The bond that forms in times of shared anxiety is different than ordinary friendship. It may be brief but it leaves a lasting impression. I witnessed this during my experiences in SMHS Hospital and its medical ICU where I spent over two months attending to my ailing sibling. The camaraderie among the attendants of the patients in the ICU was palpable. We were a diverse group from different backgrounds and from different regions of Kashmir – rural and urban, young and old, lettered and not. What bound us together was the fact that we were all staring at uncertainty in the eyes; hoping it would be the first to blink.
Each day brought a new set of challenges, and yet each day was the same. It was easy to lose track of time as days melted into weeks in a hospital that stands still in its administrative inertia – despite the outward chaos of overflowing wards and overcrowded hallways. This hospital is itself sick with multiple complications and multiple diagnoses for each of them – set, as it is, within a healthcare system that seems to amble along only by the Grace of God.
The peeling paint on the walls of this beautifully designed hospital is a reflection of a schizophrenic healthcare system that leaves very little room for expectations. One learns that early on. What saves the day are those technicians, doctors or nurses who choose not to let the system jade them and who take the time to listen, to feel and to understand. One of the most memorable among them was a young doctor who, in the rush of the emergency room, found time to notice a disheveled and disoriented old man, addressed him with the utmost courtesy and kindness and offered the help he needed. One day she will be one of our finest doctors. It is these few good men and women – most of them young – who are the bright light of hope.
Hope is elusive when you are in the ICU. You try to decipher its threads in the monitor graph going haywire and to which your eyes are transfixed on an especially stressful night. You search for its footprints in the numbers on a blood test result, or its shadow in an X-ray. You hear its step in the reassuring nod of a doctor listening through a stethoscope. And you finally see it in the ‘Get Well Soon Baba’ balloon that your niece fashions out of a surgical glove. You join in defining the features of hope with a pen and name it ‘Abdullah Khan’ after a character in an old children’s rhyme. Hope then takes on a smiling face and transcends to the faces of everyone around. We laugh together momentarily.
Inside the ICU social and cultural divisions may be erased but outside of it – in the corridors and wards – they are very much visible. Sleeping in the relative comfort of a ‘paid room’ I often wondered about the many attendants who were sleeping and eating in the cold corridors of this hospital. The very same people who, with utmost graciousness, invite you to join in for a cup of tea or a meal when you pass by. Every morning, just before 10 a.m. and without fail, one could hear the loud commotion of the guards trying to empty the wards and corridors of these attendants before the morning rounds began. It is as if they are stuck in a perpetual ‘repeat cycle’.
We tend to snub our noses at these attendants. But what choice does a poor laborer from a remote region of Kashmir have than to sleep in a cold corridor while his child is being treated in the ward next door? In the absence of proper nursing care the attendants are forced to take on the role of nurses. Every patient requires at least two attendants. One who stays with the patient; begs the nurses to give injections at the right time and take out the IV line when the fluids run out; feeds, changes and generally looks after the patient. The other attendant is there to run around in frantic circles – buying medicines, dropping off blood samples, picking up test reports etc
The process for doing a patient’s blood test is something like this. First the attendant may be sent to collect the right vial from the right building. Once back, the blood is drawn and the attendant is marched out again to drop the sample off. This time the hapless soul has to stand in two different lines – one to pre-pay for the test and the other to drop off the sample. The final trip is to collect the test result. Each of these stages requires standing in very long lines. God help the attendant if the patient requires more complex blood tests because then the vials may have to be collected and samples dropped off at two to three different buildings.
One is left to wonder why, in this day and age, is this process so cumbersome? There is no attempt to streamline any stage of this process. Couldn’t a simple computer and its operator in each ward be able to take payments or pull up the test results of a patient if that system were centralized?
In the 2 a.m. eerie silence of the long hallway connecting the casualty block to the main wards, the anxious faces and the tired feet of the daytime rush linger in ones mind. Ironically, it is the stillness in that hallway that brings into stark focus the administrative lacunae that are the norm in many of our institutions and that most of us take for granted.
SMHS is a hospital with an ICU that has a toilet less than 5 feet away from a patient bed and with no facility to wash hands. It is also a hospital where staff members pay for the medicines of a poor patient out of their own pockets. Here some doctors, drunk on power, sometimes find it necessary to insult the anxious attendants of very sick patients. Here also some doctors work tirelessly to save lives amidst the bangs of mortar shells from a nearby encounter. Here people help each other when the system fails them. That is what we do.
In this hospital my brother fought a long and hard battle for his life and won. In this hospital life meets death head on.