“She should die… sooner!”

The toll of patients was on rise and so was the toll of the dead bodies. The situation was grim but as a doctor, you had to be there each day expecting for the things to calm down… at some point of time.

With all this on her mind, she got a call from the main gate of the hospital,” Madam, there is a patient who wants to be taken inside… the boy is not listening and insisting to speak to some doctor at least.” This was the security at the main gate. Although, there was a board on display at the gate – Beds full, No new admissions, it had become a routine affair. A doctor was also supposed to handle such administrative hassles… the state of affairs was fragmenting.

She moved to the main gate, contemplating the words she would say to the relatives. As she reached the gate, a young boy in 20s came rushing towards her with folded hands,” Mam, save my mother… she is unable to speak… she is breathless… oxygen is 70…” She tried to console the boy,” I understand but we have no beds available… take her some place else.” These words were almost auto-generated because she had been saying similar lines to similar faces since past one month. 

But the boy was unconsolable. When the boy would not stop weeping, she went on to see his mother. There was a lady lying in an ambulance with a face mask on, breathing heavily. On seeing someone in white coat with a stethoscope on, she folded her hands with all her effort and nodded the head greeting the doctor. In her mind, she had been saved… a doctor had arrived.

The medico could see that her state was bleak, oxygen saturation fluctuated in 70s. She knew that this lady, if not treated well, barely had any time. In a normal situation, such patient would be rushed to ICU however, the situation was far from normal. Patients with worse profile were lying inside the hospital. She boasted of being a doctor and the lady had presented as a patient, yet today, they reeled on the same boat – a boat of hopelessness and helplessness…. carrying a whole nation.

At that moment, floating in the sea of emotions, where your decision decided life and death of an individual, she requested the boy to look out for another hospital. She assured him that if a bed were to go vacant, then his mother would be admitted. Saying this, she moved back inside the hospital gate.

As the doctor ambled back to the ICU, she could not help but ponder upon what was happening. No medical school ever taught a doctor to generate oxygen or to arrange for beds. No medical school coached a doctor in saying no to a patient. Yes, there is a concept of triage – where you treat a patient based on how severe he is, when the resources are scarce but triage would be a short term measure and the resources would either match up or the patient load would eventually decrease. Howbeit, triage had become the trend since past few days and it had its own detriments. 

Reasoning with her own-self, she reached the ICU and looked around… expecting for some bed to have gone vacant. Alas! That was not the case. She indulged herself in the daily routine trying to forget what would happen to that lady on the main gate and trying not to blame herself. 

Few minutes later, an ECG monitor started beeping. It was from the bed of an 82 years old lady, who was already a case of Tuberculosis and had also contracted COVID-19. She was admitted two days back and had shown no improvement since. Her prognosis was poor.

The nurses rushed to the lady to check on her… her heart rate had dipped drastically. As everybody checked on her vitals, the time slowed down for the doctor. A subpar thought came across her mind, maybe for a moment,” She should die… sooner.” Standing frozen in this thought, she could not hear the nurses shouting for her assistance until a nurse grabbed her back to reality.

She shrugged off her mental clutter to check on the old lady. Just as she went on to palpate the carotids, the regular short beeps of the ECG monitor turned into a constant long beep. She could not feel the pulse. The old lady had gone unresponsive and was not breathing. Resuscitation was not to be done as per the COVID protocols.

Behind her face shield and mask, the doctor smiled. She instructed the nurse to immediately call the main gate and to check if there was a lady waiting in an ambulance. The answer was affirmative. Almost like a robot with predesigned course of action, she made her way out of the ICU to break the bad news to the son of the old lady who had just passed away.

An anxious looking man stood outside the ICU. The doctor patiently spoke to him and informed him about the demise of his mother. The man broke down in tears… the condition of his mother had been bad and sometimes despite knowing things, you anticipate a miracle. 

Just as she tried to provide some solace to the grieving son, she caught the glimpse of a lady with folded hands being wheeled in to the ICU by her son. The lady recognised her and nodded again with gratitude. The doctor could not help but acknowledge her nod with a smile… behind her mask.

A death had provided a hope of new life to someone and the concept of relativity… the concept of yin and yang had resurfaced. Yin-yang is an ancient Chinese ideology – a notion of dualism, which aims to describe that how seemingly contrary forces or events may actually be complementary or interdependent in the natural world.

A son had lost his mother… a doctor had lost his patient… a bed had been vacated… another sick patient had been admitted and a son had a chance to save his mother. Grief for some but hope to few… you never know what life has in store for you!!