E.R.

When Raghav was wheeled in to the emergency room, he was barely conscious. Between lurches of delirium all he could remember was turning a bend in the road while riding his motorcycle when he was blinded by a pair of headlights. The next memory he had was that of noises, lots of noises, and movement, to and fro, and yelling voices. He prayed they would stop, the voices, so that he could rest in peace, but they would not; and the lights, God the lights, they were driving him crazy. Not that he could remember whether his eyes were open or not, but still, they hurt.

Rahgav was being carted to the emergency resuscitation room in a stretcher trolley with the stretcher bearers yelling for people to give way to the trolley. Raghav had been in an automobile crash and had received grievous injuries to his head, chest, abdomen and legs. His pulse was feeble and the blood pressure was dipping. The emergency officer with the trauma team in the ambulance had been wise enough to detect a decrease in breath sounds over his left chest and had rightly made a diagnosis of hemothorax. Raghav was losing blood inside his chest, the blood causing a compression of the lungs and the heart, and also inside his abdomen. The blood inside his abdomen was raising the intra-abdominal pressure thus splinting the diaphragm and impeding the already laboured breathing. His skull was fractured and there was a large blood clot inside his cranial cavity pressing on his brain. Raghav was critical, in capital letters.

He was wheeled in to the Triage area, the area reserved for managing critical patients. His pulse was almost imperceptible now, the blood pressure too low to be recorded and breathing coming in gasps, few and far between. ‘IV line, plasma expander, injection adrenaline quick’, the trauma surgeon in-charge of the triage room yelled, ‘and someone put a Foley’s in his bladder and get me a tube thoracostomy set!’ Noises, more noises and pain! Raghav was in terrible pain, people were jabbing at him everywhere. If only they would let him rest, let him have peace. Where was he? What was this smoky place? ‘Mamma’, he yelled, longing for his mother in his moment of pain. She was there, wasn’t she? He had seen her standing by the side of his trolley; yet how could she be here, she was dead long ago! His mind was playing tricks on him, yes, yes, it could not be anything else.

Suddenly he felt a softening of all the senses, the pain began to dwindle; he was happy – at last! And then it returned, with a force which was almost unbearable. His chest was being crushed. The doctors were performing CPR, the Cardio Pulmonary Resuscitation, on him. His heart was failing. The surgeon had just inserted a drainage tube into his chest and out gushed one litre of blood; his heart had plummeted. The cardiac massage and mouth to mouth respiration was started. The doctor was counting 1, 2, 3, 4 now! It went on and on and on. Raghav prayed they would stop and let him be, let him float into that beautiful oblivion which was enveloping him. He was painless, light, happy. ‘Oh my God, am I dying’ Raghav thought? Is this it, the moment of reckoning? Will I be asked to explain all my actions now?  What will I say?’ His whole life flashed before him, he was a child again playing with his father on the beach, crying on the first day of school, hugging his mother when his father died. His cousins were there and friends and Mamma and Papa; yes, he could swear they were standing by his side right now. ‘This is not true. They are dead. How can they be here?’

Darkness…light, soft, mellow, loving. He could feel love in the air, Mamma’s love for him. He felt safe. Papa was here. Pain! Light! Harsh, hurting, naked like a sword; he felt alone. Light, pain, light, darkness. The cycle went on and on.

‘He is coming, keep going’, the senior surgeon said to the apprentice who had taken over the CPR from him after five minutes. Push, puff, push, puff, the CPR went on. ‘Did someone get the cross-matched blood’ asked the surgeon? The blood was started through another line which had been set-up. The urinary catheter was in place, but there was no urine. His kidneys had run dry due to the blood loss.

Raghav did not like the new light which had replaced the previous glow. It was harsh, hurting his eyes and he could feel pain all over his body again. His head was bursting, his chest hurt every time he breathed and his leg felt as if it had been crushed. His vision was still not clear, but he could sense that Mamma and Papa had gone now, and so had all his friends and cousins and everyone who had helped him through whatever had just happened. Was he alive, he was wondering when he heard a thundering voice as a middle aged face came into focus, ‘Welcome back son. You sure gave us a big fright!’

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