A cup of tea

STORY

“Dr Bashir is calling you. He’s in the ICU,” the nurse said. She left before any of the students could inquire after her statement, slamming the frosted door shut behind her. The force of it shook the small glass window, the only source of light in the cramped classroom.

For a moment, no one spoke. The medical students eyed each other nervously. They were in their third year of medical school. It had almost been a month since they had started their Pediatrics ward and most of it had been spent goofing around.

Brown eyes darted from face to face, waiting for someone to take the lead. A tray filled with Styrofoam cups of tea sat temptingly on a small stool in front of them; the old sweeper that tended to the children’s ward had brought it in just seconds ago. Steam curled up into the dust speckled air.

Then, as if in response to a signal, the students stumbled to their feet and rushed out the door.

It was still early in the morning. Women in dark, flowing veils and kohl rimmed eyes stared at the students as they jogged down the hospital corridor. Children’s screams and laughter echoed down the sunlit hall, while men in sweat-stained shirts and tanned complexions slumped on benches.

The walls of the neonatal intensive care unit were as white as the students’ overalls. The usual hum of machinery was punctuated by the agonizing cries of a teenage girl huddled in a corner. Her jaws were working around the cotton dupatta balled inside her mouth. Her teary, red eyes gazed desperately at a pair of doctors working over a cot. Uncomfortably, the students realized that she was probably the mother.

Dr Bashir stood at the head, holding the bag valve mask. One of his hands was supporting the mouth mask, while the other methodically inflated and deflated the bag. The doctor next to him was massaging the child’s chest with her thumbs. Apart from the mother’s sobs, the only sound present in the room was that of the doctors’ exertions.

The students stood close to the door, unsure of what to do. One of the girls anxiously tapped her feet. Dr Bashir, noticing their presence, beckoned them forward.

“What are you doing? Come here,” he commanded, his slick moustache quivering as he spoke. His hands did not cease their expert motions.

The students reluctantly did as they were told. They gathered around the tiny cot and peered into the patient’s face.

He must have been around two months. He was dressed from head to toe in blue. The only thing that wasn’t blue was the bib tied around his neck. It was covered with thick, yellow vomit and flecks of bread. His eyes were open wide, as if held there by invisible pliers. They were staring at the ceiling, the bright lights reflected across their dark depths. It was easy to assume that he was indulging in a moment of childish curiosity, examining the glowing fixtures. Except that he wasn’t.

“The mother brought him in 15 minutes ago,” the doctor said grimly. Perspiration was dripping down his face, cascading along his hook-shaped nose. “Said he hadn’t been eating well for the past couple of days. 

Wouldn’t take milk. Anyways, he had a seizure this afternoon - history of epilepsy - and wouldn’t respond after that. So what do they do? They open his mouth and stuff it with milk. Keep on stuffing it until they can no longer hear him breathe.”

He shook his head in frustration, molars grinding together.

“There’s even milk in his airway. In his airway! Of course he wasn’t going to be able to breathe. What did they expect? These people...”

The mother’s wails grew louder. It was almost as if she was being ripped apart from the inside. Finally, a nurse picked her up and gently led her away from the room.

The doctor continued his ministrations in determined silence for a few minutes. Yet, it was becoming painfully clear to the students that the situation was hopeless.

“You kids know about CPR right?” Dr Bashir asked suddenly. The students muttered in affirmation.

“You know how to do it, right? Thirty chest compressions, then rescue breaths. Here,” he said, abruptly passing the bag valve mask to the student nearest to him, who took it with a gulp. “Try it out. One hand around the mouth mask like so ... and the other around the bag. Wait for it to fill up before squeezing.”

As the student tensely followed the doctor’s instructions, he faced the rest of them and spoke. His tone was flat, the emotion from earlier gone.

“As you can see, his chest’s completely caved in from the CPR. That can happen sometimes. In fact, it’s rather frequent. That’s why you have to find the middle ground between being gentle and hard. Too much pressure and you can break the ribs and cause even more damage. Too little and the CPR will fail completely-”

“Sir,” one of boys interrupted. The single syllable had been ejected with a great deal of effort, as if he had been holding his breath underwater for a long time.

“He’s dead...isn’t he?” the medical student continued in a hushed tone. Sweat glistened on his upper lip.

The teacher looked calmly into the boy’s pale face and replied, “He had no respiratory rate when he arrived. Still, we have to try and resuscitate him for a certain amount of time. Does that answer your question?”

The boy nodded, his lips squeezed together.

“Good. Now, who wants to try next?”

And so, the students, with cold sweat covering their palms, and their heart hammering inside their chest, took turns. They each tried very hard not to look at the child’s face while they did so.

One of the boys, in a moment of thoughtlessness, slipped his finger inside the baby’s sock.

“What are you doing?” a girl asked in a horrified whisper.

The boy blushed and sheepishly removed his finger.

“Just feeling for a pulse,” he muttered and scratched the back of his head. Then he aimlessly kicked at the floor.

Finally, the doctor glanced at his watch and sighed. “Shit, the tea’s probably cold by now. We should head back. Let me break the news to the family first.”

He turned to leave, but stopped as if suddenly remembering an important engagement.

“Oh, wait. Almost forgot to show you.” He serenely put his hands on either side of the dead baby’s head, and with a violence so sudden that one of the students flinched, he twisted the child’s head left, then right, then left again.

“See that? No doll’s eye reflex. The eyes stayed right where they were. In a living person they should have moved with the head.”

He repeated the motion again, the dead baby’s tiny limbs flailing lifelessly with the action. A girl grimaced and looked away hastily.

Dr Bashir reached into his pocket and took out a small torch. He shone a light into both eyes separately.

“The pupils don’t constrict in response to light. Pupillary reflex absent. Also, if you’ve noticed, there’s dust already collecting on top of the cornea. You got that?”

The students didn’t respond. They didn’t think they could.

The doctor slipped the torch back into his pocket. He left and the nurses began clearing up the cot. One of them mercifully covered up the baby’s face.

The medical students stood in silence, as dumb as cattle. One of the boys agitatedly clicked a ballpoint pen.

Then a scream, so piercing and bloodcurdling that it made the hair on their skin stand and their insides shrivel up, tore through the room.

The doctor’s head popped up from around the door.

“Come on everyone; let’s go back to class.”

And the young doctors fled outside, past the grieving family and the mother tearing at her scalp and beating her chest, and down the passage filled with the stench of human sweat and disinfectant. With each step they took, the white room with its tiny cot slipped further and further away from their mind. By the time they had rounded the corner, they had all but forgotten about the entire ordeal and were wondering about the cup of tea that was waiting for them.