The Way Things Were

TOMORROW MAY RAIN

CHAPTER 1

JUNE 2021. GOA

“Code Blue. Code Blue” The public announcement system crackled. Anya felt the familiar surge of adrenaline coursing through her veins. There were still 10 minutes before Anya’s 8 a.m. shift but she pushed her croissant back into its wrapper and rushed towards the swivel doors of the Emergency Room.

"Dr Anya Chopra. It’s my first day today” She introduced herself to the emergency technician who had wheeled in a frail elderly woman.

“Good morning doctor. The doctor on this shift is doing an emergency procedure. I was just about to page him.”

“Don’t bother. I’ve got this”

"57-year-old woman with difficulty in breathing. Pulse weak. Cyanotic" The shrill voice of a nursing officer interrupted them. Anya turned to examine the woman. It was an acute attack of asthma­—one that wouldn’t respond to the inhaler she was clutching.

“Emergency response cart" Anya called

Anya inserted a nasal canula and reassured the patient.

“It's okay. We are getting you some oxygen”

The next couple of minutes would be critical, and she would need to decide if the patient needed intubation. Anya started steroids and closely monitored the patient while adjusting the oxygen flows. The breathing settled, but the blue tinge on the nail beds was a reminder that the patient had only just made it.

Anya wrote out instructions for steroids to continue.

“I am guessing that you are the new doctor from Delhi?”

The head nurse, a stout woman, whose name tag read “Mariam”

“Yes, Dr Anya Chopra”

“Welcome. I am the head nurse for the ER. “

“Good morning. I had just reached the ER when I heard the call”

“It has been quite a busy night here. Thank you for rushing” Mariam smiled

“Let me show you the locker rooms”

~ ~ ~ ~

Anya followed Miriam out into the corridor. Large windows gave a view of the lush green grass and a symmetrical row of tall coconut palm trees, which were commonplace in Goa.

At 5 feet 7 inches, Anya didn’t need to stretch to reach for the number lock of the locker that Mariam had allotted her. She quickly changed into the scrubs and the plastic protective gown. She tightened the rigid cup mask and pushed back her frizzy hair into the plastic cap. She was thinking about her new workplace as she walked back to the ER.

She had been at a crossroads at her career a few months ago, when she had chanced upon the website that had called for applications. Struggling to reconcile with how a tiny virus had changed everything for her, she had filled in the application without putting in much thought into them. A couple of weeks later, when the appointment offer had landed in her inbox, she had been no closer to having figured out the course she wanted her career-and life -to take. She had accepted the position on a whim. It was an escape from the circumstances of the last year. She could decide about the fellowship programmes later.

H-of-H was smaller than the places she had worked at, and not as prolific as the Morton centre in New York where she was to have joined her residency last year. But the rain-washed façade of the hospital and the shroud of greenery around it had impressed her when she arrived last evening. The hospital had received some good press too and a short stint here wouldn’t hurt, she thought. At the very least, being away from home would help her to block the memories of Zoya that kept surfacing. And she wouldn’t have to listen-in to her father’s discussions with brokers about looking for a new house.

~ ~ ~ ~

The patients who trickled in with a steady pace into the ER were like those she would attend to anywhere else. Severe stomach-ache, an intense allergy, and a heart attack in quick succession. For the last one, she stabilized the patient and called the cardiologist from the intercom.

"Rodrigues, Dr R Rodrigues", the genial elderly man introduced himself, before proceeding to prepare his patient for an emergency angiography. She recalled his name from the email exchanges with the hospital. He was one of the Directors of the hospital.

“Good to have you here. I hope you like working here, and in this lovely city”

“Thank you”

“Please go to the administrative block after your duty is over. The other directors would like to meet you.”

~ ~ ~ ~

Done with her shift, she followed the colour coded signs to the administration block. The sprawling hospital campus was designed more like that of a college or university than a health care facility. The lawns that surrounded the 4 blocks of the hospital were punctuated with cemented paths that connected the buildings to each other, which added to its charm. The colour scheme of the administration block and the layout was the same as for the rest of the hospital. The teal seashell textured cladding outside on the main entrance might have seemed frivolous or overdone, but it was perfect for Goa. It also complemented the neutral cool beige which gave a warmth instead of the impersonal clinical feel that white used in hospitals often gave.

In the reception area of administration block, Anya noted the signs everywhere.

‘Do not occupy these seats”, “Only three people in the elevator”

Covid had left nothing untouched.

“Good morning. I am here for my initiation formalities. Where do I need to go for those?”

