Unconditional love but conditional discharge

“I’m coming to your place right away. I’m tense about this Math exam. I need your help,” my friend said, sounding jittery about our final exams in college. She is always so when it comes to Math. And we had two days. Within an hour, I was on my way to pick her up from the nearest bus stop. She kept pacing up and down while I was explaining constants’ values. “Calm down. It’s just an exam. Here, hold my hand. Relax and you’ll be just fine,” I said. “You sure know how to calm my mind,” she said, as she sat down holding my hand with a smile. 

She aced the exam.

I was reminiscing about this instance while she was holding my hand in the hospital on Day 4 post her emergency admission. 

“I feel my neuropathy has worsened,” she complained to the doctor, who suggested she get examined by the neurologist. My friend had to be subjected to a nerve conduction test. “I’m super worried. I remember, they did this before I was diagnosed with Tilotama. They send electric shocks and that part of my body would pulse,” she said. “Calm down. You’ll be holding my hand. Remember that,” I said.

The neurologist was kind enough to ensure the electric pulses were limited. The oncologist was trying to see if my friend’s neuropathy was worsening due to one of the chemo drugs - Vinblastine. The neurologist said that the drug can be continued, but expressed worry regarding the reflexes in her legs. She said, “I’d suggest an MRI of the spine, but that’s not important now. Finish your chemotherapy and then we’ll get all of these things fixed.” She also advised her to wear the compression gloves as my friend has been suffering from carpal tunnel syndrome too.

Her mental agony was just the same, but her sudden bout of diarrhea had stopped and she was talking better. “I’m not asking any questions. Don’t keep nagging me to speak to the doctor,” she said, irritated when I pestered her to remain her usual self when the doctor arrived. Well, I had jotted down a couple of questions on her behalf. 

She was maintaining her oxygen saturation without external support for the first time since being admitted on emergency. 

“My neck is killing me. Every part of my body is weak. I want to get up,” she complained as I rushed to help her out of the bed. She was fighting to trudge up to the door with hands held behind her back, when the doc and his team walked in. My friend and I admire this doctor. We often discuss his trademark dialogues, exchange looks when we recognise his voice echoing from the other end of the corridor and even get disappointed if he doesn’t show up on time.

This time, she seemed aloof. She kept hauling herself painfully up and down. “So, how are you?” the doc asked her. She didn’t even turn around. “I’ve nothing to say today. You can talk and I’ll listen,” she replied, very matter-of-fact. The team of doctors were stifling their laughter. They always enjoy her witty remarks. 

“So, you have no questions for me? It’s gonna rain today,” laughed the doctor.

“No,” she said. “I’ve jotted down a few,” I claimed immediately.

“That doesn’t count. You can’t delegate,” he remarked pointing to her. My friend continued with her business - strolling up and down in discomfort.

I questioned the oncologist about the next course of action regarding her chemo. “We will knock off Bleomycin. And continue with A,V and D,” he said. 

“If you were thinking of removing Vinblastine too, had the neurologist confirmed, what would happen to her disease cells?” I wondered.

“I would have reconsidered introducing Brentux,” he answered.

“I heard that,” she commented, turning around. “Good, I wanted you to,” he replied.

“I am just tired of all this. I was telling my friend if I could just stop all this and go home,” she mentioned to the doctor.

Every single person in the room fell silent.

“Just have faith,” the doctor said, almost reassuring us that he would do nothing to compromise her quality of life.

I requested the doctor to visit her in the evening once as I explained how her mood and emotion plunge to a new low as night follows day. He promised he would.

And he did. My friend was glad to see him and so was I. The obvious question was to know if she can get discharged soon.

He soon nudged my friend to get a PET CT done so she can get a green signal to get discharged. Her night sweats were a cause of concern. He has a knack for convincing my friend. What took me 20 years took him 120 days!

“I’d like the senior doctor at the radiology department to insert my IV needle. He did it very gently the last time,” she stated. The doctor smiled and said yes to her demand.

Another PET. Will it be clear? The answer was 12 hours away from us then. The nurses on night duty took care of her so well. She was lying down there chatting with the nurse, while fidgeting with the stethoscope and listening to her own heartbeat. She even urged me to click a picture. The nurse knew she was a light sleeper. Cetrizine for her mild cold didn’t help either. As the bottle containing the antibiotic got empty, the nurse was there even before the alarm went off so as to not disturb her. I couldn’t keep my eyes open. I don’t remember when I dozed off.

The nurse woke me up early in the morning to remind me not to feed her anything. It was soon time to wheel her in for the PET scan. The nurse said she’d stay with her inside. “Baby, thank God, this sister will be with me inside. That’s some support,” my friend said, flashing a smile.

