CONFESSIONS

Geeta Sundar

So many details I am privy to…
Even if I don’t want to be aware of it, even if I don’t want to hear it, even if I don’t wish to be part of such conversations, I am drawn into the web of secrets, the furtive, the innermost confidential hidden things people want to share.
So many details I am privy to…
We as doctors, are exposed to the intimate deepest visceral nakedness of a person, literally and figuratively. Often times, we make allowance for these facts – we care for additional cover and screen especially when we are dealing with sensitive areas of the body and with good measure too.
The operating table is another whole story. So many people see the patient in the nude, it’s accepted as a norm for surgeries and whilst care is taken to reduce the display and the baring, its need is understood.
What then of the most ingrained, private elements that are stored up deep within an individual?
What do you do then when they unleash that depth into thin air, for you to absorb? How do you react? How do you tackle that situation? How do you gather your wits with their covert confessions? How do you face them? What do you wear, what do you armor yourself with to bear that burden?
So many details I am privy to…

Twenty seven year old, multiple comorbidities, SLE, Pulmonary artery hypertension, Autoimmune hepatitis, Hemolytic Anemia, steroid induced diabetes, pneumonia, and pancytopenia with unknown cause. We were seeing her for the lower limb cellulitis. Her mother cried daily. Cried for her daughter’s health, her wellbeing, her survival. She knew that her daughter was in a bad shape. The prognosis wasn’t good. Multiple specialities had come in and said their piece, given their best advices and done their best interventions. Her mother withstood that tumult tirade every day, all the while crying and imploring us to the best we could.
Late one night, with low saturation and platelets as low as 6k, she got shifted to the ICU for intensive monitoring. She breathed her last only a few hours later.
Her mother was inconsolable. She caught hold of me, held my hands in hers and broke down. “She was managed on medications all her life, you know. All along. Many years we have been fighting battles. One organ after the other. Blood test after blood tests. 2 months ago in Bangalore, she was working, a normal middle class girl. We had planned her wedding. Got a nice guy and everything was set. We were so prepared to let her go and get moving on in life. But then that leg cellulitis got her in to the hospital. Then a downward spiral. And now she is gone. Gone…just gone…”
I stood there just quiet. Nodding my head, and listening. I could understand, but I could never understand what it actually means to feel like what she was feeling.
“In a way I am glad…,” she whispered. “The pain, the torture, the multiple hospital visits are done.” She clasps my hands in a stronger grasp. “Does it make me a bad mother that I wished for her demise?”
The sting behind my eyes palpable now, I press down the emotion running through me. I want to hug her. I want to bawl my eyes out. I want to express so many things like her. But I stand there like a statue, just shaking my head…
So many details I am privy to….

Thirty one year old male, 2nd to 3rd degree burns over the torso. States an alleged history of hot oil dropping over him. Alleged power cut and he lost his footing due to the water on the floor and skid, and the hanging big lamp from the ceiling shook and its contents dripped all over him. The burns were too deep and an eschar had formed. It took weeks before it could be segregated from the underlying tissue and we could pull it off.
There were many daily visits to the burns wards. His doting wife helped with his dressings and was a cute, talkative thing, unlike the patient, who was a boor, grumpy and irritated with the pain and the long hospital course.
At the end of the dressing, I usually pulled her across the ward and gave her an update on his status. This one day, she collapsed her weeping self in front of me. “It wasn’t the oil. It was a suicide attempt. Kerosene.”
Frankly, I had suspected it. The burns weren’t distributed in a pattern akin to the oil dripping. It was wider and elaborate.
“We are in severe debts. He knows that this wrong. We have three children and he is the only earning member of our family.”
I nod and leave. It’s a medico-legal case. I know my obligations and my responsibilities. I know I have to inform my seniors. It could change a lot of things for their insurance. And that could mean no more free treatment and hospital stay. It could mean a loss of so much. Why did she confess? Why didn’t she just slam that feeling down and keep it quiet?
So many details I am privy to…

Forty year old female. Blunt abdominal trauma. Perforation peritonitis. Emergency exploratory laparotomy, on table, there were multiple jejunal perforations, which we primarily sutured and after a thorough wash, she was placed it the ICU. A background of low socioeconomic status, they weren’t able to afford the blood products or the higher antibiotics and the high protein diet needed for her low albumin levels.
Post-surgery, she developed an intra-abdominal abscess. We needed to release some of the abdominal skin sutures due to the SSI. On a day I was doing her dressing, she clasps her hand around my wrist and pulls me closer.
“My husband was drunk.”
I scrunched my eyebrows, not understanding her train of thought.
“I said I had a fall and a stone hit my abdomen. But that’s not true.”
I stared at her, waiting for her to continue.
“My husband was drunk. He kicked me hard. I fell and hurt my abdomen.” Sobbing, she sniffles and assuages her entire abusive history on me.
I stand there, again, in silence. No words to support her, no words to alleviate that pain, that hurt. I understand, but I can’t do or say anything or even comprehend how severe it must be for her to stay with the same man, and even have him care for her in the hospital, and go back home with the same man eventually.