Tuesday, 13 October 2015

Nightingales, Nurses and Aruna Shanbaug.



          Abundant respect for the ‘sisters’ in white of the Mumbai’s municipal hospital, the KEM. Not a couple of them, not several graduate batches, but entire generations of nurses there have earned an ‘unparalleled anywhere-in-the-world’ tag because of the care they rendered on their comatose colleague, Aruna Shanbaug. For forty-two years.
          Like all public/general hospitals in India where treatment is free, in overcrowded KEM patients (many who’ve come from distant corners of India, suffering from dreaded illnesses) share beds or sleep on ward floors whilst their visitors/relatives rest in corridors/passages. Linen, when available, is discoloured and frayed, the toilets wet and dirty. Appointments for tests are delayed, acquisition of medicines requires running around, but those who’ve experienced the professionalism of the hospital will vouch for its quality.
          Medicines are administered on time, wounds dressed and reports filed according to the (brusque and overworked) scurrying ‘resident’ doctors’ orders. If there’s one person the latter fear more than the consultants, it’s The Matron, a stern disciplinarian who brooks no laxity in her ward. Under the watch of these (usually sour-faced) proficient ‘madams’ are trained the backbone of any hospital: the nurses.
          Whilst India had eight general elections, witnessed the Rath Yatra and its aftermath, whilst Mumbai suffered riots in ’93, serial blasts, 26/11 and got itself a sea-link, through Sharukh Khan’s rising career-graph and AR Rehman’s ‘Jai Ho’ becoming internationally famous, whilst the Nano was introduced and the internet, cable television and cellular phones changed our lives, whilst ‘Kargil’ was fought and won, Aruna’s caretakers ensured she didn’t have a single bedsore, force-fed her nutritious mush and convinced the Supreme Court of India that she did not deserve euthanasia. Not a mean task. No one paid the nurses to do it. No one would have taken them to task if they didn’t do it. Anonymously, sincerely and unsung, they gave their hapless mate quality of care that has gone down as a chapter in the annals of nursing history.
          No private hospital, however big, can deal with the logistics after serial bomb-blasts. Or a flood/ earthquake/ epidemic/ war. Institutions like KEM gear up instantly to give medical aid when needed. That’s expected. No extra points for that.  Nor for bringing to life from the brink of death bullet-riddled gangsters or those who drew their ire. What has earned KEM the headlines this week is Aruna Shanbaug’s life. She died on 18 May. She had been strangulated by a dog-chain in 1973 and a damaged brain left her blind and in a vegetative state for so many, many years.
          Four years ago, around the time I returned to settle in the home of my ancestors, the Supreme Court responded to a plea for euthanasia filed by a journalist. It set up a three-member medical panel to examine her. It concluded that Aruna ‘met most of the criteria of being in a permanent vegetative state’. A landmark judgement followed: it allowed and laid out guidelines (withdrawing treatment/ food that would allow the patient to live) for passive euthanasia in India. Through that legal battle, the doctors and nurses of KEM took up cudgels and fought tooth and nail against the mercy killing. (Apparently, she used to show some sign or ’response’ when she was fed mangoes and fish.)
 Interestingly, when the Municipal Corporation of Mumbai made two attempts to move Aruna outside the hospital to free the bed she was occupying (after all, these beds are valuable for salvageable cases), the nurses launched a protest in a show of precious solidarity and the Corporation abandoned the plan.    
A senior nurse at the hospital had said, "We (had) to tend to her just like a small child at home. She only (kept) aging like any of us, (did) not create any problems for us. We (took) turns looking after her and we love(d) to care for her. How (could) anybody think of taking her life?"
Whether patients like Aruna suffer is debatable. Whether or not she was aware of her surroundings, her condition, or pain, is unknown. When her own family had abandoned her, she was still lovingly tended to by strange but caring hands. Her case proved that compassionate personalized care is possible in public healthcare setting.
In the years that Aruna was in bed, totally dependent on others, I finished school, college, got married, became a mother and then an in-law. In those many years, half a lifetime, I’m surprised that no one filed a PIL that a bed that could have saved perhaps several hundred lives, was occupied by a patient whose outcome/prognosis was poor/nil.
Is it good that at times passion rules over pragmatism? Is that what makes us ‘human’? Debatable. 
In the meantime, my warmest regards to the fraternity in white… it recently celebrated 12 May, Nurses’ Day.
PS: I wish the television channels would do their homework. Being in a coma is not the same as being Brain Dead.
Feedback: sheelajaywant@yahoo.co.in

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