The Last Day

Tia Teresa Thomas

Today was the last day of our 10-day posting in Emergency Medicine. We were only in fourth term so the prospect of Emergency Medicine excited us more than anything.. Our posting was during the day and so far we had seen our seniors manage one man with myocardial infarction and several persons with electrolyte imbalance. A few beds were always empty and we assumed that most cases of trauma came in at night. The doctors were almost always free to teach us about trauma cases, which we were sure we would not see. 


Today was supposed to be no different. We walked in casually, 15 minutes late, only to find that the beds were full,  both on the ‘stable’ and ‘unstable’ sides of the room. Curtains were drawn around many beds and the workstation, where the doctors rested and wrote reports, was deserted. Suddenly everything was different; today was a busy day.


I do not know what drew me to the very last bed. Maybe it was the curtain flapping eerily around it, or the lack of an attendant in there. Three of us students went to that bed. It was the body of a woman, completely covered by the pale pink sheets stamped with the initials of our hospital. Her hand, the only exposed part of her body, lay jutting out of the sheet. The wrinkles on the skin, and the two rings on her fingers and the gold bangle that adorned her wrist told us she was middle-aged. I instinctively held her hand and felt for the pulse. There was none. Frantically, I searched harder, tried again. I realized I was the only one in the cubicle at that time. 


‘Tia, come out quick,’ Shruthi hissed from outside the curtain. Barely registering what she had said, I tried to palpate the woman’s pulse, a little more desperately. A staff member walked in and told me to do whatever I was planning to, but with gloves. ‘Why?’ I asked. Was it possible that she had some infective condition? ‘She is a medico-legal case; she died in a road traffic accident.’


She’s dead. I could not believe it,  and kept looking at the arm that was jutting out.  She’s dead, I repeated to myself to bring some clarity, but my brain was not processing anything. Shruthi had heard everything and tried to pull me out of the cubicle. 


No sooner had she pulled me out, the attender brought two young people into the cubicle, worry writ large over their faces. Once they entered, they understood what I had not—their instinctive cries of anguish pierced the surrounding noises. Brother and sister expressing the deepest sorrow that mankind could know—the loss of a loved one. Their cries were distressing. They were dressed up and had probably been going with their mother for some function, only to have their lives overturned. I remembered my grandparents’ sudden death. Shruthi and Nithin had to shake me out of my reverie. ‘What’s wrong with you?’ they asked. ‘Why didn’t you come out immediately after discovering that she was dead?!’ 



I saw reproof on their faces, but I had no answer. How could I tell them that I did not know that people are covered from head to toe only when they are dead? That the only deaths I had seen were those of my grandparents, whose bodies were kept in a glass casket, their faces clearly visible, for all to pay their last respects. How could I tell them that I needed to prove to myself that she was alive, that I desperately wanted her to be alive, as if my own life depended on it.  



They knew they were not going to get a response, so they quietened down and we looked for our other batchmates in another cubicle on the unstable side. Over there lay a young woman, almost completely exposed and in visible pain. Her curly brown hair was singed and burnt at the ends, bits of it having crumbled and fallen on to her face. Her face was red and swollen, and her skin peeled off her cheeks, arms and legs. Numerous heat blisters had erupted on whatever skin remained on her body.


Shreya must have seen the obvious question in our eyes. She pulled us aside so that the girl could not hear what she said.  The girl was a second year pre-university student, writing her board examinations. She woke up to a fire, one that destroyed her home and everything around it. She had 26% burns, and the other members of her family were similarly affected. She was sick with worry for her older sister, who was the worst hit, with 70% burns and was clinging on to life in the ICU. (Later, we learnt from the newspaper that her older sister eventually succumbed to her injuries and that the fire had been started by someone they knew.)


Shreya went back to the cubicle. I looked at the faces of my batchmates. They were all stupefied. I could not even imagine what the girl herself must be feeling. As they were cleaning up her wounds, she started weeping. The tears that ran down her cheeks must have caused her even more pain because the cheeks had no skin. 

 She writhed in pain and cried. Scared, alone and half naked in a strange hospital, surrounded by ignorant medical students. She was probably just a year or two younger than us. I was about to tell her that it would all be okay. That was our standard response to most patients who expressed any sort of worry. The words choked in my throat and would not come out because deep down I knew it was not true. It felt horrible and helpless. All I could do for her was hold her hand, when she needed much more. After she had quietened down a little, we left her and the staff members, with their expertise, meticulously cleaned and dressed the wounds.


Shaken to different degrees, we were ready to leave, when we saw a woman being brought into the room by two men. She seemed to be barely conscious and had a wound in the head, which was gushing blood. The two men with her were anxious and agitated. They explained that they had accidentally hit her with their motorcycle while she was crossing the road. She had lost consciousness and was barely responding.


Even now, as she opened her eyes, she looked disoriented and confused, like a frightened deer staring into the headlights of a car. She could not remember her name or her family.  


Desperate to establish an identity, they took her mobile phone. Luckily, it was a basic model without a complicated security passcode. They called the number stored as ‘home ’.


Within ten minutes, her daughter rushed in, fearing the worst. Her face shone with relief for half a second when she saw her mother alive and conscious. She called out to her mother, who stared at her blankly and said, ‘I don't know who you are, but may I please have some water?’


The daughter's anguished cry, her frantically tapping her mother and sobbing:‘Don’t you know who it is, Ma? It's me!’ – left all of us quivering. It’s strange how her brain could access the function of language, yet it failed to help her recognize her own flesh and blood.


Eyes filled to the brim, we silently nodded to each other and mutually decided that we were not meant to intrude into this moment. We walked off in a trance-like state, as she was wheeled out on her bed to have a scan done to assess the extent of the damage done.


The walk to the mess was long and silent. In a span of two hours, we had seen three persons whose lives had changed in an instant; all sense of normalcy was destroyed without any warning. Their families were torn apart and their world was shattered. It would never be the same again. Unspeakable and unimaginable tragedies mar the lives of good people, normal people. But we choose to forget them, until they confront us in the eye.


Pranav was concerned about his own mother; she lived alone in another state and if something were to happen to her, no one in the vicinity would be there for her. All of us were with our loved ones in that moment, imagining their state. My mind went back to the girl with burns, her tears and her desolation would haunt me for a long time.


Maybe I do not belong here. Maybe I can’t handle seeing lives being shattered before my eyes. Their grief and trauma is too much for me. Maybe I didn’t want to know the horror stories that are a reality. Would I be able to do my job without emotions clouding my judgment? All I know is that I am alive today. And I am lucky to be alive today, to have my family, all in good health and a state of ‘normalcy’. I am lucky today; because I have a lot to be thankful for and because everything can change in an instant.


Tia Thomas is a second year medical student at St. John's Medical College. She is a pianist , with a keen interest in music , reading and art.