“Dr Anya Chopra?” The young woman in a beige uniform asked

“Yes”

“Dr Vijayant Naik, the Chief-Director, is in his office. Second room to your right”

Dr Naik was a legend in hospital management. He had done a brilliant job of controlling the contagion in Mumbai when the pandemic broke. He had led from the front; and had been a regular on news features. He had been instrumental in defining and enforcing isolation policies analysing data proactively and ramping up testing. His stint with the authorities had ended abruptly when he had called out the governments and leaders for the lack of infrastructure. Compelled to step down, he had joined H-of-H, as Chief Director. Most hospitals were run by administrators who knew nothing about medicine; or doctors who had not been trained for management. That was the case, not only in India, but even in countries like the USA and UK. Doctors like Naik—who were blended leadership and ethics with a deep understanding of medicine and the medical fraternity— were exceptions rather than the norm. If only there had been more people like Naik when the pandemic had broken out, things could have been so different. She pushed the thoughts out of her mind and entered Dr Naik’s room.

“Good afternoon”

The bespectacled man poring over sheaves of papers looked up from his desk. The room was lined with pictures of the hospital, projected growth plans and quality policies. The large work bench with a laptop and desktop and a huge LED screen was right out of the control room from one of the detective shows on Netflix.

He must have read her thoughts.

"Tech and AI are the future. In medicine, too, they are gamechangers. Welcome to our hospital” He walked over to her. She forced herself to look back at the screen and hoped her surprise hadn’t been obvious.

It had; but Vijayant, used to people being surprised by his short stature, did not react. Given his authoritative presence and reputation, his height of 4 feet 10 inches came as a shock to many. When he was younger, this response would leave him bewildered-even troubled. Now, having learnt a lot about human behaviour, the many assumptions people made and stereotypes they subscribed to, the reactions simply left him amused.

Anya took one of the large armchairs he had signalled towards.

“Sorry to have allotted you a shift as soon as you arrived. It has been rather busy here of late”

“No problem. As an emergency physician, the last thing I expect is predictability on the job” “That is true. And is even more so since Covid happened. We have seen twists, turns and curve balls like never before since the pandemic struck. Especially the second wave.”

This tiny new virus, a mere construct of protein and nucleic acid had exposed its Machiavellian tactics right from the time it been identified a little over a year ago. And the second wave had brought unimaginable disease and death.

Anya could feel the anger in her simmering again; and couldn't let it surface. not here. Not now. She managed to calm the voices in her head.

Dr Naik continued. “Hopefully vaccination will pick up soon, and we will see things improve”

Despite a slight decline the last few weeks, the numbers remained high. It was a critical phase in the pandemic, and who would understand it better than him?

“I hope your accommodation was ready for you when you arrived yesterday?”

Her second-floor room in the residences wing looked out on to a Zen Garden and was quite cosy and comfortable.

“Yes, Thank you”

“I understand you met Rodrigues already. The third person on our board is Dr Malathi Kini. She would love to meet you”

~ ~ ~ ~

Anya asked for Dr Kini at the help desk.

“Obstetrics. That’s in the main Outpatient Block”

“Obstetrics is such a rewarding speciality Anni. I totally love it “

The sultry, moisture laden sea breeze hit her face as she walked towards the Outpatient Block.

“Dr Malathi Kini please”

“Last room at the end of the corridor. She should be back anytime now.”

Anya crossed the ultrasound scan and procedure rooms and entered Dr Kini’s room. There were some magazines and books strewn around on the coffee table in front of her. She glanced through the hospital newsletters, then began leafing through an old issue of an international obstetrics journal.

“Good morning. You must be Dr Anya”

Anya looked up, but her spectacles were fogged up. It wasn’t just the mask and the humidity- it was the wave of tears building up inside of her, threatening to flow out. Right here. In the office of the one of the directors of her new workplace.

“Please give me a few minutes to change out of my scrubs"

Grateful for the respite, Anya wiped her eyes and composed herself.

Dr Malathi Kini returned wearing a long kurta with jeans; her shoulder length hair with burgundy highlights a little unruly from having been encased in the plastic cap. Despite the greys in the roots of her hair, and tiny wrinkles around her eyes, there was a youthful glow to her face.

‘I need some coffee desperately” Dr Kini switched on the coffee maker and placed some coconut cookies soon the centre table, but Anya's appetite seemed to have disappeared.

"You would have met Rodrigues and Vijayant. I join them in welcoming you to our hospital”

“Thank you. I am sure the hospital will bring the change in health care that is much needed”

“We would hope so. Why don't you get some rest now? Once you settle in, we must have lunch together. Traditional Konkani cuisine is not something that you may be familiar with"

“I would love that” Anya drained her coffee.

“See you around”

Dr Malathi Kini sipped her remaining coffee and closed the obstetrics journal that Anya had left open on the coffee table. It was open at an article on post-partum haemorrhage from the Central Women’s hospital in Boston, authored by Chopra Z.

But, for Anya, there was no shutting out the memories of Zoya that the article in Dr Malathi’s office had unleashed. Unsure of herself, she stopped in the garden opposite the OPD block and sat on one the benches. The saltiness of the tears that rolled down her cheeks was diluted by the raindrops that were falling, but nothing could take the sting away.