Blood and the Vermillion

By Tara Rajendran  

 

Machher Jhols’ Bengal. Roshogolla's Bengal. Sandesh's Bengal. Pather Panchali's Bengal. Tagore’s Bengal.

 

I stood beneath the Howrah Bridge, letting my eyes wander in the hues of flesh, the setting sky spread, that matched the priest's dhoti. Brilliant flames of Ganga Arti flickered in the gentle breeze, which had the fragrance of camphor. Bhashkor da stays somewhere nearby, the male nurse in our cancer ward. I pulled out the orange petals from the wilted marigold. The priest sprinkled water from the silver lota with his ring finger, and he looked up and closed his eyes gently.

 

My grandfather, who was redolent of Vibhuti, was a funny old man who loved singing "O Tui Mukh Futey Toh Moner Kotha Ekla bolo re." He regurgitated his times in Kolkata innumerable times to us, lying back in the black folding Nilambur-teak-wood armchair with striped cotton canvas cloth. Many a time, the image of the iconic bridge invaded my dreams.

 

In some of them, I was trapped in the steel bridge, suffocated. We stopped hearing about the Howrah Bridge when he slowly marched into his late 80s. But we did hear "O Tui Mukh Futey Toh Moner Kotha Ekla Bolo Re" join thin air, along with the sweet smell of Vibhuti when my father forgets to close the double doors of his room.

 

My registration number in medical school was 120201468, and 120201466 was a quirky Bengali who shared aromatic and sweet Mutton biriyani with potato and Durga Pujo stories. I saw Bengal mostly through her Android Phone gallery and occasional video calls she makes to her mother during Saraswati Puja.

 

I palpated Kolkata during the general surgery Residency. Begging children with blocked nostrils with phlegm who wore only trousers encircled me whenever I got down at Chitpur Railway station. I am then welcomed by the CITU labourers who wore the communist's red colour uniform with long cotton scarf’s around the neck. And then the Yellow Taxi drivers who wore fading brown uniforms. Finally, by the scent of the first monsoon drops kissing the thirsty parched lips of Bengal soil.

After the spectacular Ganga Arti, I took a cycle rickshaw to the Indian Coffee House, Medical College branch. It had two round stickers of Mohan Bagan Football Club. We love football too: Team Kerala Railways. There were communist party red flags all across the way.

"Dada, Ekta coffee aar duto cutlet" {Brother, one coffee and two cutlets.

My father used to take us to the nearby Indian Coffee House for high-tea when we had orthopaedic clinic visits. My brother and I have broken together 4 bones in the first 2 decades of life. My father thinks highly of Indian Coffee Houses partly because of its concept of worker co-operative societies and partly because he is A.K Gopalan's ardent fan. Kolkata, too, had branches.

I saw this old man coming in loose cream kurta and pajama. He was sauntering, holding the staircase handle. I thought the last table in the vast hall was his usual. The one who looked like the manager took another chair and sat with him. He took a letter from his pocket.

I looked at him through the corner of my eye. He folded the same letter with his trembling hands through the same folds…. The letter was half torn and was dirty that clearly showed the old man had read it innumerable times and had shed tears over each word. All I could see was a beautiful print-like handwriting. I was inquisitive to know who wrote that letter…. As the schedule got busier with the Surgical Oncology rotations, I never got to go back to the coffee house, and neither did I see him again. The sky was always in a heavily pregnant phase with dark clouds and ready to break the amniotic fluid anytime soon.

#

One of our patients passed away. My first Whipple's Procedure. A 46-year-old male with a tumour in the head of the pancreas, stage 4. When we opened him up for surgery, the mass had penetrated the posterior stomach wall. The time was 11:00 PM. Then we; Senior resident, Aditya (the final year Post Graduate) and I; scrubbed in. I was holding the suction and removing blood from the field. The surgery went on till 5:00 AM. I did the skin suture and shifted the patient to the post-operative ward. First Whipple's procedure! That patient has passed away. He had an anastomotic leak.

After a quick rounding and writing a few follow-up details, I walked back; it was 9 in the night, yet the city was crowded. The tire of the empty Cycle rickshaw pulled by a slender man with pigeon chest fell on a pothole, and soft mud squirted to my white Patiala pant...

I lay on my bed listening to the torrential downpour, which is as spellbinding as Kaushiki Chakraborthy's Shudh Sarang.

I woke up to my phone's vibrations and no surprise, I get a maximum of 4 hours of sleep every day. I walked quickly through the short-cut from the hostel to the Hospital. Slippers almost sank in soft and squelchy mud. Received 6 text messages on my way.

