When death strikes over a cup of coffee..

At least a couple of trips to the coffee vending machine outside the MICU is a daily routine for me. In the good old times, not so long ago, coffee-cup in hand, I would march into the MICU, looking for Dilip Karnad in his office. Not any longer. I just spend a pensive few minutes standing in the corridor looking at things and lost in my thoughts- sipping coffee. A couple of days ago, this reverie was suddenly shattered by an ear-piercing 'shreiky-cry' of a young woman waiting outside the MICU even as relatives gathered around to console her and, students and residents in white coats, squeezed their way past them, often with disapproving looks of “How could you crowd around and block the passage?”.

Common enough, you might say.. in fact, so common, that by the time you are a one or two-year-old in KEM, you would have developed psychological deafness to the sights and sounds of “death-wails’ that we not infrequently encounter on the corridors of our hospital. But, that morning’s shriek set me thinking – to that morning - some 25 years ago - to the medical ICU at the Sion hospital. That fateful day, death - without any warning whatsoever, had snatched away a 27-year-old doctor in the prime of life .. a close relative of mine  - leaving behind a wife and, a son who was about to have celebrated his first birthday. The three days and nights that I spent on the steps of the staircase outside the ICU at the Sion hospital, were my first introduction to life and death from the other side of intensive medical care.

Time heals, they say.. but, not always without scars. The scar that this experience ‘gifted’ me was an acute awareness about how callous we ever-so-often are as we go about our day to day ‘patient-care’ chores.

The first time I came face-to-face with communicating death was as an intern in surgery . I vaguely remember my registrar instructing me:

“Go, tell the relatives that the patient is dead”.

Obedient that I was, I went out and asked for “so and so’s sagewala” and said:

“Appaka patient gujzar gaya” or some such matter-of-fact words.

QED., right??

Shocking some would say.. how could you be so callous?

But, what could I do? At 24, I knew nothing better. No one had taught me how to convey death and why it was important that it be done right.

That was in 1976. Now 34 years later, we are no better. We are not “death-conscious”, worse still we are seldom “patient-conscious” Sadly, as a rule, medical students and interns are still not taught the need for and ways to be sensitive to suffering or how to convey death.  

“Oh! That’s not in the syllabus and there has never been an MCQ on that in the CETs, so why should we know” some would say.

Young interns not wanting to ‘study’ anything but the facts that get them marks is understandable; but, we as their teachers and mentors ought to know better. If treating human beings is all about life and death, don’t we need to be teaching these skills? Because these are skills that cannot be learned from text books or the internet, these are skills of experience - experience gained by oneself the hard, long way or taught by teachers who have been in the midst of suffering and death all their lives and have taken the oath to alleviate these.

How is that we are so insensitive to what we see around us each day?

Why should a sick patient ever have to stand whilst in a queue? Do benches cost crores of rupees?

How can we let the patients fend for themselves in the maze of our corridors with out a single sign board that says “May I help you?”

Why can’t we provide decent toilets to patients and their relatives? Do they cost crores of rupees?

How can we dare to fling out off the corridors - the clothes patients’ relatives leave out to dry when we do not provide them any decent place to stay?

How can be run a hospital that caters to the poor and destitute - people who often have no where or no one to go to when death strikes - without a system of grief counselling?”

None of this costs crores of rupees to set up; none of this costs dozens of employees to be appointed…all that this needs, is for us to stop and think and remember that we are here to heal sick human beings who often remain anonymous as “that case” .

We are not just ‘health care providers’. We are supposed to be doctors - healing human bodies and minds.

How I hope - we will wake up – soon!

February 2010.