Monday, 6 August 2018

part 8 : To Err is Human

RECAP: "Absolutely!" Armaan gave her another high five and glanced at Riddhima. He would have collapsed at that moment if he had not caught hold of the bed- Riddhima was smiling at him….a genuine smile…..a friendly smile……a smile that could light up the room…..a smile he would cherish forever……and would be close to his heart all his life.



"Ok interns….now I am going to assign some new cases to all of you….we just had 3 new admissions…..I want each one of you to take a detailed history and do a full physical examination on these kids……and then report to me in the doctor's room…..let's see how thorough you guys are." Dr Shubhankar smiled and handed a file each to Rahul, Riddhima and Armaan. He walked away after wishing them,"Good luck doctors."



Rahul, without wasting any more precious time, was at his new patient's bedside within seconds. The whole Minnie episode had infuriated him; he was determined to prove that he was the best with this new case.
Armaan stood still with the file in his hand, lost in his own world as usual. He could not get the image of a smiling Riddhima from his mind. Her smile had as if transposed him into a different world- a world he did not want to come out of. Riddhima skimmed through her patient's file and looked up. Armaan's gaze was transfixed on her. She looked down at her file once again to avoid his intense gaze; she felt a little awkward at being stared at. Riddhima had always attended an all-girl's convent school and during medical college, was too busy to notice men. So far, her interactions with Armaan had been too discordant for her to pay any attention to how handsome the man in front of her was. His boyish looks, tousled hair, blue eyes and his disarming smile definitely added to his charm.




"Uh..Uh…A..Armaan," she finally looked up, "k..kya case mila hai tumhein?'



Armaan was jolted out of his trance. He smiled at her, "jo bhi mila ho…..ab tho usee ka saath nibhaa na hai….haina?" His deep dimples sent a shiver down her spine. He was about to walk away, when she stopped him, "you are a good artist."


"Thanks." He turned around and flashed his killer smile once again. Seeing her flush in response, Armaan was convinced that his charm was finally working. He took a few steps towards her and added softly, "lekin abhi tak sirf caricatures hi banaye hain……par ab mann karta hai ki ek real sketch bhi banaa daalun."



"Real sketch?" she was baffled.




Armaan tilted his head gently and nodded, "yup…..now I have an inspiration." Holding his file under his arm, he grabbed some pencils and pens from the nurse's desk and walked off towards his patient's bed. The nurses gave him a curious look; most doctors carried their own pens and stationery- who was this strange intern? Armaan gave them a most endearing smile, "sisters…..you are the best …..get used to this unorganized new intern…..main Dr Armaan Mallik hamesha apna pen bhool jaata hoon…..lekin aap jaisi sweet nurses hai na mujhey sambhaal ne ke liye." Armaan was already a hero amongst the nurses after the Minnie episode and his honest- almost humanly confession had won their hearts in an instant. He was so different from most interns who generally treated nurses rather coldly and derisively.




A confused Riddhima hobbled gently towards her patient too, "What did he mean by inspiration?"




As Armaan read the details about his patient's cancer, he almost felt nauseated at the gruesome details about the malignant tumor which had taken over the little boy's body. The little boy was asleep in his mom's arms so instead of waking him up as most doctors tend to do, Armaan settled on a nearby chair with a piece of paper and pencil.


Fortunately, his subject was right across the room with her new patient. As she meticulously wrote down the detailed history of her patient, Armaan captured the various expressions on her beautiful face on his paper. The way her hair fell on her face, her eyes widened as she talked to her patient, her head tilted as she took notes- Armaan was enthralled by it all.


"Hey Armaan…are you done? Should we go and present our cases to Dr Shubhankar?" Riddhima tapped his shoulder after a little while. He looked up and hid the paper behind his back, "uh…wo..yeah….kind of."




"Are you drawing something?" Riddhima was shocked, "kya tumney apne patient ki history nahin li?"