1) To put a central cannula for bed number 16.

2) To write a discharge summary for bed number 7.

3) Dress all the ulcers (Inters are on Volunteering duty at Gastro-Intestinal cancer CME).

4) Post-operative ward bed number 23 needs immediate attention; she is bleeding.

5) Dr. Shasawathi Chatterji has preponed a procedure in her own private Hospital, so she will not be available to take the class for Undergraduate final year batch B from 3-4 p.m; need to go there to take attendance.

6) Make a 20-minute PowerPoint presentation for Aditya on 'Carcinoid Syndrome.’ (He did 36 hours shift, and he has a lecture assigned to him for the day after tomorrow for undergraduates).

Grand rounds are already going on. I was gasping for air. The Head of the Unit is walking in the front, and behind are the Senior and Junior Residents, 9 medical students. Aditya bends his body towards me, without taking his eyes off the rounds discussion. He always scribbled on his spiral binding notepad.

"Sidhi, Put a hemostatic suture for him."

He pointed. "Sir, the intern asked to see post-thyroidectomy Day 2 bleeding."

"Minor gaping. I'll take care of that." Aditya continued to make diagrams of the procedure, professor was explaining.

I walked out of the rounds to the unusually calm patient sitting on the outpatient Nilkamal Plastic chair, which read the property of Surg OP43, bleeding from his foot. It took me back to my first year, Anatomy University examination, surface marking of the Dorsalis Pedis artery. The midpoint of 2 malleoli and first inter-metatarsal space. I was still panting; took a pair of sterile gloves.

He was thereby himself. He is a 65-year-old porter who injured his feet while working. Took a mosquito forceps and pulled Dorsalis Pedis from deep inside and asked me to put the suture. His eyes had a single teardrop that didn't trickle. The old man placed his hand on my head for a few seconds, then joined hands. His first few steps were imprinted with blood.

Patients literally flood in on OPD days. The senior resident, made me smell the green Bile tied to the leg of the patient's bed, today —something I will never forget in life, which was her goal exactly. She took us for lunch, and macher jhol came in heavy brass plates with rice. Skeleton of fish - thin, fragile, symmetric, beautiful.

 

I returned to the hostel the next evening at 5:00 PM, 33 hours shift with 1 emergency procedure, three elective amputations, 6 burns dressing, among others. I immediately crashed into my hostel room floor carpet as soon as I entered. I woke up with the banging on the door by the hostel's annoyed matron.
"Why no answering phone, Madam? New Patient aaya hein. Aap ko bula rahi hein. No responsibility only.”{New Patient has come, and you are being called to the Hospital.}

"Ji, ami aashchi.” [I am coming]

#

"Bhaskor da, patient hai kahan?.” {Where is the patient?}.

"Ekhanei chilo…..O dekho Okhanei.” {She was here only…Yeah, there she is.}

I saw her sitting in the Surg OP43. It was 10 at night. I switched on the dust-laden old fan.

"Maa……ki hoeche?" {what happened?}

She extended a half torn, dirty yellow admission card of hers. It was a referred case from Medicine. She was in her mid-fifties, no co-morbidities with an advanced stage of Infiltrating Ductal Carcinoma breast, I ordered a few imaging studies.

#

My old porter patient visited for redressing the wound, but this time, with his wife.

"Kyamon acho?" {How are you uncle?}

The old man smiled full-heartedly, showing his teeth less pink gums and grateful eyes.

“Bhalo, khoob bhalo. Tumi Kotha Theke go?”

{Good, very good! Where are you from?}

“Kerala”

“Ohh! Tumi Madrasi hoe? O Bangla kyamon kore shikle?{Are you a Madrasi? Then from where did you learn Bangla from?}

“Ami Madras theke na go; Kerala theke. Ami Malayali. My friends are a Bengalis.”{Am not a Madrasi. Am from kerala. Am a Malayali.}

“Ohh acha Malayali Madrasi alada?“ {Are Malayali and Madrasi different?}

"Haan go Kaku" {Yes}

He told his wife, "Tumi dekho … O Khub bhalo daactar hobe" {You see… she will become an excellent doctor}.

At night, my mom spoke to me on the phone.

"Aa anugraham eppozhum venam" {In Malayalam: That blessing should always be there…}

Oh ……I forgot my umbrella at the Hospital. I opted to walk to the Hospital using the longer route. Each house, building, shops, trees, and even vehicles are decorated with flowers and vibrant, alternatively blinking LED lights. Bangle markets have opened up like the sprouting in the soil following the first rain—plenty of them on either side of the busy road.

