Walking Amidst Tragic Love Stories
Written by Dr. Geeta Sundar
Trigger Warning: The following contains descriptions of the loss of a loved one, descriptions of death, miscarriages, and blood/organs.
Check in with your doctor friends and family; we heal trauma, and but in doing so, bear the brunt of it ourselves.
He was wheeled in at 9 pm that night. I was on the roster duty and saw him first. Not a good prognosis at all. GCS – E1 VT M2, anisocoria, and almost barely alive, large bleeds coating his CT scan in almost every nook and corner. But not brain dead. In all circumstances, as is the most logical, I gear up a resolve of underlying stoic facies, mentally tasking myself with what needs to be counselled to the family.
But I am met with a bewildering mass of a small, rounded woman. Already weeping. Intense sobs rack her system and she is almost pleading, her eyes, her face holding the grave knowledge of what fate awaits her.
“Don’t tell me bad news. I can’t handle it!” her wail is sharp, but has a begging note to it.
I steel away. Look around to see if anyone else can accompany this woman. I cannot simply talk to her when she is this emotional. I don’t have the time to be patient, hold her hand and stroke her to some ideological prognosis where she can stop crying. Reality is reality. I don’t have the sympathy gene in me.
I find the patient’s brother and draw the two of them in to a smaller room where we counsel people. But in walks a horde of 4 other relatives, all with shocking expressions on their face, sad looks and an etching hope that is really pointless. I sit down on the battered chair, looks at my hands, continue to wear my mask, for fear that I might twitch or express any micro-expressions that communicate an underlying possibility of optimism in this horrible scenario.
“I am going to be honest…” I start, but I am cut short by the woman. She just wont stop crying. Tears just keep pouring out of her face. Over and over. She is here to say her mind, say her piece and I have to give her the chance.
“Please. Do everything. I can’t go back home. They will kill me.”
I stop. I let her proceed. The story is simple, but so weirdly tragic – she is the patient’s wife, and early in the morning, in preparation for some worship at home, she had requested the patient to get her some flowers from their garden, the ones hanging away from their compound wall, that required him to climb up a wall. He, all of 35 years old, quite fit, obliged her wishes, and climbed up the 5 feet compound to peel away those flowers. But unfortunately for him, the early morning rain had created a mossy patch on the wall, against which he slipped and fell, hitting his head against the grill inserted on their garden floor.
Tragic. Unfortunately, awful.
When she had relayed her story, the young love they had, the way they had found each other, and gotten married, had 2 beautiful children under 7 together, did I continue the task I had come prepared for. In reality, there was nothing much to do, I said, we can offer surgery with very high risk, to the extent of severe complications under GA, on table and an overall extremely poor outcome, tracheostomy, infections, prolonged stay, ventilation etc.
Sure enough, her eyes pop out, discerning disbelief in her face, and she starts to weep in earnest again. Scared, terrified of what his family will do to her, how they will brand her, call her names, shout/yell at her for forcing her husband to get flowers that had absolutely no consequence whatsoever, and that he had to lose his life for such a small act. That his one act at her behest would cost their entire family so much price. Invaluable. And she would be the sole perpetuator on this one action that cost so dearly.
Insane.
Love is kind. Love is patient. Love is endless. Love is forgiving. Love is empathy. Love is healing. Love is everything. But love is pathetic. Love encompasses everything. It takes many forms. It breathes, it lives, it tarnishes.
If Bollywood, Hollywood, Romeo-Juliet, Erich Sehgal and my own experiences have taught me anything, love always comes at a price. It takes away time, it gives conflicting emotions and has the ability to break your heart even in the best situations. Love is tragic. Love is melancholy. Love is the only feeling that gives and takes so much. And somehow love creates happiness, but also so much sadness. It is better to have never loved, than to have loved and lost. (I know, I am mentioning the wording wrong!)
We operated on him in the next 30 mins, only to lose him after 2 days. He had been climbing up the stairs towards that door to the Citadel anyway, and the surgery just enhanced the rate of his ascent. I had to be the one to break the news to her. I sat her down again, in another room, smaller than the prior, 4 dusky walls coating, with a fan running in speed, buzzing through the air, and told her we did our best, but he succumbed.
She cries again. “This is my fate. I did this. I made him fall. This is my cross to bear. You have been telling me right from the start that this would happen, and I didn’t listen. I am the sole doer of this to myself, and my kids’ life. I deserve this. But how will I go on now? How…?”
I have no answer. Absolutely nothing to tell her. I keep silent. I look down, and walk away, hearing her sobs, her screams, her wails.
Love comes at a cost. It pays severely. It takes painfully.
*
The 25-year-old brought in, bruised, battered face, Raccoon eyes of 2 days old, but stable enough to recite his history and talk adequately. “Brother banged me up. We got into a fight over some financial properties and he was mad.”