"Well…he was sleeping…dekho…dekho," Armaan pointed at the patient, who by now was wide awake and playing a video game on his console.




"Armaan….don't tell me you haven't even started." Her eyes widened in disbelief, "what were you doing all this time?"



"Apni inspiration ko kagaz par utaar raha tha," he smiled mischievously.



"Matlab?"



"This is for you…..a little gift for you." He pulled out the paper from behind and gave it to her. Riddhima could not believe her eyes. With her mouth wide open in disbelief, she looked up at him, "It's beautiful….lekin Armaan…tumne apna saara waqt meri tasveer banane mein kyun nikaal diya?"



"Aisa sunhera mauka na jaane phir mile ya na mile…..iss liye maine," he paused and looked down apologetically.



"Thanks…..I am really touched," her voice cracked slightly. She had heard compliments about her good looks and big eyes before, but Armaan had really portrayed her so beautifully on paper that she was speechless.


"I hope you can forgive me for being mean to you earlier….I didn't mean to Riddhima jee." He looked at her soulfully.




She smiled at him, "I will forgive you once you complete your work…..and please don't call me jee," she blushed slightly, "I feel old."


"Ok JEE!" he winked at her and ran to his patient's bedside. Riddhima admired her sketch once again- he had captured every detail of her face so well, probably even a mirror could not replicate that. She rolled the paper and placed it in her bag and blushed gently. It was a strange warm feeling she had never felt before. She twirled the corner of a hair tendril falling on her shoulder as she thought about Armaan and her picture but was back in the real world when she saw Rahul marching towards the doctor's room




Armaan had just started talking to his patient. Armaan needed to hurry with his case but once she saw both patient and doctor playing video games instead, she knew that she had to rescue Armaan. Riddhima had figured out that it did not take long for Armaan to get distracted by extraneous stimuli easily. A feeling of sympathy, camaraderie and affection soaked her at that instant. She sat down next to Armaan's patient and started talking to the boy's mother. Within minutes, she had written down the little patient's case history on his file as Armaan played video games with his patient. She performed a quick physical exam on the boy to Armaan's surprise.



"Armaan….your file is ready…let's go now."



"Oh…thanks," he grinned as he placed the video game console down, "bye Gappu….see you later buddy."


"Bye…doctor uncle."




"Armaan…chalo ab," Riddhima dragged him into the hallway and rattled off the details of the case as they hurried towards the doctor's room to present their cases to Dr Shubhankar, "remember that Gappu is here to be enrolled in the new Lymphoma study…..theek hai…..and they are going to use…." She rattled off the names of the new chemotherapy drugs they were planning to use on Gappu. Armaan listened carefully and to his surprise remembered everything that had been said in her beautiful voice. How could he not pay attention to Riddhima's words?


Armaan was intrigued by the way Riddhima had literally taken over his case. It was just this morning that he had incurred her snub but the tables had somehow turned in his favor in the cancer ward. He looked around and wondered, "is cancer ward ne Riddhima par kya jadoo kiya hai……kitna apna pan dikha rahi hai yahan." Armaan was used to calling the shots when he was with women but here it was the other way around already- she had done all his work, briefed him on his case, she was looking out for him and ordering him around……and he was loving every moment of it.



BACK IN THE OB WARD:


After making rounds with the interns, Dr Kartik stretched his arms and announced, "Ok interns…..you all can take care of the cases I have assigned you…..just monitor these women in labor…….if any woman is ready to deliver….just page me….I will be in a meeting….Ok good luck." Dr Kartik walked off, leaving the interns in charge of the labor room.



"Dr Kartik humein akela chhod gaye?" Prithvi was mortified, "I…am not sure I can handle this Kripa……shouldn't he be here at least on the first day?"




Kripa loved challenges and having worked in underserved rural areas during her medical college rotations, was comfortable handling women in labor without much supervision as long as it was a normal delivery. Medical students were not allowed to do a cesarean sections or complicated deliveries without a senior doctor's presence.