 

Cows chewing and walking at their own pace, creating traffic jam. Women haggling vehemently in the market, fathers managing recalcitrant children, giant wheels with loud Bangla music, pink candy floss sellers, goats licked the glue of the posters stuck on walls where it is written 'Stick No Bills' in bold, dogs wandering in search of food, Tram slowly running through the middle of all this. It's Sapthami today, and two days later, Dashomi and idols of Mother Goddess will be immersed in the sea.

Bhashkor da was there in the OP. "Tum chhatha bhool gaye the na; maine Samhal ke rakh diya."

{You have forgotten your umbrella. Haven't you? I have kept it safely.}

I smiled and took my umbrella back. I saw a familiar face sitting in the window side bed.

"Kyamon achho"

She was completely covered in her red cotton Dhakai Saree, and I could only see her eyes. I sat in the beds of 1980s ….Patients in the surrounding beds had slept already. I kept my hand on her shin. The lady who was sleeping beneath the bed woke up and smiled at me.

The patient told her.

"Leela, Uni aamar daaktar; uni shob bhalo daaktar …. khoob bhalo.”{Leela, she is my doctor. She is an excellent doctor, very good}

"Ami more jete chai na….Ami baachte chai.” {I don't want to die… I want to live.}

Her penetrating eyes metastasized right into my heart.

#

CTVS -cardiothoracic and vascular rotation is equally hectic yet emotionally less taxing than the cancer rotations. 120201466 called me after a long while, and we went out to visit the Oshtomi day pandals together in the evening. Her mother draped red silk saree for both of us. She said candidly:

"Almost 25, still both do not know how to drape a saree, baba re baba!"

We took a break to have Phuchkas.

"So, are you aiming to quit surgery post-graduation when you go to Oxford? Can you pursue the residency when you are back after 4 years of Ph.D.?"
I gulped two Phuchkas at once.

"First of all, it's highly unlikely".

"What if you get accepted?".

"If I get accepted, I will quit the residency. There is no provision for a sabbatical in the training years".

"And, what will be your Ph.D. in?"

"DPhil in Oncology, Colorectal cancer".

"Accha"

"Remember, the popliteal aneurism case we presented in medical school?"

"Haan" (Yes).

"We have one patient in our ward."

"Vividly remember the blood pool on the floor."

"It smelled different too."

"Please, not now."

We continued to walk, and in every pandal, Mother Goddess was draped in Red. Auspicious, blood red.

#

Vascular surgery fellow called me to Hospital at 6 AM for shifting popliteal aneurism patient to the Operation Room. His knee had 2 inches of dressing that got wet with blood in 30 minutes. I ran with my wet hair that dribbled water drops like tears. I saw my breast cancer patient lying on the floor, rigid. Cold. In the shabby red Dhakai Saree Attender was cleaning her bed with Dettol for the next patient waiting on the side in a wheelchair. Leela told me she had asked for me at 4:00 AM. Her eyes invaded my dreams, like how the Howrah bridge haunted me as a child. Dolak played from a nearby pandal…followed by Devi Mahatmyam from the speakers.

#

Dashami day, I got a few hours off in the evening. I called 120201466 to know if she would like to join the procession.

“Matha Khorab ho kya? (Are you mad?) Ma-baba will kill me. Only married women play Sindoor Khela".

Thousands of married women in red and white sarees and arms full of glass bangles applied Vermillion on the deity and on each other. Multiple Processions joined into one and became a river of women in red, like flowing blood. Somebody applied Vermillion on my right cheek, I said nothing and gave her my best smile. She welcomed me into what looked like her tribe. They were dancing in big circles. I danced, to their songs, uninhibited.

 

A hand from behind applied Vermillion on my left cheek. As I closed my eyes, the fine red powder was all over my forehead. Feet looked pretty, as though it was painted with Alta. They immersed Mother Goddess in the giant waves …. The waves rushed to kiss my feet to kiss till my knee … my phone vibrated. "Decision letter DPhil Oncology Program: University of Oxford." I walked back from the waters leaving the crowd behind.

Perhaps I would choose to live in the auspicious city that worships red.

 

Dr. Tara Rajendran from India is a medical doctor and was a finalist for The Rhodes scholarship '18 for her academic brilliance, outstanding extracurricular achievements and leadership qualities. She plays the Veena, a string musical instrument. Her work is published in the Fall edition of 'Blood and thunder" Magazine, University of Oklahoma.