The same ordeal as before. She was cold. I could catch a quick glimpse of her inside. As I waited outside, I heard her scream. I realised the IV was set for the contrast. An hour passed, the nurse, who was with her, told me the scan had begun.

Another 30 minutes and she was wheeled back to the ward. “This time, the IV was painful,” she whimpered. I hugged her tight. We both kicked ourselves for having forgotten to apply Prilox - a cream that can be externally applied to keep the skin numb. My friend finds it helpful while handling pricks - be it for her IV, blood tests or even while inserting the needle into her chemo port. Or is it a placebo effect? 

I quickly ordered some cereal for her breakfast. While she was halfway through it, the junior doctor hinted that she may have to undergo another CT. 

My friend was seething in temper. “I just ate. They should have clubbed both the scans if they were necessary. You can’t poke me again. I’m done with this,” she screamed.

There was a miscommunication. The nurse had mentioned about a CT scan, but we asked them to cross check since the doctor never mentioned this to us. “Even then, I can’t get poked now again baby. This is it!” my friend asserted. I was quiet. I thought it’s best to face the doctor and let him explain. We waited.

As the doctor entered, my friend was preparing to get combative. “There is no need for a CT scan,” he first said. It took us a while before the words sank in. I could hear her cool down. “The good news is, your PET is clean!” he continued. A single tear dropped from my right eye.

My friend didn’t react. I gently patted her, signalling her to say something. She asked me to help her sit upright. “But?” she asked, speculating a complication like in the last PET report. 

“No buts,” he emphasised. 

We were all in delight, but I am not sure if we thanked him enough. Left to me, I’d have jumped on the bed zillion times. 

So, what now? “Get ready to go home! You have had your break. See you next Thursday for the next chemo,” the oncologist cheered her and left. “It’s a big deal to get a clean PET baby. I should have thanked him more,” she said to me, echoing my thoughts.

It was a conditional discharge - long list of antibiotics, frequent blood tests followed by GCSF shots. 

I felt that lump in my throat as she held my hand in the car after getting discharged. It was her way of saying ‘thank you’. 

Our love for each other will always remain unconditional.

Don’t raise your head!

“I got through all seven rounds and in the end, was rejected,” my friend once said, disappointed that she didn’t get through. She was desperate to get into her dream company. She was so hopeful. “When I cleared every round, I stuck my neck out and flashed a bright smile. And God finally ensured to bury me underground again,” she then added, “I’m sad.”

I am with her. We always need to bend backwards to realise our dreams. They are never served on a silver platter. The moment we think we are nearing success, I would tell her, “Let’s not get ahead of ourselves. Failure is listening to us and scheming against us with its ready volunteers.” And we would laugh it away only to be challenged by those volunteers sooner than we imagined.

This time, after the emergency admission, things weren’t any different. 

We didn’t sleep well. She was sweating and shivering alternately, and I kept switching between the fan and the AC to keep her as comfortable as possible. “It’s weird baby. I’m swea… on the head, the neck, under… arms and ba… of my knees. But my fore… arms, thighs and fa… ce… feel col... How can I hav… diff… temper… atures… in… same bo… dy…?” she expressed.

She was able to slowly and steadily complete sentences on day two. She smiled. Having read my thoughts, she said, “I am spea…in… better.” 

Her joy knew no bounds. She never would show her teeth even while posing for a photo. This time, she was smiling ear to ear. 

“I want to video ca… my par… ents,” she said. I chipped in when she was intermittently gasping for breath. She was still in need of the oxygen mask and her pulse rate was still high. She was struggling to swallow and her lips were cracking to the point of bleeding. But, she could connect sentences. That’s all that mattered for now. She was telling her parents, “My onco… said he’d fix me!”

She was talking to everyone - the nurses, the cleaning staff, the pantry fellow. She was telling them all about her job, her family and friends. She didn’t stop there. She asked each one, “Did you eat? Are you okay? How are things at your home? Thank you for taking care of me. I’m sorry for troubling you here. Shall I get you something that you like once I get discharged? What do you like?” 

People could understand some of what she spoke, and if they didn’t, they simply nodded in acknowledgement. They turned to me, urging me to stop her from speaking so much. We were worried she was straining herself.

“Give your voice some rest. Remember, your throat is still dry. You are unable to drink water so frequently,” I said, while she agreed. Yet, when the nurse stepped in, she said, “Hi sis… I was jus… thin… king… o.. you.”

The day did bring in joy, though infinitesimal in quantity. I was thanking all the stars. The night then again was the same - a struggle between hot and cold. This time, we had to keep changing the pillow covers that were drenched in sweat. 