"We will be fine Prithvi….chalo let's go and monitor Mrs Bhatia….her contractions were becoming frequent….come on," Kripa pulled Prithvi's arm and walked past Angad. Angad stood still with his hands on his hips and glanced at them through the corner of his eyes.




He knew Kripa had purposely ignored him. Angad grinned and followed his co interns to Mrs Bhatia's bedside. Kripa had one hand on Mrs Bhatia's very pregnant tummy and counted her contractions carefully.




"Prithvi likho….contractions lasting 30 secs…..every 5 minutes," Kripa ordered.


Angad watched them with a bemused expression and thought, "kya order chalaati hai yeh ladki….Prithvi ko jaanti hi kitna hai jo usey abhi se apne ishaaron par nachaa rahi hai….aur yeh saala bhi iske aage kutte ki tarah dum hila raha hai!" The comfort with which Prithvi followed her instructions angered Angad a little. He did not know why he was angry, but Prithvi was getting a little too much attention from her. He clenched his fists in his pocket and gnashed his jaws angrily.


"Now…let's do a pelvic exam Prithvi to check her dilation." Kripa put on gloves and took permission from Mrs Bhatia for an internal exam. As she got ready, she looked at Angad standing with his hands in his pocket, "can you please pass me a speculum?"


"Main tumhara naukar nahin hoon," Angad replied arrogantly, "chaahiye tho apne aap le lo."




Prithvi was perturbed by Angad's tone, "koi baat nahin main paas kar deta hoon." He ran to the drawer next to where Angad was standing and passed the required instrument to Kripa.




"Thanks Prithvi….I am glad at least some of us believe in team work here!" Kripa glared at Angad and resumed her examination.




Angad shrugged his shoulder, "Yeh team work sirf kamzor logon ka funda hai…..I just believe in myself." He stood there with his hands on his hips and a smug expression as Prithvi helped Kripa complete the examination in silence.



"Abhi time hai," She pulled away and threw the gloves past Angad's face into the trash can. Angad ducked a little as the freshly used gloves almost brushed against him, "yeh kya kar rahi ho?'




"Oh sorry…..I didn't realize you were still here…..I thought you don't want to be a part of our team….tho tumhein bhool hi gayi thi…..bechare gloves…..tumhein choote tho shayad aur gande ho jaate." Her smug expression left him speechless this time.




"Let's go prithvi…..behenji….abhi aapki delivery mein time hai….hum baad mein wapas aate hain." Kripa patted Mrs Bhatia's shoulder and reassured her.



"Kripa…let me finish these notes…..I will join you in a sec." Prithvi scribbled on Mrs Bhatia's bedside chart as Kripa left the room.




Angad followed her and caught up with Kripa in the hallway, "tum apne aap ko samajhti kya ho Dr Kripa?" he confronted her finally.


"A better and nicer person than you…..that's what I think of myself." She snapped.



"And who gets to decide that?" Angad asked.




"Apne aap ko dekh lo phir khud samajh jaaoge…..ek chor…..paise ka laalchi……bad tameez……aawaara……lafangaa……mawaali……aur aur…." She searched for some more colorful terms to describe the tall, dark and handsome man in front of her.



"Lagta hai mere baare mein bahut soch ti ho," Angad had a crooked smile on his face, "tabhie itne saare pyaare pyaare naam soch rakhein hain mere liye." He grinned and came closer, "kuch naam apni poonch ke liye bhi soch lo tho achcha hoga."




"What rubbish? Yeh poonch kaun hai?" she pulled away as his face was inches away from hers.




"Dekho aa raha hai dum hilaata hua," Angad laughed and walked away as Prithvi joined Kripa.



"Kripa…yeh batao Mrs Bhatia ka cervix kitna effaced tha?" Prithvi was still preoccupied with his notes when he stepped out and saw Angad walk away, "yeh Angad itna naaraaz kyun rehta hai?"


