anomalies. Those ears that listened to my heartbeat had trained themselves to distinguish not just normal from abnormal, but also between a hundred different types of abnormal sounds, while listening through layers of my skin, flesh and bones.

So, it was with great pride that I bought my first stethoscope upon being accepted into one of the foremost medical schools in the country. I was going to learn to do all of that, and so much more. At the end of five-and-a-half years, I would to be armed with the knowledge and skills to diagnose and manage an array of medical problems ailing the people around me. I had worked harder than I could have imagined possible to get into this competitive field, and I was going to endure, with the ultimate aim to earn not just a decent living, but also immense professional satisfaction from service of the sick. My life was made!

It wasn’t long before the Indian medical education and healthcare system began tearing these illusions to shreds. Medical students were a burden to teach, and, for the most part, were expected to fend for themselves. Interns were lowly beings at the bottom of the hospital food chain, whose purpose, far from honing their professional skills, was to perform scut work and assist in transportation of patients, biological samples and lab reports inter-departmentally across the 44-acre hospital campus. It’s not like they were going to be awarded a general practitioner’s license after this year of supposed multidisciplinary professional training. The few interns who managed to take (and ace) another series of even more competitive entrance examinations graduated to the position of residents, who were simply manpower to get through the sheer volume of patients that entered and exited the doors of our hospitals every day. And after 3 more years of underpaid sleep deprivation, they were suddenly licensed to independently practise medicine in a specialized field, unless they chose to take upon the next daunting task of sub-specialization.

Disillusioned, we began branching out. Some, like me, chose to undertake the pursuit of graduate medical education internationally. Others turned towards entirely different careers altogether: business, administration or the arts. Many, however, persevered through all these discouragements for the long haul. Today, it is these very determined souls who are suffering at the hands of the general population and fighting for their rights without any support from the government or judiciary whatsoever.

In the short span of a few weeks, multiple resident doctors have been physically assaulted for a variety of reasons ranging from unavailability of a subspecialist overnight to poor patient outcomes. Resident doctors working unending hours caring for scores of patients have been deemed heartless, lazy or negligent, and beaten, threatened with rape or murder, and in one case, even blinded for trying to prioritize cases and manage several sick patients at once in pitiful working conditions. When they decided to stand up for themselves and demand a safer work environment, the government responded with false assurances of security, the judiciary with threats of termination and the general population with accusations on the collective character of the entire profession. While the media paints a sorry picture of the innocent patient denied elective services during a resident strike, the voice of the protesting medical resident goes unheard. Although I am not at Ground Zero in this situation, I feel obliged to summarize the rationale behind the remonstrations of my colleagues back home, in response to the highly-publicized opinion depicting the modern Indian physician as a corrupt, greedy, lazy youngster with neither the knowledge nor the skills to assume responsibility of the care of another human life.