The next morning, she woke up to a sudden bout of loose motion. She was drained. I took the help of the nurse on duty to shuttle her between the bed and the restroom. She couldn’t walk after three hours of this unending trauma. The doctor rushed in and sought a stool report, immediately put her on fluids again. One of the strong antibiotics prescribed for her - Piptaz - was suspected to cause this reaction, according to the doctor. 

“We will change her antibiotics. The CT scan report points to PCP. Good we started her medication. We will monitor this closely,” the oncologist stressed. One of the team doctors pointed out that my friend had earlier complained of shortness of breath. An athlete in the past with shortness of breath is what led them to believe that she could perhaps have a lung infection. I was amazed by these doctors and the mystery of medical science. I remembered the way my friend talked around 15 days ago. She would say, “There are times when I complete my sitz bath and feel quite exhausted like now.” And she would stop to catch her breath. I felt a pang of guilt. Did I take her complaints too lightly?

She wasn’t eating much. I tried my best to make things interesting for her. While her mother sent some food, I ordered some soya milk, porridge and soup from the pantry. I tried to warm her food by placing the small cup of cooked rice or even milk in the kettle with boiling water. I didn’t want to leave her alone and run up to the microwave oven placed at the other end of the corridor. I kept feeding her every three hours - starting with coffee, fruits (with outer skin that can be peeled like banana, pomegranate, apple, cantelope, mango), soup, mixed rice with veggies to porridge, biscuits, badam milk, curd rice with vegetable gravy, Horlicks, etc. I felt like I was running a restaurant with limited resources that can provide my friend variety and keep her healthy.

That night, she felt dejected. “I was happy yesterday. I thought I was getting better. This seems like those job rejections. Each time I pop my head up, something hits me. I can’t take this any more. Let’s stop the chemo. I’ll live with Tilotama. Please baby. I just want to be,” she whispered. 

I tried to cheer her up. “Didn’t our oncologist promise to fix you? He will be walking in here tomorrow with the perfect plan. You always look forward to his visit with 20 questions right? Let’s grill him tomorrow,” I said, as my heart felt as heavy as a 100-ton truck.

“I’m not writing any questions. I don’t want to ask anything. Let’s just quit all this. I want to call it quits,” she mumbled.

“What about me? Once all this is over, I was planning to amass your wealth in return for all this favour,” I joked. 

“I will write the will right away,” she stated. She meant every word. She was ready to choose flight over fight.

I was stupefied. And she was sullen.

We couldn’t sleep. We were lost in darkness.

 

We speak the same language

“How was the weekend?” I asked my friend during the initial years of college. 

“It was okay,” she said and walked away. I was stumped by her curt answers.

A decade later.

“What did you do last weekend?” I asked. 

“Oh! I forgot to tell you. You remember my school friend, who accompanied us to that movie The Bourne Identity in college? She is now here in Bengaluru. She came home and she is just the same. We also spoke of all our school friends. Let’s go for lunch and I’ll tell you all about my weekend,” my friend replied.

Wow! What an influence I hold!

Another ten years passed.

“Hi! How are you feeling?” I asked as my friend, who was at war with Tilotama.

No reply. 

“Do you hear me?” I asked again. 

She looked at me and nodded weakly with eyes welling up as she tried to hide her pain. 

“You remember my friend from my dance  class, who was also our senior in college? She called and we were talking about you at length,” I said. 

She didn’t respond. 

I thought I was disturbing her and decided to read a book. 

“Talk to me,” she said, “Your stories are keeping my mind distracted. I like that.”

She never talked, but loved listening to my gibberish. Has life come a full circle? I wondered.

Until one day, when she couldn’t talk, nor breathe, nor swallow.

“I….. ca….brea…,” she whispered as words failed to tumble out, but just gusts of wind. Her oxygen saturation level fell to 70. Her pulse rate was over 120. She couldn’t breathe. As she was rushed to the hospital, her temperature rose up to 103. 

Aren’t these typical COVID symptoms? I shuddered at the thought. Her parents wondered the same. The COVID ward was packed as Bengaluru was fighting the third wave with Omicron being the current variant wreaking havoc all over the world. 

Her parents looked at me anxiously. I knew what they were thinking. I held their hand and said, “Even if it’s COVID, we will get through this. I will be with her at the COVID ward. We will not leave her alone. I promise.”

They broke down like little children - helpless and terrified. I was equally terrified.

She was in the COVID ward. I walked up to her when she tried to shoo me away, “Don… sta… he… go… go….,” she fought to catch her breath.

I held her hand and said, “Don’t talk please… I will take care. Don’t worry. Do you want some water?” 