Kripa was startled by Prithvi's sudden appearance. She stared at him as Angad's words echoed in her mind, "Poonch…….poonch…..poonch…."




"Oh…wo….haan…about 90% effaced thi," she had to gather her thoughts once again. Angad had a bad habit of irritating and distracting her. She was thankful that he was not near anymore.



"Doctor….doctor….doctor….Mrs Bhatia…..jaldi aaiyie," a frantic nurse ran towards Kripa and Prithvi.



'Kya hua?" Kripa ran back towards Mrs Bhatia's room.




"She is ready to deliver doctor," the nurse panted.



"Kya? Abhi tho hum dekh kar aaye hain…she was not ready…..sister Dr Kartik ko please page karo…jaldi…..and prepare for delivery!" Kripa ordered. She was at Mrs Bhatia's bedside. Quickly, she put on a gown, mask and gloves and was shocked to see a tuft of hair pushing to enter into the real world as Mrs Bhatia howled and screamed holy terror. A nervous looking Mr Bhatia was at his wife's bedside, "Billo…main aa gaya hoon…..tu fikr na kar."



"Tum dafaa ho jao jee yahan se….yeh saari gul tumhari wajah se hi tho huyi hai…..chudd mera haath!" Mrs Bhatia snubbed her husband and screamed at the top of her lungs, 'Hey vaahe guru…..mujhey bachaa lo tussi…..warna aaj main mar jaawaangi …..BACHAO!!!!"




Prithvi was taken aback by all the commotion in the room. He wiped the beads of sweat from his forhead, "Kripa….main Dr…Dr Kartik ko bulaane jaata hoon." Before Kripa could answer, a nervous Prithvi had left the room to page Dr Kartik again.




"Prithvi…Prithvi," Kripa called for him but he was gone.


"Mrs Bhatia…..aap lambi saans lee jiye…..main jald hi aapka baby deliver kar doongi…..lekin aapko mere saath cooperate karna hoga….please….thoda patience rakhiye." Kripa's calm but affirmative tone reassured Mrs Bhatia. She shut her eyes and took deep breaths, "ik…do..teen….ik…do ….teen."


A cautious Mr Bhatia counted along with her but when she heard his voice, she slapped his hand on her tummy, "tussi chup raho jee…..mainoo ginni karne do."



There was still no sign of Dr Kartik. The nurses paged him repeatedly but he did not answer.



"What's up sister?" the familiar deep voice behind her back froze Kripa's hands on Mrs Bhatia's perineum.



"Doctor sahib….Mrs Bhatia is ready to deliver," the nurse answered.



"Hmm…looks like the baby's heart rate is falling with each contraction," Angad looked at the heart beat strip being regurgitated from a machine at Mrs Bhatia's bedside.



"I know…that's why it is important for her to deliver right away…..the head is stuck," Kripa murmured through her mask. She was aware of the urgency of the situation but did not want Mr or Mrs Bhatia to panic so had not mentioned anything yet. A panicky doctor would just make the situation worse.


"Ok….let's prep her for a cesarean then," Angad replied.



"No…we don't have time Angad…..just hand me the forceps…..I know we can get the baby out." Kripa said firmly.



Angad looked up and saw the panic and fright written all over Mr Bhatia's face. He knew that Kripa was probably nervous too and at this point arguing with her could be detrimental for everyone. At times like this, they had to present a unified front so their patient could have faith in their caregivers.




"Here you go Dr Kripa," Angad handed her the pair of metallic forceps to help deliver the baby promptly and safely.




Kripa slipped the forceps securely around the baby's head stuck at the outlet. Angad kept an eye on the baby's heart monitor-she was right; there was no time to even take Mrs Bhatia for a cesarean. The baby's heart rate was critically low and if the delivery did not happen in the next couple of minutes, Mrs Bhatia could lose her baby.



