Outside the Intensive Care Unit (ICU) of a hospital

Obviously no one in his senses would expect Holi-like colours and riotous festivities outside the ICU of a hospital.  But that fact should not deprive one of the right to be dismayed about what one gets to experience.  It was about 9 pm.  Family members of patients in ICU were just recovering from the utterly clinical and sanitized lecture-demonstration given to them by a seriously matronly `sister' who emitted strong signals that she had seen it all and had neither belief nor interest in interactive sessions with her audience.  Her icy cold tone, curt demeanour and stony visage, which was completely bereft of even vestiges of emotion, made for a compelling spectacle and no one even stirred during the 4 minutes, which actually seemed like 40! Come to think of it, everyone suddenly seemed to have developed amazing breath control and was breathing in and out at half the normal pace, just so that he or she did not inadvertently become the target of wrath of the presiding authority.  The lecture part of the performance sought to sear into the minds of listeners the rules of play for the duration of their stay outside the ICU; the demo part involved the protagonist and a superlatively submissive minion, who enacted the role of an `attendant' (meaning, a patient's family member or friend).

Nothing was left to guesswork and even the exact locations from which the attendant should execute chores were identified on the floor with circles painted in white.  Finally, the drama ended with the dire warning that no attendant could ever move away from the immediate vicinity , because the 'shout' could come any time; 'if the attendant was not around to answer ...............' - the rest was left to the imagination and mine ran riot thinking of an entire hospital bed, with all the paraphernalia (oxygen cylinder, array of drips, monitors etc), with the hapless patient still strapped and attached,  being sent crashing out of the ICU for the attendant to take care of, whenever he/she chose to be present again!  When the matron flashed one final glare and left, there was a palpable lifting of the chill which had descended on the scene, pretty much like what Gregory Peck experienced in the presence of you-know-what, in the movie The Omen.  Still, no one dared utter a word for half an hour in the aftermath!

The prognosis neither looked nor sounded good and we are not talking of what was happening inside the ICU.  Let me make this clear since the medical attention given was consistently excellent.  It was made clear that the attendants had the choice of `resting,' even though the hospital staff were programmed diligently to avoid that crucial word in this context and their general drift was something like `do it if you can'.  Support for this proposed activity came from some stone benches and rickety chairs strewn about.  The chairs especially merit a full sentence.  It was one of those arrangements whereby four chairs were clamped together, joined at the hip as it were, and seemed innocuous when a family sat down.  But God forbid if the sitter on either end suddenly decided, without notice, to assume a more vertical position by standing up. When such an abrupt transition occurred, his end of the sitting arrangement swung up pretty much like a see-saw, causing serious disruption in the working of the vitals of those who continue to be sitters.

Or the attendants could retire to another room close by to await the `shout'.  One look at the specified lodging convinced this scribe that the  hardship outside, perceived and real, was a bed of roses.  There was an abundant supply of mosquitoes everywhere - one wondered whether the hospital authorities were breeding them as pets, with some ulterior motive! Some very diffused lighting could be felt rather than seen  (as if the management wanted to impress the clientele with their effort at creating a dimly lit entertainment area but abandoned the idea halfway through), which discouraged any attempt at reading anything.  One could identify the outlines of  a couple of very ancient pedestal fans of monstrous proportions.  They seemed more adept at producing a constantly loud `whoosh',  frequently punctuated by loud crackling noises indicative of their inclination to take off sooner or later, than being successful sources of air circulation.  The hospital no doubt installed them to further their stated objective of  keeping everyone awake.  Frequent `shouts' for attendants from staff members ensured that even `trying to nod off' became a pronounced Sisyphean activity.  Remember that Greek hero who is part of mythology for his endlessly futile effort? This scribe's grouse is that this glorious tradition seems to have ceased; such gutsy but fruitless activity is no longer given due credit.

The process of a staff member shouting the name of a patient and calling for the related attendant itself provided some comic relief from time to time.  The hospital did not necessarily screen the names of the patients for eligibility for ICU - not part of the criteria - and this gave rise to some occasional confusion, petulance and mirth.  When the call was for `Rafique's attendant', `Ravi's attendant' went bleary-eyed and half-comatose to receive instructions, his only mistake being he was relatively more awake.  He unquestioningly bought medicines worth a few thousand rupees from the pharmacy, paying cash, without realizing he was procuring medicines for a stranger.  When the drugs reached the ICU, they were administered promptly and correctly to Rafique, thank God, because the ICU staff was vigorously trained to focus on the destination of the drugs rather than the delivery channel.  A few minutes later, `Ravi's attendant' was again jolted from stupor with instructions to haul another load of drugs and other consumables.  When he saw the list, the only identifiable item for him as a half-awake layman, was 'Inspection Gloves-50'. He querulously told the sister he had just delivered 50 gloves, among other things, ten minutes ago and asked whether that item formed part of the night-time diet for all inmates of the ICU including the staff! When the mystery was eventually solved, Rafique's attendant got admonished for dozing off and gave an IOU for the cost of the medicines to Ravi's attendant because the former's treasury situation did not permit such an outflow immediately.  Hope was that the final settlement would happen to everyone's satisfaction.

A smart attendant, quick on the uptake, became acutely aware that even if no `shout' came his way, he could neither read nor sleep during the tenure outside the ICU.  While the tendency to blame the hospital for the state of affairs was inevitable in the attendant-victim, a clear thinking individual could definitely rise above the mundane and see the process as well as outcome for what they truly were - masterstrokes in achieving desirable social behaviour.  Obviously,  the authorities were creating genuine empathy in the attendants for those inside the ICU, without too much dance and drama.  When their near and dear ones were lying in the ICU, either semi conscious or in pain, how could the attendants shamelessly seek creature comforts, as if everything was hunky-dory?  This state of deliberate deprivation, carefully organized by the hospital through well-orchestrated moves, resulted in the attendants suffering a bit themselves and thereby forced to dwell on the trauma of the inmates of ICU.  There could be no denying the fact that if the attendant stayed in an air-conditioned room with 400 TV channels and music for company and was able to read Steig Larsson's `The Girl Who Kicked the Hornets' Nest' (I was honest when I reaffirmed to my wife I read the book during the daytime) or sleep for 8 hours like a baby, forget about empathy, not even a fleeting thought about the ICU inmate would have crossed his mind.  So, the hospital's superior motivation and well laid out strategy to help people achieve the goal should come in for praise rather than criticism, according to this scribe.

If, in the process, some attendant unfortunately developed malaria after a few nights' co-existence with the hospital's invasive mosquitoes or if continuous stone-bench-sitting-and-sliding aggravated one's sciatica or if the `uplifting' contraption of chairs caused grievous physical injury or if mere sleeplessness for a few days culminated in disorientation bordering on dementia in some dainty darlings, the positive aspect was that they were in the right place! The venue was luckily a hospital and one could  undoubtedly count on very prompt medical attention.  What more, one may, with some good fortune and help from the hospital authorities, gain entry into the same ICU as a patient and (a) make others outside go through the meticulous course in empathizing that the hospital had designed and (b) satiate one's baser instincts by gloating over revenge on the society at large!

PS:  With profound apologies to and prayers for all those inside all ICUs!!