Sunday, October 27, 2013

Shyam

This is a story about Shyam and his family. Shyam was a frail man in his late forties. The day I first met him he could just about open his eyes half way, each of his feeble attempts dying in an anguish of confusion. He had emaciated arms and legs but a markedly large belly. Shyam was dressed in a yellowish-brown shirt, and track pants that went a palm’s length below his wobbly knees. Two young men helped lay him on the bed and his wife wrapped his shivering body in the warmth of a shawl. She touched his sweaty forehead and gently ran her fingers through his messy hair. She closed her eyes for a couple of seconds and took in a deep breath. Like the other women, she wore a circular maroon bindi on her forehead. Her green bangles clattered as she fixed her hair into a tight bun. She sat on the stool beside his bed, patiently, as each of his breaths turned into fragile gasps for air.

My name is Sana and I work as an Intern at the largest government run hospital in Pune City. Shyam was a patient who came in three weeks ago. His wife – whose name I do not know - had the most heart-warming smile I ever got at work. Her smile was a reflection of her kindness, blended with a bit of sorrow and just enough courage to overcome it. The first night that Shyam spent at the hospital was very critical for him. His relatives were advised to be prepared for the worst. It must be so devastatingly painful, being told that somebody you love is going to die.

Shyam’s haemoglobin was 1.2*. His platelets and white blood cells were really low too. He was transfused with a lot of blood products that night, some that were available at our Blood Bank and some that had to be urgently arranged for from outside. I tried to be of as much assistance as I could. I am certain that Shyam may not have any memory of me from that night. It was a long first night for him, but he did manage to make it till the crack of dawn.

Shyam had hypersplenism, and his spleen was demolishing all his blood cells. It was decided that once his condition stabilized, he would be posted for an elective splenectomy surgery. There was a lot of paper work, mostly compromising of forms to issue blood products for Shyam. In due course, I knew his hospital registration number by heart. As the days passed, Shyam sat up in bed with support. Every morning when I would head over to his bed to draw blood for routine labs, he would give me the look. Eventually he learned to say - I will not lie down for you, take blood while I’m sitting; or, why do you come every day; or why do you people transfuse blood daily when you yourself come and withdraw it the next morning. He got crankier with each passing day. But whenever Shyam made his grumpy face his wife would promptly strike up a conversation to compensate. I don’t remember Shyam having ever smiled at me. I wonder what happy Shyam must look like.

Things looked good for him, and to be truthful, I was really glad that his wife would be able to get back to her routine life. For the next two weeks I was posted in another department. The Tuesday I came back to the General Medicine ward, it looked as full as ever. There was a list on the table, of errands to run. I browsed through the list of labs and saw Shyam’s name on it. I walked to that bed on the left side of the aisle where he always was. I looked around for his wife. I thought she would spot me and say ‘Sana Madam’ like she always did. I got back to the list to check if he had been allotted a different bed. The registration number beside his name was wrong. I called up the Resident to tell him that. Apparently, this was another patient with the same name. Shyam had died a while back.

There are so many people in India that I wonder if sometimes we overlook the value of a life. I wasn’t there in the ward the day Shyam took his last breath. I never saw his wife cry, as I expect she must have. I did not see her try to wake him up, as every relative does when someone dies. The only memories I have are of her smiling, and at times blushing when I would playfully ask her how ‘her Shyam’ was.

What could we have done differently? Perhaps if Shyam had come in way before his condition had deteriorated so much, he could’ve had a chance. Was it his destiny? Was it that he had been ignorant? Did it have anything to do with not being educated and aware? Could Shyam not call in sick at work and get checked? Did he not come forward because he couldn’t afford the expenses? Did he maybe not have job? Or was it because we are over-populated and there are too many equally sick patients for him to have gotten undivided attention at the hospital? Would it have helped if had gotten an earlier surgery date? Or, was it because he did not have money to get admitted at a private hospital?

Shyam was an ordinary man. He doesn’t have a great story, one that would change your life. But his life is much like that of a million other people in our country. May you rest in Peace, Shyam.

*Normal range for hemoglobin in a male is 13-15%, below 7% blood transfusion becomes essential.