She said no for she had no strength and she dreaded walking up to the loo later. I managed to feed her a slice of bread. Imagine trying to chew a dry piece of bread inside your mouth that is as barren as the desert. I didn’t know what to pray for. Should I hope it is COVID and be relieved we know the culprit that landed her critical? Or do I pray it’s not COVID and launch a manhunt to find the new culprit?

Her Rapid Antigen Test turned negative. Her parents and I were awaiting our RAT results. The RTPCR test result for my friend was still awaited. 

As she was being wheeled in for a CT scan, she noticed that one side of the wall was freshly painted, and the other side was dilapidated. She said to the nurse, “Th… ar… two… sides… to… thi… hosp….” She looked at me and smiled. I wanted to scoop her in my arms and tell her, “We will not rest till we get you back on track baby!”

Our oncologist was kind enough to immediately shift her to the Platinum Ward. Meanwhile, her CT scan result didn’t point to COVID, but the doctors said they can’t be sure. 

Certainty is never our friend, like many others - from luck to success.

I rushed to the Platinum Ward and I was a tad too late. My friend was taken into the ward. The administration staff refused to allow me in without my COVID negative certificate. It was pure coincidence when I saw our doctor enter to check in on my friend. I tagged along and finally stepped into the ward. 

My friend looked forlorn, malnourished and debilitated. The doctor patted her back and exclaimed, “You are a bag of skin and bones. But don’t worry, we will fix you.”

This 54 kg patient lying down next to me couldn’t even smile nor complete her sentences. “My mo is dr… ,” she explained to the doctor. I took on the role of providing subtitles. I told the doc that her mouth is dry. She is unable to swallow. It’s like her mouth is devoid of saliva and she can’t breathe nor speak. My friend nodded, looked at me with gratitude for exactly narrating what was on her mind. 

“We suspect she is suffering from Pneumocystis Pneumonia (PCP), which is a fungus-related infection residing in the lungs. We will wait for the detailed reports of the CT scan. But I will immediately start the medication irrespective of the reports,” the doctor said and left.

The nurses were skeptical of my presence there, for I had no COVID negative certificate. “There is no one by my friend’s side. This is an emergency. My RAT results will be out in 30 minutes. I promise to remain put in the ward and will not stir out. Please oblige,” I begged them till they agreed. My friend’s parents were asked to remain in the lobby, until the RAT results were out. 

We were all COVID negative. My friend’s RTPCR result was negative too. We were thankful on one hand, but were distressed about this new villain in our lives - PCP. 

My friend was breathing with external oxygen support. She was also asked to use the nebuliser. She was prescribed a combination antibiotic - Bactrim, along with a steroid - Wysolone. Since she couldn’t swallow, her medicines were administered through IV - in this case, her chemo port. She was on paracetamol and fluids too.

She couldn’t eat much. Her body pain had multiplied. When she attempted to speak, “u… u,” I tried to preempt it and present her with multiple sentences and statements. “You want the fan... you took the tablet… did you mean the letter u or the word you?” She’d get irritated, “Le me com… com…,” and I cut in, “I know you want to complete the sentence. But I want to save you the trouble.” 

We resorted to using sign language. She showed the letter ‘U’. Her mom cracked it. She is referring to the tablet Ultracet. And my friend heaved a sigh of relief.

She then tried typing on her phone. As she typed, “I am sweating,” I butt in and tried completing the sentence. “I want the fan. But the AC is on. You want me to reduce the temperature? Or shall I get you something cold to drink?” 

She was fuming by then. She erased the message and typed again. “I am getting angry that you aren’t understanding what I want and you are not allowing me to complete my sentence. Don’t you get it?” 

As I read it, I was fighting back tears. I don’t know why. I was upset that I couldn't read her mind and complete her sentences accurately. I was upset because she was getting irritated while I was trying to help. I was upset to see her gasping for breath and struggling to utter even a simple word like ‘hi’. 

The hospital staff was stringent about having only one attender. COVID fears made it worse. I said I’ll stay with her. Her parents didn’t have the heart to leave their child like this.

We managed to get the table fan, apart from the AC. My friend was sweating buckets all of a sudden, especially her face and head. By the time I got the man to fix the fan, the AC played truant. And by the time I got the guy to fix the AC, her parents would hyperventilate. It was chaos as the sun set.

Her parents were contemplating taking the booster shot, just to be safe after what we went through that morning. My friend overheard this and started weeping. She said, “Don… I… fev… worry… fee… ba….” 

She meant that she would be worried here if her parents took the booster shot and got a fever. And she didn’t want that. Her parents started crying along with her and assured her that they wouldn't. As they were leaving for the night, my friend said, “Don worr ab me. I ha my frie. She is my heart.”

I wept like a baby. To me, she is my lifeline.