To know you don't have much time. To know that beyond that throbbing heart with a soaring pulse and a fever that refuses to die down...the moments gradually converge to those few painful, insipid days spent in an ordinary Indian hospital with a voice that slowly gives way to a willowy whisper, all taste buds going to sleep one after the other with a promise never to come back. The pulse continues its monstrous overtones with a vengeance...And you know, behind all those cells that are gushing through the veins laden with at that instant with all those poisons that your body manufactured for itself...you know, that your time has come. You are suffering from Acute Myeloid Leukemia.
And this time, it wont retrace its steps; this time around it will refuse to give you more time.
How much time is enough for a seventeen year old? Who decides that he has had enough in his life? He has faithfully laid himself to the scrutiny and awe of at least 5 batches of students tottering on the brink of their graduation to the point he told them answers to the questions the examiner would ask. The first day I saw him was a warm day in August when I was in rotation in Unit 3 and we were holding this prefinal examination...He moved from his side to mine, with the complaint that he did not like to lie with other women patients and that there was " too much sun". He had Petechiae then. He told me he had cancer when I was telling the nervous examinee the D/Ds of Petechiae. Beside him stood his elder brother, not a year over 22..with angelic kind eyes. They made a fun pair. And I was insistent he leave the bed he was occupying on "my side' for "my patient" as soon as the exam was over. They did.
He had stayed for quite some time now. And I learnt from them that I love being told "Good morning Mam", instead of a "namaste doctorsaab". They perched on the bed next to the sister's common room and I always saw them first thing I entered the ward. Both the boys always had that smile.
Next he came under me in the month of October as his status went further down. His brother did every thing for him, still does. Not once have I seen this guy of seventeen cry, or whine or mourn...He is stylish, he likes to sleep on the bed with his shoes on, he gives me a flashing smile each time I see him, and I love those two always wishing me a " Good morning mam.." For once, I feel good to be 27.
Deepak quit studies when he was in 10th. His brother is doing a Bachelor's degree in Arts. Together, these two live in the hearts of most sisters in the ward. I have never seen any of the sisters ever delaying or being rude to them. And I have never seen them ever coming back to complain or crib about anyone or any thing. They stay in their ward, they smile, joke like two buddies, they are both smart and into the times. Often I have seen Deepak reading newspapers.
Deepak will go. Its a fact, and its this time. He has 90 % blasts in his peripheral smear. This time no amount of blood or platelets or chemotherapy will save his life. His tongue is white, he persistently runs a fever, and his mouth has begun to smell that bovine stench I first noticed in Omraj, my first leukemia Patient. I ordered Listerine asap.
Today his brother came back to me to ask if they would take him back because anyhow the end was explained. Unit I is running through a double emergency so it is me more or less who goes there once or twice to talk to him. I told him it was entirely up to him...He was explained that despite being on Augmentin, Levoflox and Magnova if he runs a fever, it doesn't indicate a good thing. His brother looked me in the eye, and asked me " Is this the end?"
"Yes", I told him. "Keep him happy. Give him whatever he wants to eat, whatever he wants to do"
" I will", he said, with a smile that did not quite reach his eyes. " Good night mam ."
I see this guy with his kid brother and I wonder just how people manage to take their own lives with their own hands...not very far from him lies another guy who has multiple Pyogenic Liver Abscess because of his own callousness. There is not one moment when he doesnt abuse his sister-in-law, his only attendant..He doesnt take medicines, doesn't take fluids, doesn't get nebulized, and whenever I ask him if he has any more pain, he replies, 'I am perfectly okay', in such a manner that makes me want to slap his living sardonic trait off his brains for good...but you get these two...both of them heading perhaps to the same end, albeit through different paths. But I see Deepak smiling, chatting, being happy even while he knows how its going to end. And I see this man, who will perhaps survive..but to be honest, he does nothing any single day of his living life to deserve the moments he is having.
I love this kid and his brother. I pray his brother lives a long prosperous life. Because he is a good soul. As for Deepak, I don't know what to say. I hope whatever it takes, how much time, or energy or care, he should be happy till the end.....He deserves more life than anybody else present in Ward 3 PGIMS, Rohatk. And I know he knows it. But he doesn't complain.
Thats what makes him so special. The ultimate Mam's kind of guy.
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