“We Are Declaring Him” – Part VI

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“P Ram Mohan Rao?” he said.

I stood up.

“Any other attendants here?”

“No”

He beckoned me to follow him. I packed my laptop in and started after him. He didn’t say a thing. I didn’t ask.

As I walked towards dad’s bed, a man in a dark shirt and trousers and wearing flip flops look at me and walk away, past me. I thought he was another attendant. I saw two nurses fiddling with the pipes and cables connected to dad. I didn’t understand what was going on.

“What is happening sister?”

One of the nurses looked up and signaled me to ask the person that just walked past me.

“Is he the duty doctor?”

“Yes”

I walked behind him and said “Excuse me doctor. What is going on?”

The 4 words will ring in my ears for the rest of my life.

“We are declaring him”

It took me a couple of seconds to register.

My father has died.

I turned back towards the bed. The nurses had left.

I walked to his side. His eyelids were partly open. His mouth was open. His head was tilted back. It could’ve been any other time, any other day. He was sleeping. Any time now he could snore. I touched his hands and feet. I stood there – emotional and emotionless at the same time.

It was over.

“We Are Declaring Him” – Part V

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I walked out to be met by mummy and my cousin’s wife Prashanti. I avoided eye contact with mom. Avoided any conversation. She wanted to go into the ICU. Prashanti volunteered to take her inside. The security guard protested saying two people cannot go at the same time. But Prashanti somehow managed to convince him and they both went in.

Outside, there was chaos. Family members of other patients all wanting to go in, two security guards at two separate doors trying to maintain order. There was a family that had about 25 people wanting to go in and see the patient. Ridiculous as it may seem, at the time I only felt sympathy for the family. For the hospital it’s a logistical and medical nightmare. Any one of the 25 could carry an infection that can affect any of the patients. But this is India. There will be crowds every where.

Things seemed to settle down around 9pm. Mummy was coerced into going to her brother’s house nearby. Prashanti and my aunt convinced her she needed some rest and home food. She left around 9:15. Kiran bava had left around 7:30 saying he’ll be back around 11. Chacha and Shravya were still lingering around. Around 10:15 I told them to go home, get some dinner. The discussion hinged on who will stay the night. I volunteered myself and Kiran bava. After some deliberations, they left in an auto rickshaw.

The waiting area was quiet. Only a handful of attendants remained. Some spread out their bedsheets and started lying down. Others just wandered around talking on their cell phones. I opened my backpack, pulled out the laptop, attached the USB wi-fi stick in and started reading my email. It was quite dark in the lounge area.

It was 10:30pm. I know because I just looked at the top right corner of my MacBook Pro.

I saw the security guard walk slowly into the waiting area, his eyes probing for someone. I looked up and met his gaze.

To be continued…

“We Are Declaring Him” – Part IV

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I entered the ICU.

The nurse ushered me into the duty doctor room. It had a small desk table, a desk chair and a 2 person sofa for attendants like me. The doctor wasn’t available immediately so I made myself comfortable on the sofa.

A few minutes later he walked in. A roundly built man in his late 40s, the duty doctor (for the life of me I can’t recall his name) turned out to be a very courteous and well spoken man. This was contrary to popular notion that these low paid doctors are rude and don’t really care for anyone.

“I have to tell you the situation is not good”

My heart sank. I was hoping against hope that he told me something else.

“His lungs are badly affected. There is 21% Oxygen in the air we breathe. A normal person’s Oxygen saturation is 100%. In your father’s case he’s on 100% Oxygen through the tube, but his saturation is only 78%. It means his lungs are not able to keep up”

“Additionally he has internal bleeding. His kidneys are failing. We have to put him on ventilator”

Then he discussed the legal disclosures and consent forms about putting dad on the ventilator.

I finally mustered enough courage to ask him “how long does he have doctor?”

