The Evil

It takes only few telephone rings to wake me up. After all these years, I still cannot sleep comfortably when I am on call. It was 2.30 in the morning and I guessed it must be something serious. The call was from the on call physician from the ER. A Bengali man had been just brought in with severe shortness of breath. There was no more history. Those who had brought him had left him in the ER and disappeared. He was found to have severe hypertension and was not improving on the usual lines of treatment.

I discussed with the doctor  and decided to shift him to the ICU and also requested to alert the anesthetist, in case we needed to place him on ventilator. By the time I reached the hospital, he was in ICU. He had severe breathing difficulty and was unable to answer any questions. His blood pressure was too high to be recorded, and it stayed so, in spite of receiving medicines through I V line. That was unusual. I guessed it must be no ordinary hypertension, and must have some serious underlying reason. We gave him a large dose of a diuretic    (a medicine to force the kidneys to produce urine) and another medication to reduce blood pressure. The lab results came in by this time. He was in end stage kidney failure. And that was why his lungs got flooded, making him struggle for breath.

It was impossible to get any history from him. Medical practice, without proper history, is almost like veterinary practice. In fact, half the diagnosis is made from what the patients tell us about their illness. When a patient is critically ill, the doctor is under the worst stress, the patient probably would have lost his consciousness. It took us a lot of stress and effort to get the many test results to come to a conclusion. He had severe hypertension and renal failure due to end stage kidney disease. He needed emergency dialysis. By this time the medications had started taking some effect. His BP was coming down and breathing getting easier. We alerted the nephrologist for emergency dialysis. The patient would die without it.

It was when I started to chart his file that I found he was removing his oxygen mask and calling us by gestures.  Morphia had taken its effect and he was drowsy. He couldn’t talk still, but was desperately trying to say something. Through the gasps for breathe I could gather some words

“ Kapda !, mera kapda !” (Clothes! My clothes!)

I couldn’t make out first. But he was frantically looking all around for something and again removed his oxygen mask and repeated

“Mera  kapda”

I understood it then. In the ICU, the nurses had removed his own clothes and put on him the hospital gowns .I told him there was no need to worry and his clothes would be given to him when he leaves the ICU. He was not satisfied and again kept on repeating the same slogan.

I was close to getting irritated. We were desperately trying to keep him alive, and here he was, worrying about his clothes!

 I asked him  “Bhai, why are you afraid ? No one will take your clothes. They are kept in the cupboard”.

This time he added” Hamara Paisa”, (My money!)  and I understood. His purse was in the shirt pocket and his money was in it. The nurse told him” Brother your purse is with us, and we have counted and kept 120 dirham also’

He appeared bit relaxed after that. He kept his oxygen mask back in place.