‘The child is deformed‘.
That’s the first thought that crossed my mind when I first saw him. The mouth hanging open, rotund belly, protuberant saucer like eyes, muddy complexion, disproportionately thin limbs and a very questionable hygiene. He wore a blue sweater stained with the contents of his breakfast. I surveyed him as I walked towards him to monitor his vitals before the morning clinical rounds. His case file said he was ten years old; it was hard to judge from his appearance.
My approach scared him. He perceived the stethoscope hanging around my neck with apprehension often seen in young children but not usually a ten year old. He put his thin arms around the old man’s neck who was sitting on his bed. His grandfather, I presumed. I gently pried him away from around his grandfather’s neck and put the cuff around his thin arm to monitor his blood pressure. I tried not to look at his face with the saliva drooping from the corners of his mouth and remnants of his breakfast still stuck on his face. Something wet hit my hand. I inwardly cringed as I rubbed away a drop of saliva that fell onto my hand from his mouth. I hurriedly examined him and went out of the room.
‘I love children‘, I reminded myself. ‘All children deserve unbiased loving‘. But even during evening duties, relatively less hectic and allowing me the leisure to chat and play with the children admitted in the ward, I never could bring myself to approach his bed, caress his cheek and ask him how his day went. I avoided looking at his bed, at him, at his grandparents who looked defeated by everything in the world. I didn’t despise him, but I couldn’t feel the love and care that gets naturally evoked towards all children.
The day after Christmas I had night duty at the ward. At one-thirty AM I lied down to rest on the creaky bed in the room assigned for interns. Hardly ten minutes later I heard loud cries of a woman coming from a distance. I presumed it was from the adjacent female medicine ward. But just to be certain, I opened the door of my room.
It was the boy’s grandmother. Howling and running towards my room, her faded yellow sari trailing behind her. I went to check on the boy and found him breathing rapidly in short gasps. His grandfather stood rooted to the spot even when I asked him to carry the boy to the adjacent ICU. Eventually another attendant helped me carry the boy to the adjacent pediatric ICU. I alerted the senior doctor on duty, and started the boy on oxygen and monitored his vitals. His grandfather still stood transfixed in the room, and his grandmother lay sprawled on the floor outside the ICU and crying even louder. I tried to calm her down while the senior doctor examined her grandson.
I looked back at his body; his protuberant belly rising rapidly up and down as he struggled to breath and his thin arms lying feebly by his side. His oxygen mask slipped from his face and as I fixed it in place he held my finger in his palm. His eyes were closed but he could sense someone’s presence near him and held onto that person for comfort.
At that moment I could see the child in him, the lovable child that I had failed to see earlier. I felt very protective about him suddenly. I wiped the drool of saliva from the corner of his mouth. I didn’t cringe this time. I looked at his grandmother, her face pressed against the glass door of the ICU. I heaved a sigh of relief every when I saw his vitals normalize.
I left the ward at 8 am the next morning and had a twenty four hour break. I came back to ward on 28th morning and found his bed empty. My heart stopped beating for a moment. I questioned the post graduate trainee on duty about him, inwardly praying that nothing bad had happened to him. His grandparents had taken him home a few hours ago. They had left against medical advice. I don’t know whether I will ever see him again or whether he will even survive for long, since he would be devoid of medical care.
Doctors meet hundreds of patients every week, hear different stories and encounter many families in distress trying to cope with illness and death. They interact with people at their most vulnerable moments. It’d be hard to survive if one emotionally connected and felt for every patient and their family. Life would be perpetually depressing to see human suffering at such close quarters and get emotionally attached to all of them. So, an emotional detachment is vital just for basic survival!
But once in a while I can’t help being emotionally attached with a patient and their families. It’s difficult to predict what triggers such an attachment. But it renews a compassion and care that is often forgotten in this busy world. And I feel grateful to that ten year old boy for reviving it in me at the right time.
Photo courtesy: http://vi.sualize.us/tag/black%20&%20white%20photography/
Dialect of Heart 