It is Sunday evening once again and time for me to visit the Fortis Kidney Research Institute for my mother’s haemodialysis. As I drive down through the relatively posh residential areas of Southern Avenue and Hindustan Park with my mother sitting next to me, I plan how to utilize the next 5 hours. Over the last 2 years, sitting in the hospital, I have acquired enough proficiency to represent India in a Solitaire World Cup or a Cross Math World Cup or any other World Cup involving online games. Unfortunately, today there is no ODI or T20 match as well and for once I cannot help but curse the BCCI for their insensitiveness.
At the hospital gate, it is a big queue of vehicles waiting for patients to be escorted in a wheelchair. It is a Sunday and as always there is a paucity of housekeeping staff, this means that even if the wheelchairs are there, our wait is going to be longer. While most drivers remain cognizant that it is a no horn zone, one Uber driver is not so considerate. Happily he starts honking causing the security personnel to come running. There is a heated exchange of words between the cab driver and the security personnel which brings all other activities to a standstill. Some responsible citizens try to intervene before the matter gets out of control and peace is restored albeit a good 5 to 7 minutes being lost in the whole process.
After getting my mom on to a wheelchair, I walk into the lounge to complete the formalities. The waiting area has fewer people today as most doctors do not conduct OPD (Out Patient Department ) visits on Sundays. There are a few mechanical processes to be completed and there is a long queue at each counter especially at the billing counter. While the processing time for the corporate and insurance patients seems significantly lesser than that of patients paying by cash, there seems to be a problem today with one of the insurance patients. The Insurance office is closed and the helpless patient party has a difficult time getting an agent on the helpline number. A protracted discussion goes on between the concerned party and the hospital staff while people waiting in the queue tend to get impatient. Finaly a compromise is worked out and the queue moves ahead.
As far as the patients are concerned, almost all the patients are sitting on wheelchairs while the caregivers ( maybe I am being euphemistic in using that term for lack of something better) are standing in the queues. Most people are known to each other by now as they meet every weekend, so it is customary exchange of pleasantries.
As I look around, I see some similar traits among most of the patients. They seem to have gone into a reclusive mood and keep staring blankly at the gate or the walls. They do not really seem to be interested about anything that is going on around them. The relatives who accompany the patients have to really coax the patients to speak or express their views on any specific matter. Mr Basu (name changed) has been undergoing dialysis for 12 years now, Mrs Basu accompanies him on these sessions. When Mrs Basu asked Mrs Basu if he was okay, Mr Basu nodded his head and said something that nobody around could comprehend. Only a nod of the head and blink of the eyes conveyed his response which seemed to satisfy his wife.
One lady sensitized the group that her husband’s systolic BP had reached the northern side of 200. Suddenly there is complete silence as all eyes are glued no to her. She narrates the sequence of events and how she reacted to the situation while others listen with rapt attention. I am incurably tempted to believe that she is a doctor simply going by the names of a plethora of hypertensive drugs that she remembers, deep down I marvel at her ability to remain calm and combat the situation. It reminds me of how adversity brings out the best in a septuagenarian Indian housewife as she struggles to provide medical assistance to her ailing husband. As for the others, it is a malaise that can occur any day with any of the patients and therefore these tips are invaluable. Remember the saying “Experience is a very good teacher but the tuition fees are very high”.
Mr Badshah ( name changed ) arrives for his dialysis. He is one of the few people who have the strength and courage to ride a bike on his own and he carrying his helmet is proof of the fact that today is no exception. However, he is clutching on to his chest and the first impression that others get is that he seems to suffer from a bout of asphyxia. A chair is offered to him and even someone volunteers to get him a glass of water. He gesticulates for immediate transfer to the dialysis room and almost all other patient parties are willing to cooperate. I feel proud that even in this arid age of nihilism, we remain as considerate to our fellow beings. Only the housekeeping staff do not seem to be perturbed, in fact they giggle between themselves that this is a regular ‘drama’ whenever he is late and needs to overtake a long queue of waiting patients. Nonetheless everyone prays for Mr Badshah’s speedy recovery as he is escorted into the emergency room.
For this dialysis session at 16.30 PM, there are at least 20 patients lined up. It is almost 17.15 PM by now and no one has been taken in. Some of the patients and their relatives start venting out their frustrations at this inexplicable delay in starting the procedure. At the enquiry, we are told that the earlier session started late due to weekend maintenance activities taking longer than expected. One gentleman, who was one of the earliest to arrive, loses his cool and asks as to why the hospital cannot call and inform all patients to come a little later than normal. The lady at the enquiry happily absolves herself from such responsibility saying that the issue needs to be taken up with the dialysis staff.
Suddenly the phone rings and everyone present heaves a sigh of relief as the first 6 patients are called upstairs. My number is 11 and based on my years of knowledge in Statistics and queuing theory, I am reasonably confident that my mother will be called in the next 20 minutes or so.
The lift to the dialysis room can accommodate only 2 wheelchairs at a time and there is a bit of a scuffle among patient parties in trying to go up. Luckily sanity prevails and they decide to stick to their original sequence.
Contrary to my expectations, then next 6 patients are called up in about 15 minutes. As I reach upstairs, there is the customary queue around the weighing machine. Some people who are too weak to stand are actually weighed while seated on a wheelchair and the weight of the wheelchair is subtracted to arrive at the weight of the patient. Even this arithmetic by the housekeeping staff requires a calculator and the process ends up taking longer than expected. This is a very critical process since the weight of the patient reflects the amount of fluid accumulation in the patient’s body since the last dialysis got over.
Finally, it is time for the dialysis to start. Here again , some patients have specific preferences for some beds while for others there are constraints that dictate the need for a specific bed. One lady walks up to a specific bed which prompts her fellow patient to remark that she is jumping the queue. The first lady promptly responded saying that she is Hepatitis positive and that she is going to a bed which is marked for Hepatitis positive patients only. The second lady apologised and parity is restored.
A lady from the hospital canteen went around asking patients about their meal preferences. Mr Sen (name changed) called the lady and said that the cake served last time was stale, the lady refused to accept the allegation and said that several others were given the same cake and that there was no such complain. While Mr Sen remains convinced about the veracity of his allegation, the lady from the canteen simply ignored him and moves on.
As all the relatives came down having settled the respective patients, they formed small groups. While the ladies huddled together in a corner, some of the men folk preferred to go for their customary smoking session.
In a few minutes, almost every one in the waiting lounge starts looking at their handphones and there is silence. Everyone seems to have reconciled to the fact that this entire set of activities is something unavoidable.
Dialysis is a never ending process and once it starts, the patient has to undergo dialysis for the rest of his/her life. While the patient or his family members may not enjoy it, deep down the family members are grateful that they have an opportunity to get this treatment for their near and dear one. They would rather go through the process for days and months than be relieved from doing so.
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