AIDS - A Short Story

(This is a short story by Suresh Ramasubban, a Doctor by profession, and who works with Apollos in Kolkata and is among the top in their echelon. This is one of his essays into the realm of writing a story during a long hopping flight from Kolkata to Pune. On a chance reading yesterday at his place in Delhi, I found it so good as to ask for permission to post it our Jignyaasaa blog, which I felt will be enriched by such spontaneous "from the heart" pieces. Here I am . SR is a cousin of my wife Geetha. I do hope you will all like it, and that this will act as a kind of  a trigger for others in the family to contribute. - Vichu)

AIDS                  

The worship of goddess Durga (pujas) and it's festivities over a ten day period in autumn every year epitomizes Kolkata. As one more round of puja festivities come to embrace us, I look back and reminiscence  at the eight pujas that I have enjoyed in the city of joy. Pujas to me have not only been pandal hopping, eating good food and being part of a community but also work in the hospital. 

Intensive care during the pujas are a double edged sword, admissions are low as nobody wants to come into the hospital unless forced by nature and once one is forced by nature, the consequences are disastrous. This has been true every puja with a few patients making me think, what pujas? where are the pujas?, pujas are all about being in the intensive care and nothing else.

Amongst all these difficult patients during all these pujas , one that I can never forget is the pujas of 2005. That was the year, my daughter was going to witness her first pujas. I was so excited that our pandal hopping would be with our bundle of joy and a bundle of diapers. This was the year that I got exposed to intensive care for the children, literally, at work because of the dengue epidemic and at home because of my daughter.

As Shasti ( sixth day) dawned and I headed to work, my mind was racing to plan a quick work rounds, counseling sessions, home for lunch followed by some early afternoon  pandal hopping, afternoon rounds and back with friends in the evening, alas this planning was only in the mind as nature had some other plans. Just as I finished work rounds with my residents and was turning away from the unit, I was confronted by a father with his one year old daughter in his hand, asking for help. I looked at that small bundle of life, gasping, fighting for air, cold to touch, I knew nature had yet again unleashed its fury. 

As I pictured myself missing lunch, the pujas and  time with family, the only thing that I prayed to was, god whatever it turns out to be, let it happen quickly. If I have to turn this child around let it happen in a jiffy and if it's your desire that we don't succeed, please don't make death linger, while my day suffers. As these petty selfish thoughts crossed my mind, albeit for a brief while, they vanished the moment i assessed the child. I knew I was looking at a child in shock, whose fingers were getting black and she was going to lose her life or limb for sure, if I don't act. So I did act and acted with zeal and energy and in a fashion wherein time was just a witness to my actions and it waited as if dusk and dawn had no meaning. 

Shasti became saptami (seventh day of pujas), lunch time went by and another lunch appeared and surely all this happened in a jiffy for certain as I had no idea where time went. What I knew was that my team had turned around the child, the listless cold child was once again a warm responsive child, the warmth of her cheeks and the happiness in the eyes of her parents could melt many bars of cold steel, leave aside hearts. Amongst all this warmth was one cold finger, the thumb, sticking out like a sore thumb, that remained black, gangrenous and showing no signs of flowing blood and the coldness trickling down to the radial aspect of her hand.

The resuscitation had succeeded but left us with another challenge, throwing my saptami plans to an end, to get that ulnar aspect of her hand to become pulsatile. Once more the team got working, we set out to correct what was possible to correct. As we worked our way through the quagmire of diagnostic difficulties and management issues of how best to perfuse the precious right hand of this one year old girl, the ugly head of AIDS reared up and threw all of our efforts out of the window.

The operating room, the angiography suite, medications which can open up her blocked artery all were arranged and waiting, in a time and place where other than festivities nothing else was imaginable, it is at this time that the ugly head of AIDS surfaced.

Like the cold whiff of arctic air, death in the form of AIDS was  approaching, the warmth in her fathers eyes had turned into icy steel, as he stood alone and chose death for his child and choose to forego treatment as he could not withstand the onslaught of AIDS.

As time was standing still, witnessing our efforts, nobody noticed its entry, it sneaked in, but once it entered nobody could miss it, standing and raising the specter of death. Our efforts came to an abrupt standstill, not knowing how to fight this monster called AIDS. I could not fathom why this tragedy had befallen this precocious child, who was to blame, what could I have done to predict and avert this tragedy.

As in hindu mythology lord Rama prayed through the night and offered prayers to his benefactor, we also prayed for a benefactor for this poor child and as the traditional flower and fruit were being offered to goddess Durga, there appeared one for this child too. This unknown power , came from within us, the combined efforts of all the people working in the hospital, who chipped in with whatever they could, sacrificed whatever they could, most importantly postponed festivities so that this evil of AIDS could be defeated. This power within us was unknown, and what made it real was also unknown but the same power which lord Rama acquired by praying to Durga throughout the night, which enabled him to defeat Ravana, was felt by us as we battled to defeat the evil AIDS.

Defeat we did, the smile on the child's face was worth many a countenance in the various pandals that I missed, this time around AIDS had to turn back defeated. Many more pujas, numerous patients, AIDS has always been lurking around, most of the times it wins and we feel helpless and frustrated.

As I was teaching my residents, HIV medicine and the manifestation of HIV as acquired immune deficiency syndrome (AIDS), I realized that in our country the acquired income deficiency syndrome (AIDS!!!!!!!!) is more important and it can affect everybody and rarely (once in a year) we can save somebody, we have to wait for a Goddess to deliver us from this dreaded issue and give universal access to health care.

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