by Umar Mukhtar
PULWAMA: After the divine help, it is the doctor, who can bring a person back to life from the border of death. But what if doctors refuse to treat?
It was July 17, my uncle Mohammad Yousuf developed severe chest pain. At around 5: 30 pm, he called me and I drove him to District Hospital Pulwama for the treatment. In excruciating pain and breathlessness, he could not bear the mandatory mask on his face. Since we live not far away from Pulwama, we rushed and reached quickly. It might have been around 5: 40 pm on July 17.
The First Consultation
The lone lady doctor available in the causality of the hospital was wearing half protective gear, did not let him come inside the room. She asked him to put on his mask first. Groaning with the pain and struggling with the breathlessness he tried to make her understand the gravity of his illness. She was, however, unmoved with his condition. She justified her approach by loudly saying: “I cannot risk my family and children for your treatment. I am a mother first then a doctor. They are my priority, not the patients.”
I as attendant could understand the doctor’s concern though not her rudeness. I intervened and put the mask on my uncle’s nose just to make her comfortable so that my uncle would get timely treatment.
Quickly, the doctor advised a trop-T test. He was detected positive indicating heart failure based on his symptoms. After about 45 minutes in the hospital, we were given an ambulance and referred to the SMHS hospital in Srinagar. We were rushing against the time because the pain of my uncle was getting severe en route.
In SMHS Hospital
After almost 35 minutes of the journey, we were into the compound of SMHS at around 7:20 pm. There, I saw people carrying patients in their arms. They were attended by no one. As we were coming out of the ambulance, a person came to us and said: “if you have a trauma patient, do not waste your time, go to some other place, the doctors are on strike here.”
I could not get the sense out of his statement. For a moment I was like how can the medical emergency unit of any hospital – especially the tertiary care – suspend their duties? Avoiding his counsel, I proceeded towards the unit with my uncle. But as I entered the main entrance, I saw patients lying there and their attendants crying helplessly to attend their loved ones.
The heart-wrenching scene was of a toddler who was in her mother’s arms lying unconscious, blood oozing out of his head wound. “Doctor sb me bachae hun nechev (save my son),” I heard the mother crying, loudly and painfully. But no doctor came to her rescue and she was lying there pressing her hand against his son’s wounds.
This made me realise that I had done a serious mistake by not giving credence to the unknown person’s warning at the SMHS main gate. I knew I have lost the golden hour already still I wasted another 15 minutes. Realizing the gravity of the situation, I decided to move to the SKIMS – the other territory care hospital in Kashmir.
Without realising, I had another issue cropped up – the ambulance. “I am not permitted to go beyond SMHS,” the driver said. I pleaded with him and told him that I will compensate. Watching the situation of my uncle, he finally agreed. It took us another half an hour to reach the SKIMS.
Finally In SKIMS
Once the ambulance stopped outside the casualty, I searched for a wheelchair. There was none available outside. I dragged a rusty three-legged stretcher that has fresh blood stains on it and laid my uncle on it. There were no options. It was around 8:15 pm.
As we entered the emergency, it was already crowded. Four doctors were catering to a huge crowd at that moment. Then almost five minutes later; we were heard by a doctor- a senior resident. As usual, my uncle’s pain did not move them even a little. Instead, they straight away asked us to repeat the tests we had done almost an hour ago at DH Pulwama.
I wanted to tell the doctor that he has peripheral edema, as a doctor told me earlier. But I thought he will take it otherwise because doctors increasingly believe that people go to Google first and doctor later.
Anyways I was not any competent authority to question them. So, I did what they asked me to do. It took us almost two hours to get the tests done. Till then he was groaning with the pain.
A New Team
Once we were done with the said procedure there were new faces. Probably the doctors who had asked us for the tests had completed his shift. But what was shocking to me was, I saw doctors without the mandatory PPE’s.
Once we came back with the tests, I went to the doctor’s counter and showed him the reports. He said it is a case of possible heart failure. “You have to wait till the next day at 10 am. The doctors would come for the round and would evaluate you,” the doctor said. A heart failure patient who was referred in an emergency case has to remain in the same situation till the next day at 10 am! All night my uncle could not even lie on the bed. He was withering in pain.
I saw a patient who was next to our bed gasping to breathe. He too was waiting for the medical attention that was supposed to come the next day, July 18, at 10 am. But he died in the middle of the night. The condition of my uncle was too worsening from bad to worse.
I was seeing my uncle sinking. Desperate, I talked to a doctor friend for advice. “Such patients have little time,” he said. “They need emergency treatment and are given vasodilators in such situations.”
But nothing of such was prescribed. The wait for the 10 am for us was very hard. We had to endure pain and saw death next to our bed. None of the doctors visited us at 10 am. There was no round – routine visit to patients usually twice a day – of doctors. I then moved to the cardiology section on my own showed them the file. They said he needs to do an ECO test. I thought it was a breakthrough; at least, I could do something.
No ECO Without Covid-19
But for that, the SKIMS has made a protocol: anyone who has to undergo the test need to provide Covid-19 negative certificate first. They asked us to get the Covid-19 test done first then only they could carry out the test. I argued with the doctors present there and briefed them about the critical condition of my uncle. The doctor there gave me a sarcastic look and said: “am I a doctor or you.” My pleas fell to the deaf ears.
I ran for the Covid-19 collection centre two stairs up and asked them to please take our Covid-19 sample from a serious patient. They first asked me to get the patient there. I briefed them about the condition and said he cannot come here. He then handed over the file to me and said that our data has been collected and they will come in some time to take the sample. I went back. I waited for two hours but nobody came to us.
Helpless, I was seeing the worsening situation of my uncle. The doctors kept us saying they cannot proceed further till we will get the ECO test. When my uncle felt unconscious and it was only after we had some acquaintances there the doctors surrounded us. They did every possible thing than to bring him back but all in vain! It did not take me much time to realise that I have lost my uncle, barely 49. July 18, 2020, 5:30 pm.
I wanted to cry, weep, and beat myself but I had no time. I had to now arrange the death certificate. In the heart of my hearts, I had the fear that the SKIMS officials might want me to first get the test of the corpse for Covid-19 and retain it. Thankfully, they did not insist on that.
I made a request at the counter and this issued the certificate within 20 minutes – perhaps the first thing that happened so quickly in the SKIMS in my almost 24 hours stay.
My second job was to arrange the lift for my dead uncle and his inconsolable son. At the counter, they gave me a cell number and I dialled. After some wait, a Sumo came. I asked the concerned why a private vehicle, I need an ambulance, not a Sumo. He said the ambulances are on Covid-19 duty and if at all they could arrange an ambulance it will cost Rs 25 per km. I remember, a security guard saying that there is a nexus between these private vehicle owners and ambulance drivers. I had no time to seek details.
I finally lost my cool. I told them how can I visualise that all the ambulances are Covid-19 infected. I shouted at them saying that since you are not showing any respect to even the dead, they will go to hell and before that I will ensure action against you. I shouted that I have recorded all the conversations on my phone and I will make it public.
All of a sudden I felt a change. They quickly arranged an ambulance – off course – at Rs 25/kms. But thank God, I could drive my uncle home dead. It is the third day that he lays buried in the village graveyard at Koil. I am unable to look face to face with his daughters. My uncle was a physical education teacher in a private school. He was working really hard to bring up his four children – three of them daughters. I do not know what eventually I will tell them once I talk. Was I an incompetent nephew or the system is so competent that it issues death certificates faster than the basic first aid. I do not have an answer. Have you?