Marital Bliss

The first time I saw her, her face was a bloodied mess. All puffed up under the left eye, a spreading blue over the lips, dried tears cutting through caked blood on the cheek and under the nostrils, like dying rivers across a desert. Smell of stale urine. Torn clothing hastily covered by a bed-sheet. The neighbors that brought her in did the talking: she was far too weak.

"Its the husband". One of the men volunteered, to my questioning gaze.

"Again". Whispered one of the women, talking half to herself and half to no one in particular.

I had a rapid look-over. Detailed examination will have to wait. There was the face, with injuries suggestive of a fracture of the nasal bone or septum. The right hand was bend at an unnatural angle halfway between elbow and wrist, swollen and exquisitely tender; possibly a broken arm. Smell of urine, incontinence probably from a kick to the groin.

The woman was in far too serious a condition to be managed at the peripheral center where I worked. At least for the first 48 hrs, she'd have to go to a higher center. I gave first aid, filed a police intimation, and referred her.

She came again a few days later. There was a cast over the arm, and the nose was in a protective covering too. She had been referred from the Medical College, back to my care.

I could see, then, that she was a young woman, younger than I had somehow assumed her to be, last time. Perhaps younger than I had thought possible to have undergone so much unkindness.

We talked.

"Its usual. When he is home, that is."

"The neighbors tried to help, until he started threatening them too. Then we were left to our own fate. Me and the two kids, that is."

"He was particularly mad yesterday. I had sent the kids away to my relations, where they might have had a chance at schooling."

She hadn't consulted him, apparently. Not that it would've made any difference. As far as he was considered, the kids were an accident, a vague annoyance at most. But to have a decision taken without his permission, that was to his way of thinking an unacceptable challenge to his authority. It didn't matter that he never wondered how and when they ate or whether the roof was repaired before the rains. It didn't matter too, that he was away most part of the year, sometimes for weeks together, only to return in the middle of the night reeking of alcohol. The only times he would be reminded of his family, would be if and when someone tried to help his wife make ends meet, wherein he'd be reminded of his pride that his wife had let down.

Perhaps he was simply mad that the children might get an education.

"I really thought he was going to murder me that night. The neighbors thought so too, probably, for they came looking for me in the morning. I had dragged myself out of the house, but couldn't make it up to the road. I'd have died, if they hadn't come looking for me."

I told her about the police intimation that I had filled, and urged her to follow it up with a complaint at the commission for prevention of atrocities towards women. I must have sounded more confidant than I felt, for she was cheered up instantaneously. She had a face that lit up when she smiled, and even through all the pain, I could see that she was beautiful, once, before all this.

She was discharged a few days later. Not once did he visit her.

I saw her a few times more during the following weeks, seeking to ease the pain of a body destroyed by more abuse than one should have to go through in an entire life-time, and the hard labour of raising two kids all by herself. However crowded the OP was, she'd wait till she caught my eye and give me a smile, which I'd always acknowledge without fail. Then, slowly, she was seen no more, and I forgot the whole episode in due time.

The next time was the happiest I ever saw her. She had come to get a certificate attested, she said. The kids were away at her relations, and going to school. They were both working hard, and she hoped of putting them through college. She was being offered a job as sweeper somewhere now.

"Him"?

She had followed up the police intimation. But even before her complaint could be lodged, he had done everyone a favor by getting arrested for some petty offence, and was sent to jail for 3 months.

That was 4 months ago.

I saw her again today. The light had gone out of her eyes, yet again.

"He came looking for me after he was released. Created such a scene where I worked, that the employers asked me to leave, for fear of having him back. He tried to get me to go back and live with him, but I wont have any of it. Neither will I allow him to get to the kids. He has threatened to hurt me, and I know he is perfectly capable of doing that."

She opened up her handbag, and after ensuring that no one was watching, showed me the kitchen knife she was carrying.

"I've a surprise ready for him, though. He wont hurt me or my kids for long now. I am waiting for him to show up".

I was shocked out of my trained calm demeanour. Too shocked to think coherently, I think I tried to say something. I am sure it must have come out non-sense.

She had a different air now: a confidence that terrified me.

"You are a good man, doctor" she said.

"But you are young. There are things you don't realize quite well as yet"

I knew she was not that old herself, but today was not the day for arguments.