I jot down his history and assess him. CT brain is recommended – and shows a large EDH in the frontal region with multiple junctional cranio-facial fractures. I pronounce that we need to operate, since this would not have a good prognosis otherwise. Reluctant for surgery, but worried about the outcomes, the sister of the patient gives her consent and we operate on him.
As we prepare him for the craniotomy, his sister sits down and volunteers her story – her brothers were extremely close, best buds, but things changed ever since the older brother got married. The sister-in-law had eyes on the family’s worth and wanted a hand in it. Things got complicated when she had a miscarriage and then things just went south. So much south that the brothers beat up each other recklessly, but this younger brother being weaker could not put up much of a fight and he lost.
I shrug. “Injury is severe. Grievous hurt. Punishable offense.”
She nods and worries her lower lip. “I know. We are concerned about the implications as well, but are not sure if he will press charges, after all, it’s a family matter.”
Love, again. Love forms the basis of family. The thread that connects everything. The joy that is representative of belonging. But the same love can stab you in the back, and break you apart into a thousand pieces. The very same love, the same love that is understanding, patient, can turn blind and be savage in rage.
Oh, love. What, love? Love is a disaster recipe.
*
80-year female, heart condition on 3 anticoagulants, prior stroke, injured herself with a slip and fall at home and has been deteriorating by the hour since then. She was brought with M6 status, but climbed downhill to M3, was intubated and an emergent repeat CT scan showed a large blooming right SDH. Now comes the dilemma – to operate or not? Age, comorbids, bleeding, lab investigations, poor GCS with M2 response, dilated pupils…what to do?
We counsel the family. Tell them honestly all there is to share. The older, mature son of the patient agrees – let’s leave it be, he doesn’t want her facing too much pain and ‘torture’ towards the end of her life. His wife agrees and they don’t want the surgery done. However, ten minutes later the younger son walks in. He has a different story to tell.
“I want the surgery. Operate.” he commands. His abroad education rolls off his tongue in a fake authenticity that I know is a drag. “My mother is everything to me.” he shrugs. His face depicts sadness and a repertoire of fear.
The older brother and this brother share a few words in private. And then they are back with a decision. For us to go ahead with the surgery. No matter what. Even if there is a tiny, minuscule chance that the surgery can give her “life”, they want us to do it. Go aggressive. Go big.
So, we take her up for the procedure, somewhere deep down knowing that we are about to do an act that might push her to the brink of no return, that her body might not even sustain the surgery in the first place and have grave repercussions on her last few minutes/hours before her demise. But they consented and requested for it.
The brain was pale, non-pulsatile, literally peeling off at the edges. Her BP kept dropping. We did what we could and got out at the earliest. When I spoke to the daughter-in-law after the procedure, the mature, wise woman nodded to the events described. “The younger son ‘loves’ his mother. He hasn’t seen her in over 7 years, always busy with work and what not. The old lady stays with me and my husband, and we have been caring for her since long. I am concerned about the implications of the postoperative care – if she survives, then she comes back with us and we will have to do much more in her care…after hearing everything, I just want a peaceful demise for her…I know the risks. I have seen her deteriorate in front of my eyes since her fall. So, yeah, do what you can do. As a family we support her younger son, but he does not know what real caregiving is for the elderly.”
Such is love. Love for a parent, especially a mother is something you can’t express. I know how much I adore my mother, and I’d probably want every little bit of time with her I can, in any case, in any situation. And so I know where the younger son was coming from, where his thoughts lay.
Having said that, I think for my family, if a measure was lifesaving, I would consent, but if it’s supportive management in a lost case scenario, then I’d stay away and opt DNR. It’s tough to make that call in such situations especially when faced with the onslaught of such a huge responsibility but I think after seeing all I have, logic and rationale would prevail.
The old lady didn’t make it through the next 8 hours. She was gone, as expected. Thing is, I wonder, what form of love is more enhancing, calculating? The love of the younger son to just appease his conscience, his probable guilt, or just to have his mother around the mortal form for a few hours longer?
Or the love of the older son, who had stayed day and night with his mother, caring for her, ensuring her health and life, and hoping that she not undergo any further ‘torture’ at the hands of the medical aid that might be futile?
Can we even compare the two kinds of love? Isn’t it so tragic to see? Love is lost, in eons of time. Love cycles around, envelopes us to only leave again, gone into the thoughts and words, into the smiles, into the cries and then when we least expect it, makes a comeback to stare us right in the eye and remind us of the love we used to have? Is love a burden? Does love force our hand into responsibilities? Is love nothing but a ruse to describe all that we want and need? Or is love just an expression used to connect to the humanity in us?
You decide.
What tragic love story is yours?