In one corner of a huge, dimly-lit emergency room (ER) in a public hospital in India, a young doctor is struggling in one of the most miserable conversations of his life: communicating the death of a patient to their loved ones is, after all, a skill doctors take time to master. Loud crying has erupted from the adjacent room -- the seasoned doctor there seems to have communicated the difficult message.
Outside the ER is an ominous mob of dozens of people, discussing animatedly the fragile health of a friend undergoing treatment. The security guards are on their toes. Their discussion about when the authorities will end the three months' salary-drought was interrupted by the CMO (Chief Medical Officer) asking them to watch the crowd.
An ambulance screeches to a halt and who looks like a pizza delivery boy is rushed inside on a stretcher with blood gushing from a huge wound on his head. His arrival makes a surgical intern visibly excited, as he had been waiting the whole day to "practice suturing". His senior is quick to chastise him: "Our profession may rely upon people's misfortunes, but you don't need to make a spectacle of it." Meanwhile, the surgical resident braces herself for yet another sleepless night in the Operation Theatre.
"Rumour has it that Dr X has just one work agenda: Don't call it a day until the bulge in the pocket parallels the bulge of the paunch."
Suddenly loud noises emanate from the main cabin: the CMO has apparently lost his cool over a patient who subtly offered him a bribe in exchange for a false injury report. The nurses promptly start buzzing -- they know there is another CMO (Dr X) for whom such offers are like manna from heaven. Rumour has it that Dr X has just one work agenda: Don't call it a day until the bulge in the pocket parallels the bulge of the paunch.
Meanwhile, in the labour room on the upper floor, three doctors are unburdening their wallets and pooling together money to help their patient. A woman in labour needs two units of blood and her husband, a restaurant waiter, does not have the money to buy it.
In one OPD a doctor is harshly berating a patient for not "seeing straight ahead" during an eye exam, while in the ward downstairs a doctor is waving away the profuse thanks of her patient by humbly saying, "We are what we are only because of you."
These highly unique and powerful scenes are a daily occurrence in a government hospital in India. If it were ever possible for all the emotions of all the people in the hospital to collectively float above and form a cloud, that cloud on condensing would rain ecstasy and hope, and despair and melancholia, and everything in between, all at once.
"When a poor Indian needs the cheapest medical help, it is the place to go; when a rich Indian wants the best medical education, it again is the place to go."
The public hospital is one of the most significant addresses in the lives of most Indians. And just like the country itself, it is a place of glorious contradictions. When a poor Indian needs the cheapest medical help, it is the place to go; when a rich Indian wants the best medical education, it again is the place to go. For an optimist it is a venerable temple: despite so much despair and frustration in the air, hope and kindness always spring up from some or the other quarter.
The camaraderie between neighbouring patients and their kin is legendary. If there were a "best ice breaker" contest, ailments would trump the weather as a conversation starter. In the hospital, inquiries of "So what brings you here?" between strangers snowball into riveting discussions on family matters within minutes. The relatives of patients are quite a significant volunteer force in any Indian public hospital, helping the medics and paramedics in everything from holding the arm of a patient during a blood draw (well, our hospitals suffer from a lack/truancy of formal staff), to fetching food and medicines for those whose kin are absent or away.
Doctors in India are being much maligned of late for a lot of reasons, but that is just one side of the coin. Here you will see them huffing, puffing and drenching themselves in sweat to save someone's life, or defying sleep heroically so as not to miss a single change on the monitor of an ICU patient, or relinquishing festivals, parties and family get-togethers so that there's always somebody at the hospital to look after the patients.
"[W]ith its gallant army of coated, gowned, scrubbed, gloved and masked soldiers inspiring it, the Great Indian Hospital marches forth day and night, unshakeably."
Just like that other eternal symbol of Indian society and culture, the Indian Railways, the public hospital too provides wonderful insights into the psyche of this electrifying nation. And despite the hundreds of glitches due to the peculiar nature and functioning of India's government organisations, both these entities have been going strong and running fairly satisfactorily due to the passion and zeal of their unsung, anonymous ordinary employees.
At the hospital, the unspoken diktat is this: The show must go on. While in one room someone breathes their last despite health workers' best endeavours, another room sees their efforts help someone take their first breath. As if the countless incarnations of disease were not enough, this unremitting contest between Life and Death dominates the hospital all the time. Yet, with its gallant army of coated, gowned, scrubbed, gloved and masked soldiers inspiring it, the Great Indian Hospital marches forth day and night, unshakeably.