  1. The ideal doctor exists to serve: no. Most of us do have altruistic beliefs and do really hope to serve the community with our hard-earned expertise, but just like an engineer’s prime interest lies in creating innovative designs, our first love is biological science. It is our privilege to contribute to society in such a direct manner with our proficiency, but if all we wanted to do in life was serve, we would have chosen social work. We do, however, love to serve within our capacities. Are you aware that several young residents currently on strike have organized a blood donation camp amongst themselves to help stock up on this precious commodity for patients in need?
  2. The modern doctor is incompetent: preparing for medical entrance examinations in India required us to study 11 different textbooks of plant and animal Biology, in addition to 2 each of mechanical and electromagnetic Physics, as well as organic and inorganic Chemistry. We took an average of 10 different examinations and competed with greater than 300,000 aspirants across the state for a few more than 6,000 government medical college positions for undergraduate medicine. We then spent the next five-and-a-half years trying to learn everything we possibly could about the human body – both normal and abnormal – as well as how to prevent progression, halt, reverse or even completely eliminate disease processes or causative agents. This cycle was repeated each and every time we decided to pursue further specialization in a field of interest.
  3. The modern doctor is lazy: most of us were 22 or 23 years old while interning at the hospitals attached to our medical colleges. We worked 36-hour shifts, caring for more than 100 outpatients and 50 inpatients on our busiest days. We survived these rigorous hours on bites of unskilfully prepared junk food stuffed into our mouths between drawing blood from one patient and suturing up another patient’s gashes. I once knew a resident doctor who started working in the outpatient department on Monday morning, spent all night with us interns admitting and managing patients in the Emergency Room and then coordinating pre-operative care for elective surgery patients all of Tuesday. As interns, we got to leave for home by Tuesday afternoon, but when we returned on Wednesday morning, the resident still hadn’t had the time to change out of the same clothes, and was preparing to scrub into the OR for a string of elective procedures for the rest of the day. Another one of my supervising residents had to apply for a weeklong vacation 2 months in advance to visit her family for Diwali. Her home was a 20-minute train ride away from the hospital and she hadn’t seen her parents for 4 months. A company with such rigorous vacation policies would find it hard to find employees to fill its positions.
  4. The modern doctor is greedy: in all honesty, if that were true, we would not be doctors. As interns in one of the largest metropolitan cities in India, my colleagues and I earned Rs 5,825 per month (paying the government Rs 175 as “professional tax”). A second-year Pediatric Surgery resident I worked with earned Rs 26,000 a month for being on-call 24/7 (he was the only resident in the program). The average rent in the area of the city our hospital is located in is Rs 36,000. Go figure. True, when he graduates, his earning potential drastically increases – but only if he manages to secure a position at a wealthy, privately owned and operated hospital in a major city. He will probably by in his late 30s at best by this time. So yes, all of us do firmly believe that after sacrificing our entire youth to work towards attempting to allow you to enjoy yours, we do deserve compensation for our efforts. You would not accuse a telecom company of cheating for charging a service fee, so why can you not extend that comprehension to the person who is working to help you hold on to your health?
  5. The modern doctor is negligent: a resident doctor in an Indian government hospital is facing the horrendous doctor-patient ratio of somewhere north of 1:1600. Setting aside the deplorable working conditions and sleep deprivation, they must also deal with patients seeking care at end-stages of lethal conditions and expecting medical miracles without fail. One of my own colleagues from medical school suffered a serious head injury at the hands of several relatives of a pediatric patient who died of dengue after presenting to the hospital in shock. Never mind that he was brought in critical condition, yet initially stabilized, receiving ICU level care on a general ward due to lack of ICU bed spaces. His ultimate clinical deterioration and demise were blamed on medical negligence, and physical assault on 3 young residents by an angry mob was deemed fit punishment. Arrests were made but bail was granted within 2 days, despite attacking a medical officer on duty being a non-bailable offence in India. And still, this case is quoted in newspapers all over the world, focusing on the bereaved family and how they feel no remorse for their actions because their son is dead. Could you legally and morally justify assaulting a politician because his policies did not agree with your own political sentiments?

Look where this blame-the-physician mentality has left us. A budding orthopaedic surgeon has lost his vision in one eye. Do you think anyone would trust him to operate on their loved one? His surgical career is finished. All because he directed a family to seek medical care at another facility equipped with subspecialty services their patient required. Young doctors under training are being threatened with expulsion if they do not return to work, and with bodily harm if they do.

In this hostile atmosphere, what choice do physicians have other than to protest? Would an entrepreneur feel safe if an angry mob of investors could burst through his doors at any minute and pummel him half to death because his venture did not do quite as well they had hoped? Why are physicians held up to a different standard than everybody else? Yes, we deal with human lives, and yes, this is a huge responsibility, but medicine is, after all, just another profession. We are not miracle-workers and we certainly never asked to be viewed as Gods.

Believe us when we say that we do not take our scientific and social responsibilities lightly. Every undiagnosed case keeps us up at night. Every bad outcome takes a toll on our own mental health, no matter whether we could have made any difference with more interventions. We only ask that you consider our side of the story. Recognize that we too are trying to balance personal and professional lives while earning a decent living in exchange for our scientific expertise. We truly do love serving you, but if you could only reflect some of our compassion back to us, we would not need any added security. We are human too, and if we can live by the tenet of “Do no harm,” why shouldn’t you?