Vartika Mishra
Lucknow, India

“This is all I have ever wanted. I have worked hard for this, and now is the time to rise and shine,” I reminded myself as I entered the shabby gates of the hospital. As a first-year resident in obstetrics and gynecology, inspiring myself to get out of bed every day had become a necessity.

It was still dark outside. The whole hospital was asleep. I started my rounds with the gynecology ward. Five other first-year residents, all with files stacked in one hand, blood pressure machine in the other, and stethoscope around their necks, were waking up patients one by one to take their vitals. All five pairs of eyes were sleep deprived, all five faces looked starved, but all five pairs of hands moved swiftly to get the maximum possible work done in minimum time.

My biggest concern as I rounded were that my discharges were not done, and I needed to complete them before the consultants rounded. Discharges are merely paperwork—a summary of the treatment, medications, and follow-up given to the patient before they go home. An incomplete discharge means a patient cannot go home, a new patient will not get a bed, and the whole system will come to a halt.

So, consultants tend to lose it if discharges are not ready on time.

Even patients, the moment they learn that they are fit to go home, get impatient and act as if they have been kidnapped by hospital authorities.

No first-year resident wishes to be responsible for a “discharge disaster.” Our whole existence revolved around making discharges, and if they were not done on time, we could be blacklisted and deemed lazy. And one could never predict how long it might take to remove that label.

My plan for the morning was solid. Except for one obstacle: Kalawati Amma.

She was a heavy post-hysterectomy patient with a gaping abdominal wound. I had anticipated the wound dehiscence, but I had not expected her postoperative care to be so taxing. She was easy to spot from a distance because she was always clad in a bright red nightdress. Also, she was the only patient who did not get out of bed, no matter how much I talked to her about the advantages of postoperative mobilization. So, every morning, I had to dress her wound at the bedside.

There was only one functional dressing trolley in the gynecology ward, and it required spy-level planning and execution to get hold of it before anyone else. Sakshi and I ran towards the dressing room simultaneously. I beat her by a few seconds, took the trolley, and thanked my lucky stars. I hurt my elbow in the process but it was worth it.

“Let me have the trolley. I will be super quick,” said Sakshi from the other end of the trolley.

“Sorry”—I was not sorry—”I cannot. I have Kalawati Amma. It’s going to take me ages. I haven’t even completed my discharges for the day.” I pulled the trolley away.

Once I started dressing Kalawati Amma, it seemed like my plan was finally falling into place. I waited patiently for about five minutes while she adjusted her nightdress to expose her wound. She yelled and screamed in agony even before I could touch her, waking up the rest of the sleeping patients. They all stared at me with sheer disapproval for being so ruthless. I dressed the wound, taking the utmost care to remove all the slough to ensure her speedy recovery. I looked at the work I had done and was pretty pleased with myself.

I realized that I could not tape the gauze without shifting her, so I pleaded, “Kalawati Amma, would you please turn to your left so that I can tape your dressing?”

Kalawati Amma stared at me in horror. “Aaayyeee, I can’t even breathe and you want me to toss and turn to make your work easier!”

I did the best I could with the tape and left, but not before giving her another small talk on postoperative mobilization. “You know Amma, if you try to move it will help with your recovery, and soon you will—”

She cut me off abruptly and looked at the other patients for approval. “Why can’t she let it go? I am in so much pain all the time.”

I gave up.

The most crucial part of dressing comes when you are done and you have to convince the patient that in case the consultant asks, the dressing was done by the second-year resident. Since Kalawati Amma would not get out of bed, we had come up with this unspoken pact. The arrangement seemed to have worked well for both of us.

Next, I pitched my plan to complete my discharges to my co-resident Richa, “I am going to casually slip out of the consultant’s round, take the discharges to a secluded corner of the hospital, and quickly complete them.”

Richa added, “I, on the other hand, will ensure that if you are spotted missing, I will exclaim that you were on rounds only seconds ago and call you immediately.”

My accomplice and I were fairly certain that we would pull off the plan, unaware of what the day had in store for us.

Jammed in the resident room on the ground floor, hiding behind the center table, I was writing frantically, hoping to complete my work before the rounds were done. Suddenly I felt giddy. The whole room seemed to spin and for a moment I felt like the central table was shifting towards me. I told my mind to calm down, and my body to stop falling sick before the discharges were done. Right then the door burst open. Richa was staring at me, aghast.

She yelled, “Earthquake!! We need to get out NOW!”

We rushed out into the corridor and ran as fast as we could. At least forty other people were running alongside us. Irrespective of what position they held in the hospital, what job they were doing, or how close they were to the door, everybody was running towards the exit. Being alive is the number one priority for most people.

This is the conversation we had while we were making it to the exit, now with a hundred other human beings alongside us.

“How many discharges are still incomplete?” Richa asked.

“Oh no! I accidentally left the discharges in the resident room!”

“Should we go get them? In this chaos, we might get some extra time to complete them.”

“Yes, sure, we have to get them…what if this earthquake subsides, everything gets back to normal, and it is discovered that the discharges are not ready yet!!”

Thus, together we resolved to rush back to get our discharge files and only then make it to safety. We made a U-turn and darted in the opposite direction. As we cut through the racing crowd, we were met with astonishment and disbelief. Some people thought we had lost our minds, but luckily everyone chose to move to safety instead of ridiculing us.

Eventually, we made it to the resident room, grabbed our files, and made a run for the door. But the highlight of the day was still to come. While we were sprinting towards the door, an unidentified person moved so fast past me that it appeared like a huge bright red blob.

On further examination, I realized it was Kalawati Amma.

I watched her on the other side of the gate. With her eyes widened, she was telling everyone, “The moment I felt the first tremor I lifted my nightdress and ran like the wind.” She grinned, “These youngsters were too slow.”

I vowed to never do her dressing bedside again.

It took us years to mend our perspective on life and set our priorities right, but for now, Richa and I agreed on one thing: the deal with Kalawati Amma was off for good.