That was when he made the chilling statement, “To be very frank with you, he won’t make it through the night

I managed to nod and ask him if I could see him. I slowly and deliberately walked towards his bed.

He was strapped in, unconscious. He had tubes going in and out of his mouth and nose. There were monitors all around beeping. It was a surreal situation. Here was my father – the healthiest 74 year old I had known, on his last breaths, that too assisted. I touched his left hand and stood there staring at him for a few moments with a blank mind.

I walked slowly back towards the waiting area, not knowing what to answer if my mother asks, “what did the doctor say?”

How should I face her? What should I tell her? Can time stop at 6:45pm? It sure seemed like it to me.

To be continued…

“We Are Declaring Him” – Part III

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As the ambulance started to make its way through the crowded and congested streets of old Hyderabad (yes RTC X Roads is now old Hyderabad) the NRI in me surfaced and began to think the worst. How is an ambulance going to wade through this notoriously indisciplined and indifferent traffic?

To my surprise I saw a different side of Hyderabad that day. Vehicles stopping or moving away at the siren. Even RTC buses were making way, or stopping. Others asking non-conformists to move away. This is what runs this planet – basic human nature to care for another being. A thousand thoughts raced through my mind. How am I going to repay all these people? Then I realized – No. I just have to pay forward, you cannot pay back.

We reached the hospital in about 15 minutes. As we were pulling in, I saw Kiran bava’s car enter from the other side. Clearly he found a way to match our speed. And no he didn’t tail us.

The next hour was a blur. I think I filled out a couple of forms while dad was taken into the ER. Mummy and Shravya accompanied him. Word got around so my aunt and cousins from the area started reaching the hospital. The doctors were checking his vitals. His breathing was still labored. But at least he was stable. At least he was in the hospital. He was in good hands, skilled hands.

Meanwhile I had another task to complete. My flight was in less than 24 hours. I had to go and reschedule it. It turned out to be a simple process, thanks to the rather helpful agent in the Qatar Airways office. I blocked for Dec 10. We returned to the hospital.

Dad had slipped into unconsciousness. His lungs weren’t keeping up. His kidneys were failing. The doctors thought he had internal bleeding although they couldn’t tell where unless they looked deeper. They took him to the ICU – his most hated portion of the hospital.

The ICU is on the fourth floor of Apollo Hyderguda. There were several families like ours. The small waiting area overflowed with anxious relatives. The visiting hours were after 7pm. There was a single security person manning the glass door entrance to the unit. It was humbling and empathizing there that day. There were others in the same situation as ours. Others going through the emotions that we were going through. Others facing decisions that we were facing. Some faces hopeful, others worried and yet others scared.

Around 6:30pm I walked towards the security guard hoping to get into the ICU earlier than the 50 others waiting in line. To my surprise, he said the duty doctor wanted to talk to me anyway and let me in.

To be continued…

“We Are Declaring Him” – Part II

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Mom went and called chacha. I needed physical help to assist daddy on to the wheelchair. He came in. We lifted dad off the loo seat and tried to shift him to the wheelchair.

And he slumped.

I knew exactly what they mean by ‘dead weight’. Between chacha and me we weren’t able to help him on to the wheelchair. Dad had slumped but wasn’t on the floor. Chacha and I both were holding him from falling down. We HAD to get him on the wheelchair. The cramped quarters of the bathroom weren’t helping. I somehow got under him and with all my might lifted his upper body. Chacha pulled from the top and we were able to get him on the wheelchair. He wasn’t sitting right. His position on the wheelchair was slouched. But that’s the best we could do. We desperately needed to get him out of the bathroom.

That was when I realized his stomach wasn’t moving in its regular breathing rhythm. He had stopped breathing. I called out a couple of times “Daddy, Daddy” No response. I lightly slapped him on the cheek trying to wake him up from his unconscious state. Mummy was in panic. I can’t recall what chacha was doing.

