(c) Dr. Rajas Deshpande
Time and again, relatives dump the invalid, disabled, psychotic or infectious patients in govt. hospitals, provide false addresses or names, and disappear. By default, the ward staff (mainly nurses, servants / ward boys and resident doctors) look after such patients. We sometimes help by shifting them to wards where there are less patients etc. Almost every doctor who has studied in India has spent for such patients from his / her pocket umpteen times: for their medicines, tea, etc., often sharing tiffin with them.
A disoriented, shouting and violent sturdy young man in his twenties was admitted one Friday in the psychiatry ward via casualty. The police had dropped him to be admitted, he was found talking incomprehensible words at a bus station. No relatives, no history available. When I first saw him, he was restrained (hands and legs tied down to the bed) and shouting in spite of the injectable sedatives and antipsychotics given to him. He refused to talk. I called my lecturer on telephone, he told me there was nothing more to be done, as higher doses could cause respiratory paralysis, and as there was no ICU or ventilator, I’d have to intubate him and sit by his side with an ambu bag to ventilate him all night.
I had had my first son just a few weeks ago. Being my son, he was entirely nocturnal, and so it was my duty to entertain him all night till he slept early morning. He preferred that I carried him in arms and walked through the hostel’s dark corridors, starting an agitation if I sat down. So I could not stay out of the hostel at night.
Next morning, around 9 AM, my lecturer took rounds and plainly instructed us that as soon as the patient was “calmer”, we must discharge him, and inform so to the police. “If something happens in the ward or he runs away and harms anyone, we’ll have to spend a lot of time in silly, stupid, mindless paperwork and enquiries” he said. He did have a point there.
“But sir, he has no relatives. Where will he go?” I asked.
“You take him home. He will feel at home with you.” My lecturer commented with a big devil smile, as my colleagues laughed aloud. They had found their gossip topic for next few days. Dissent is killed in Medicine with cruel sarcasm all over the world, we must all grow up to this.
At 5 PM that day, I got a call from the sister: the patient had run away, when she untied him to go to the washroom with servant. I informed the lecturer, who said unprintable things in his local rural mother tongue, fortunately directed only towards the patient. “Inform police” he said at the end of his brief monologue about his life being screwed by this govt. job.
I took my scooter and went to the ward. Informed police. The nurse was terrified, she told me that the patient had gone towards the resident hostels.
Although dirty, most govt. hospital campuses are big. GHATI, where I was training for MD, was super big, over ten acres, with multiple ward buildings, a huge college building and staff quarters. I decided to give it a try and went on searching every road. I found him sitting upon a stone in the big ground behind staff quarters, an isolated area covered with grass. Parking my scooter, I went to him. He saw me but didn’t react. I sat near him and asked him questions softly. He kept looking away. Then I just sat there. The sun started downing.
“I am hungry”, he said in hindi, all of a sudden.
“OK. Five minutes. Stay here, I will get you something”. I said and ran. Proud of my speed on my scooter, I broke my own records that day and reached our college canteen.
Our eternal food god, Mr. Sundar anna, who knew hundreds of budding doctors by name (he had to keep accounts and use funny sounding threats in his Malayalam accented Hindi to stop their food supply, which he never did) took my order with a masked face (I was overdue 80 Rupees by then, and he would next smile at me only when and if I paid it).
He reminded me of the total in stern tones “Paile ka assi abbi ka bara. Paisa dena mangtay nai toh next time nai dega (80 rupees pending plus twelve now, you must pay or next time I will not give you any food )”as I took the parcel. “Sorry Anna, I’m a little short of funds this week” I told him, making an innocent face. He looked away too.
Our patient was still there. He took the pastry and ate it. He threw away the other dish without tasting it. “Come to the ward, it will be cold out here, you cannot sleep here. Plus there are insects”: I requested him. He got up and walked with me to the ward. The nurse was ever happy, and the ward boy brought him dinner in few minutes. He kept staring at that food.
It is beyond us to understand why we do some things instinctively. Just having had a son myself, I was all of a father at age 23, and that spirit is divine. I picked up a morsel from his plate, and held it to his mouth. He ate it. As the nurse stood there with water and in a shock, he ate a complete dinner that night, like a child, as I fed him morsel after morsel. Somehow we were not afraid of him now.
This was so rewardingly peaceful, that I thought it was all gifted by the Universe with some purpose. I understood it much later: that no one is insane at all times. If you touch their hearts correctly, almost everyone is amenable to love. But you must yourself possess it at all times for it to work.
It was the most beautiful thing I learnt as a doctor.
He improved. His name was Ramsharan, he was from Uttar Pradesh. He had run away from his home, as his parents did not allow him to marry his love. The girl who loved him was forcefully married to someone else due to the pressures of their community. They had threatened to kill him if he revolted against the community. He came to Mumbai by a train, then boarded a random bus. He did not remember how he reached Aurangabad where police had found him.
He was discharged in a few days. My lecturer gave him some money to last a few weeks.
By then Ramsharan had regained a narrow minded sanity that our society could grasp.
© Dr. Rajas Deshpande
True, except patient’s name.