"PULL KRIPA! PULL!" Angad nudged Kripa. As Kripa struggled to pull the baby out, Angad placed his hands on hers and as if by miracle, the energy generated by both their hands was enough to deliver the baby's head within seconds. A sigh of relief filled both of them as the rest of the baby squeezed out smoothly into Kripa's slippery gloved hands.




Prithvi watched from a distance as Kripa wiped the baby gently and carried the little boy to the warmer. Angad assumed the role of the Obstetrician and completed the delivery of the placenta and secured Mrs Bhatia back again. The nurse was pleased to see the team work between the two new interns and the confidence with which they had handled the whole case on their very first day.



Mr and Mrs Bhatia had tears of joy as they heard the wails of their newborn in the room.




"Sister Lovely…..what happened?" Dr Kartik walked in authoritatively.



"Sir…..the baby has already delivered," a smiling Prithvi came forward.



"Sorry guys….got a little late in the meeting…looks like the case is done…and congratulations Mr and Mrs Bhatia," Dr Kartik nodded and walked out again.




Angad and Kripa glanced at each other. Only they knew what tense moments they had gone through together. Two lives had just crossed the most precarious bridge – a bridge between life and death and two lives had just witnessed this delicate game between a beating heart and a still one. Just as a lifelong bond had been formed between the newborn baby and the mother, an unsaid bond had been formed between the two interns who had helped them cross that fragile bridge where a moment's delay in judgment could have cost the baby his life, and also fractured their confidence in each other forever.


"Oye…Dr Kripa…Dr Angad….yeh badhe doctor sahib apne aap ko samajhte kya hain?" Mr Bhatia was upset at the way Dr Kartik just walked away after a cursory visit. He was well aware of the tense moments in the delivery room and how well the two new interns had handled his wife's case, "main is Dr Kartik ki complaint karoonga billo…..pehle tho aaya nahin…phir in do naye doctors ki tareef bhi nahin ki….kaisa senior doctor hai yeh?"



"That's OK Mr Bhatia….yeh raha aapka beta….ab aap apni billo aur billoo dono ko sambhaliye….hamara kaam ab ho gaya," a smiling Kripa handed the little swaddled bundle to his dad.



Angad got up from his seat and discarded his gloves and mask, "Mubarak ho Bhatia jee….vaahe guru kare aapke aise aur bahut bachche ho."



"Tumhare mooh mein ghee shakkar Dr Angad," Mr Bhatia kissed his little son, "lekin ek shart par."




"Shart?" both Angad and Kripa asked simultaneously.



"Ki delivery par aap dono zaroor honge….vaahe guru aap dono ki Jodi salaamat rakhe," Mr Bhatia beamed.



Kripa turned red at the comment and left the room silently. Prithvi followed her promptly, "Kripa….great job."



Angad smiled and winked at Mr Bhatia, "twaade mooh vich vi ghee shakkar Bhatia saheb!" and walked out.




"Angad….great job yaar....kitni confidence ke saath kaam kiya tum dono ne," Prithvi ran towards Angad.



Kripa just gazed at Angad; she silently thanked him for his presence in the delivery room. If it were not for him, she did not know what might have happened in those crucial moments. Even though she was indebted to him, her ego would not let her thank him openly.



"Good team work guys," Prithvi tried to break the ice and patted both their shoulders.



"Waqt aane par kaante hi kaam aate hain…..phool dekhne mein achche lagte hain par toofan mein murjhaa jaate hain," Angad glanced at Prithvi with the corner of his eyes, "lekin kaante har toofan ko bardaasht kar lete hain Dr Kripa…..now shall we all go down for coffee?"



Kripa was rendered wordless by Angad's remark; she lowered her eyes and nodded, "let's go Prithvi."




The three of them took the elevator to the cafeteria for a well deserved coffee break.



….to be contd…

bheegi

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