Intensive Care Unit — entry restricted
One didn’t have to be a soothsayer or a wizened interpreter of the birth charts to visualise the fast approaching culmination of that patient’s sojourn on Earth. A flurry of frenzied activity had been going on for some time now near his bedside in the ICU. Our intensive care colleagues had deciphered the cryptic yet evident messages being beeped from overhead monitors and contained in what could appear as some weird data to an unaccustomed mind. Sometimes, though not very often, we find ourselves in a dark blind alley despite the indubitable ability to interpret and act according to that data. An almost ritualistic conveying that information in a relatively straightforward language to the family of such a patient would follow these deliberations.
Was it giving up the efforts, resigning to fate, accepting defeat or just acknowledging our limitations? Despite all the scientific and technological armamentarium at our disposal, the imminently unavoidable futility of our efforts with the onslaught of visible and invisible adversaries in the form of disease and disability stared rudely at us. In the face of some mysterious force, our most sophisticated medical gadgetry seemed rudimentary. This is certainly not an uncommon event in a medic’s career, yet something was mystifying, at least for me, that evening that makes me share my thoughts with you.
‘Intensive Care Unit (ICU) — Entry Restricted’, this not an unfamiliar signage, is a telltale indication of vigour and pace of the activity likely to be witnessed in that awe-inspiring enclosure within any hospital premises. All through the week, it continues to be a unique world radically different from the one outside. Year upon year, it has witnessed the same scene repeating itself, though in a variety of different hues and shades. An interminable, fervently passionate play has kept on getting enacted here without the curtain ever going down. Day in and day out, a host of actors played their assigned and assumed roles at this stage. The actors change at a regular frequency. Their functions, and the acts in this play transit with imperceptible smoothness, merge into one another without any conspicuous distinction lines. Ever wondered who directs this play and for whom? It is the same inexplicable force that produces as well as witnesses this play. Every now and then, it comes up with new dimensions and challenges all the actors to decipher the messages. Sometimes it mocks at us imperceptibly for our foolhardiness. At other times, it rewards us for our tenacity, our belief in our efforts and struggles, our faith in the experience accumulated over a year of similar actions and struggle and the wisdom bequeathed to us down the generations.
It was an evidently hopeless surgical situation. Having unsuccessfully tried my best to salvage it, I decided to physically remove myself from there. Having done that, I felt that despite my physical withdrawal, my Self had stayed on there. It was not a reluctance to act but the realisation of possible aggravation of the patient’s misery due to my efforts that made me withdraw from the activity’s epicentre. However, I couldn’t really move much far away from there. Was it that I was sharing my bit of moral responsibility for the patient’s treatment by continuing to stay on? What was it was that kept me glued to that spot? Did I also nurture the same kind of hope as his family? I wondered at myself; for a fleeting moment, I found myself awaiting a miraculous turn in the course of events so that I could again resume my professional efforts at salvaging another life. Miracles do happen every moment. One doesn’t have to be a believer to appreciate them or a non-believer to denounce; they keep on happening nevertheless. The unfolding and folding back of life itself is a miracle of incredible proportions. The data being poured out that day by all the machines reinforced that one doesn’t wait for miracles to happen, but one gets to witness them happen if they have to happen. These extraordinary events, which stand out from the rest of them, also have their roots in some pre-existing milieu made possible by some known and maybe largely unknown factors.
A thick, toughened glass panel isolated this zone of intense activity in this building from the placid blue domain that stretched all around it as if comforting and nursing everything else in its lap. I found myself staring into the nothingness that permeated both sides of the world across the glass partition. Was it really a nothingness? The stillness betrayed the uninterrupted flow of sap from the roots to the farthest leaflets in the tree. The botanists had all sorts of explanations as to the mechanism of this flow. But for the moment, our only concern was his vital parameters. The message from emerging data was getting more precise. His system was getting depleted of all the reserves at a very rapid pace. Was disease the culprit or efforts to come out of it or the invisible load of years weighing heavily on his being or all of them put together? Was finding an answer worth anything?
A little far away from there, another tree looked like a veritable treasure trove of gold. Most of its leaves had matured and were dancing merrily. It was a celebration of their life. Having reached their prime, some of them would suddenly start on their earthward journey. One by one, they came to settle around the tree trunk like children around their grandparents, asking for stories even though each one of them had countless stories of innumerable moonrises and sunsets wrapped up in their beings. My straying vision made me notice an empty nest in forking of branches in the tree, and I wondered about its occupants. Where would have they gone? And why? What or who might have made them take that decision? Did they actually decide, or they merely acted following a decision made already by someone unseen? Did they have a choice? Does someone have a choice? No one could have known these questions arising in my mind, let alone answer them to my satisfaction.
Soon it was time for the family briefing. They came up with their own questions and almost palpable anguish. While for us, there was hardly anything in it which had not been repeated earlier in one form or the other, with one family or other in almost similar circumstances. I sat through the discussion, trying to figure out how to enable them to walk across that chasm between fact and fiction to come over to our side and partake of our anguish as well.
A baffling mix of emotions, feelings and the responses to those mental and intellectual stimuli pervades all-around within the charged confines of an ICU. Blinking lights on the monitor screens and regularly irregular lines seem to be executing weird dance movements to the tune of beeps emanating from the monitors. One may have to invest an entire lifetime searching for a method for successfully preempting the message likely to be conveyed by them. Most of our actions are responses to events in the past which was once a measure of the future. And how about the current moment, the present? Does it exist independent of the two? Does it exist at all? Aren’t we at best making juvenile attempts are creating compartments within an incessant, immutable continuity that has no beginning and no end? Participating in the ICU struggles, contributing to interactions with families and patients at the two ends of an ever stretching elastic band about to snap or about to recoil; helping people being moved in wheelchairs and strapped to stretchers makes me turn inwards searching for an undefinable uncharted shore.
Whenever the shrieking ambulances rudely scare my constant companions, those bewildering questions away from me and turn dreams into ghosts, I wonder at the birds carrying twigs in their beaks and the nests they will weave. Don’t they also dream to survive the next squall and stay on till it is time to fly away? How would they become aware of that time?
There is hope and so is despair, there is light and so is darkness, there is birth and so is death, there are smiles, and there are tears, there are songs, and there is silence, echoes and words, and so are the pauses which have nurtured the continuity of existence. It has existed since eternity, and eternity too has prevailed since then.
… a cloud drifted past the window, and I was with my sky again.