"I know you could call up the police about this, but I don't think you would. Besides, do you think anyone gives a damn if I kill the bastard or he kills me?"

I tried to say something. She raised her hand to stop me.

"Please give me something for the back-pain, it has worsened this past week. I have difficulty getting up from bed in early mornings."

I wrote out an injection, two types of tablets, and one ointment of which I had a sample that I gave to her.

I sat there wishing there was something more I could do.


(slightly fictionalized)

a place by the sea

Bernada is the name of a nearly 100 year old clinic by the beach, in this city.

A quaint little place, still run pretty much the same way as it was when first established by some missionary with a sense of beauty.

I say it, because the place is beautiful.

An ancient building, and an even more ancient sister in charge. Neat white half-curtains on wooden windowpanes. Everything in its place.

A lone mangotree.

A sense of permanence.

The duty doctor's room having an old table and chair, bed and almirah.

Too bad the bed is not a four-pillar complete with mosquito nets, completing the colonial set-up. Not that a mosquito net was necessary, with gentle breeze from the sea flowing through the building at all times there are no mosquitoes to speak of.

As of now, the duty doctor's room has a regulation iron frame hospital bed. There are other indications too, of cracks in this otherwise picture-perfect place. Like the attached bathroom with missing toilet cover. I am sure Mr Romantic Missionary that started the place would never have stood it.

Perhaps, all is not quite well about this picture-perfect place.

Bernada is a place on the decline. As sad as it is true. Sadder still that it doesn't have to be. As I said, its still run pretty much the same way as when it was first established. A Nursing home giving basic healthcare. There must've been a time, before the city grew upon itself and extended right upto the beach, before the airport and not far-away tourist village were established, that it was the highlight of the area populated mostly by christian fisherfolk. Back then, the place must have been indispensable.

That is not the case today. Or Atleast that's what most people seem to think anyway. There being no dearth of fanciful multi-speciality hospitals in the city, they say the day of the nursing home, manned by a single doctor or at most a handful of non-specialists, is over. That they'd rather pay extra and go to one of those places that you couldn't at first sight differentiate from a star hotel lobby.

Now, I have nothing against multi-speciality hospitals. Or star hotels for that matter. And I honestly do wish everyone had the money and opportunity to get the level of healthcare that they deserved.

But there is still a strong case in favour of your neighbourhood nursing home. Your friendly neighbourhood doctor you would want to visit not just to talk about your ailments, but also about your daughter's marriage. Its About a whole value system that is being withered down by the onslaught of corporate culture (or the lack of it)

I have nothing against corporate culture either.

Its just that the relationship between doctor and patient is a sacrosanct one, and the best part of it is irrevocably lost when you try to manage it along the lines of a consultant-client contract.

I know how that one sounds. Repetitive and Pedagogous.

But that doesn't make it untrue.

Emotional issues apart, there is a really strong case in favour of having small nursing homes alongside large multi-speciality hospitals.

I say alongside, not instead of.

The issue is not just one of spiralling costs of healthcare.

It is also about local responsibility.

About inclusive access to healthcare.

About not losing your identity, Anonymity being the hallmark of what is known as Evidence Based Medicine or simple EBM.

They figured that out in the west a while ago: That corporate logics dont work that well in healthcare. They are going back to small single-doctor clinics in the UK right now. The Americans know it too, but since its bad business they would rather not talk about it. One look at comparative figures of UK and US health statistics will tell you the rest of the story. Guess who is better off - the Brits or the Americans?

I had ample time to think of all this while I worked night shift at Barnada Nursing Home recently.

For there were not very many patients that came to the hospital. I wonder if they had been forewarned about a certain doctor being on duty on a certain date. I wish that had been the case.

But I know that it was not. That Barnada, alongwith many other small clinics like it, is facing closure.

Patients dont want to go there. Doctors dont want to work there. Unable to hire full-time doctors, small-time nursing homes time and again fall upon a pool of just-graduate (and sometimes not yet graduated) doctors to mann their services.

That's where the person who wrote this comes from.

I once read while in school, many years ago, that Home is the place, where, when you have to go, They have to take you in. I did not understand one bit of it, but for some reason the words stuck in my memory. It was only much later, when I had understood a little more about the tortuous ways of love in the world, that I learnt what whole turbulent world was hidden beneath them.

There's still very much a case in favour of your neighbourhood nursing home indeed.