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Difficult times this.....

 They were an elderly couple and every month they came to me for their diabetic medication. Like a lot of my regulars I tried to make their time in the outpatient as simple as possible.Recognising them by sight,I would cut the line because of their age and the familiarity of their medical problem to hurry things for them.They had a lot of questions but they continued to come to us beyond my absence of six months during the covid lockdown.One day I saw them after a gap of one month and I found that Achala had lost a significant weight.Her diabetes was well controlled so I started digging further and found that she had had a bad bout of loose stools.Clinical examination did not show any pointers for concern so I decided to keep a watch on her weight.

Each time she came to us her weight was the first thing I would check and the husband would be all ears and demanding to know how it was going.She gained back what she had lost.Whenever she weighed herself she would beam at me with relief.

This covid season ,the thing that I dreaded the most,to see my regular patients infected and symptomatic happened.One afternoon my colleague was seeing the patients in the emergency and we were struggling with accessing enough qxygen ,I got a call from my colleague that one of the patients with low saturation was asking for me.My heart sank ,and there was Achala with her husband .Her sugars were sky high and she had covid in the CXR.

Somehow my colleagues organised Oxygen cylinders and we put her in.She was the sickest person in the ward.

After quite a struggle we got some kind of control over her blood sugar although we had to put her on IV dexamethasone.Thus began the ordeal for my colleagues and I .Every day was a strife and a battle to fight the enemy.Unlike our other patients who faced the ordeal of the NIV well she was vocal about the discomfort it brought her and we had to cajole her like a child everytime we had to put her on NIV.She would bargain,ask for breaks,...we fed her,chided her,gave her man to man nursing,prayed with her and some days the doctors sat by her bed for hours together adjusting her oxygen,just making sure everything was fine.

She went downhill gradually.In the last but one day she stopped mantaining saturation when off the NIV .Her husband a stern looking man  ,initially would guard her and flap around her.The old man in his late sixties and seventies slept in the Sarai and would come over whenever we needed help talking to her.

Last night just before handing her over to my colleague,I had an inkling that she might not make it so I requested my colleagues to be gentle with her by which I meant 'let her have her way'..Pooja took a wet wipe and wiped her face and her feet on my request.We moved her to a more comfortable area.

I wondered how the husband would cope.

The next morning she rapidly sank with her husband and her son by her side.The old man who had always walked to the hospital with her. sat by the bedside with his eyes on the saturation in the monitor.

She asked for water which I gave her and then after fifteen minutes she started losing conciousness and then she succumbed.My colleague had been communicating with the family.I had wondered how the old man  would cope.When she passed, one of the sons who was present, started sobbing even as a colleague of mine held him.The old man firmly reprimended the son.It went something in the line of. 'Why are you crying?' and the son immediately stopped.

The old man asked my colleague to get the paper works done and went about making arrangements to take the body home.I looked at Achala's body and felt the grief immensely but the old man's reaction confounded me and after doing the paper works I walked back home feeling defeated.I met another colleague of mine who informed me that a father of her friend who had been transferrred from Delhi to Ludhiana in an ICU ambulance had succumbed to a secondary infection with acinobacter.

'Come with me to a quiet place and rest awhile.' Mark 6 vs 31.







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