I asked mummy to check his pulse. She said there was none. I decided we needed to first wheel him out into the bedroom. We did. By that time he started breathing again – wheezing and gasping. Mummy went and called Shravya – chacha’s daughter and a doctor. She checked the pulse and said it was faint but on.

I called 911 108. Told the dispatch I needed an ambulance and told them the general address. The lady kept asking me district and mandal. I got irritated a bit and told her this is Hyderabad city. She hung up. The dispatcher hung up the phone. SHE FUCKING HUNG UP! No time to get mad. I gave the phone to chacha and asked him to make the call as he probably knows the answers to some of their questions.

Meanwhile I made one more call. My cousin Kiran is an amazingly resourceful person and someone who acts out instantly. While we were wheeling dad out from the bathroom he was the only person I could think of. I called him and just said “Emergency”. I knew he was on his way.

That morning, I had asked my friend Raj to arrange an oxygen tank for dad. He sent his driver to get one and deliver at our home. He called right at that moment saying he was in front of the gate. We quickly got the tank in connected it. Dad’s breathing was still heavy but at least regular.

The ambulance came – within 8-10 mins of the call. Kiran bava came – right before the ambulance. The paramedics loaded him onto a stretcher and into the back of the ambulance. The discussion there was whether we should take him to Apollo Hyderguda – the nearest location, or Apollo Banjara Hills – a 40 minute drive – where he was being originally treated. I can’t recall who made the decision (I think it was Kiran bava) but we decided to take him to the closest ER.

The siren was on, we got into the ambulance and set out. I felt a strange feeling. 6 years ago I had got into an ambulance with Aarya in it when he burned his face during July 4 celebrations. Son then, father now.

To be continued…

“We Are Declaring Him” – Part I

Monday November 24, 2014.

It was 4 days after dad got discharged from the hospital. His fever was under control. His vitals were normal. But his counts weren’t increasing. The doctor gave him a few months. I knew that. Mom suspected it, didn’t accept it and was hoping for a miracle. The rest of the family either didn’t know or did not want to believe. Elderly AML is a deadly disease. At 74, he had slim chances to begin with. But lack of any co-morbid conditions raised our hopes. But a very early relapse three weeks after the first chemo killed those chances.

I was nervous that morning. I was supposed to fly back to the US that night. I wanted to stay back but my work situation was getting tenuous. I had spent several days in India this year. I was working on and off while there. If I had to work any more from there, I would’ve had to declare myself to Oracle India HR and report my income during that time to the Indian Revenue authorities. Things would’ve gotten complicated. I had to make a tough decision and I chose to play safe and leave – hoping that I can be back late December or early January.

When he woke up that Monday morning, he was visibly weaker than the previous day. When I helped him sit up on the bed he wasn’t able to support himself, unlike Sunday. When he tried to get off the bed he said he couldn’t move his right leg – he had lost control over it. We attributed it to extreme weakness.

Still we got him to sit on his chair. I fed him a quarter of an omelette. He hadn’t been eating well so I was force-feeding him.

“ఇంకొక్క చిన్న (one small) piece daddy”.

“ఒద్దు నాన్న(No dear)”

Still I fed him two more before I let go. He washed his mouth, drank some water and said he wanted to sleep. Chacha and I helped him on to the bed. He seemed to slip in to sleep very quickly.

Around 12:45 dad wanted to go to the loo. Chacha was in the chair next to me so he stood up too, to help move dad on to the wheelchair. It took a lot of effort to make him get him off the bed and on to the wheelchair. He was limp, absolutely no effort from him, no energy. I was concerned a bit. It took an even larger effort to make him sit on the loo. His position was awkward – not upright, slouched and without energy, staring at the wall in front. He was breathing heavily and his speech wasn’t clear. He was trying to tell us something but we couldn’t figure out what it was. After about 25-30 minutes in there he signaled he was done and wanted to go back into the bedroom.

In hindsight, this was the moment we lost him.

To be continued…