Women's days

I started writing this (in my mind) on Women’s day. I wanted the first story as a celebration story for women’s day. But as usual, many good intentions, this fell on the way side but I am thankful that it was not forgotten. The story has grown from one into stories multiple women, and a one good man.

It was almost 2 months back when I saw this girl PK, first. When I saw her, she was deeply comatose, on ventilator, with history of “Hexaconazole” poisoning. She was 14, and looked much younger than that. Somehow the clinical presentation did not fit in with the diagnosis. The family from a very poor background, had no idea what happened other than that there was an empty bottle of Hexaconazole lying around. We met with the father who was all in tears and said, she is his “apple of eye” in the local Bhojpuri equivalent, and pleaded with us, to make her well. I was not at all sure if she would make it. Deeply comatose, running high fever, with extensive aspiration pneumonias, no respiratory effort, I did not give her much chance for her to pull through. Couple of days later, based on our enquiry, father had gone back home to look out for any clues again. He came back with three bottles of pesticides. What she had taken was a concoction of three pesticides that too full bottles. I gave up all chances of her pulling through. After almost 8 days of waiting watching, we decided to tell the father about the inevitable end. But he was persistent – though he had no money he was pleading, do not give up, do something. (we had agreed on treatment on the house). We decided to get a tracheostomy done and slowly move her out to palliative care for caring for a person in a vegetative state. And having made the plans, I left for a three week travel outside. The day I came back was couple of days before women’s day. And I walked in to the ward and what greeted me was this girl sitting up and smiling. Couple of days later, on women’s day, she was off to her home, fully recovered, family rejoicing. Just before she left her story came out. Mother having scolded her for not washing utensils, she out of a feeling of being discriminated because she was the girl in the house, she took this drastic step.  The hero in this story for us was the father who stood beside her through her 5 weeks of hospital stay, of which more than 3 weeks in ICU and 14 days on ventilator.

As we moved couple of beds ahead, there was yet another girl who had just come from ICU. Not as sick as PK, PuK had been on the ventilator for again for more than a week or so. Having had multiple seizures and aspiration pneumonia's and having had tracheotomy, it took many days for her to get better. Again, like the previous girl, this was a young one in her mid-teens.  I did not see any heroes beside her, but she, as she was about to get ready to go home after being de-cannulated from her tracheotomy, she went into a psychosis. She was shouting and screaming her lungs out. All this after a month of stay as she was getting ready for going home. Unlike the other girl, something seemed to be disturbing her. Sedating her and putting her down with some anti psychotics did the work, but somehow, we did not see the joy to go home on her face. We knew a bit of her story though. It seems, she was told to feed the cows by her mother when she was playing with her siblings, and in anger went outside and drank the pesticide that was kept in the shed outside. What was troubling her, and preventing her from happily going home? Was there something more than what we heard? Or was the story the truth or the “tipping point” of many previous stories which we had not heard? One would never know. But one stray comment from her close relative gave some hints. When talking about the bill which they had no money to pay anyway, (hospital had agreed to take care,) but when asked by a staff to bring some money, the close relative shared, if you push us, we will leave her here and go…..Was she the unwanted one and she sensed it?

And in the next bed was K, again a girl in her late teens this time a married one. Having been again in almost similar situation – attempted suicide with a pesticide ingestion, on ventilator and supportive management, she recovered much earlier. But still took about more than 3 weeks. Her story was slightly different. She had a fight with her husband regarding sending their son to school to study further. She wanted her husband to arrange money to do the same. Her husband didn't have enough money which led to an argument, and subsequently led to the ingestion of poison to end her life.  Was this again like the previous stories, just an impulsive decision that led to this? Or was it the final of a series of events, the last one being the tipping point? Because of a husband who was not too concerned? One would never know.

But one thing stands out these three events. The precipitating events were simple, ordinary events (at least what was communicated to us), that does not warrant such a drastic step. And such young girls landing up in serious situations is not an uncommon event in this part of the country these days….

One more story from a different context, again same week from OPD.

This 30 odd year old lady who has been with us for a year or so came for follow up and sat down in OPD. Summer OPDs are busy and we run the “conveyor belt” OPDs – patients in and out fast! As usual I was about to quickly sort her list of drugs out, and send her off, she stopped and asked me a question. She was admitted with us a year ago, with severe peripheral vasculitis, and was found to have SLE. On regular follow up, with us, doing well, a year into treatment. Again, from a low socio economic back ground, but regularly coming for follow up. Her question was about the longevity of treatment – how long will I need to continue this. I told her 2 years or even lifelong. I stopped to ask her any other issues – she said – I stay with in laws and they keep talking negatively about my illness and treatment and verbally abuse me. I can’t keep going on like this, I have three small kids. I had never met her husband, and I asked, where is your husband? She reminded me, I had told you sir, he is in jail! I had completely forgotten the story. She shared in again – He being a driver, had a freak accident and was in jail for a term of 5 to 7 years, having had no money or support system to pay the legal system! And so, she has to live bearing this abuse till he comes out! And she also had asked for a Tubectomy earlier. I had previously checked out with the OG team and they were ready to do. I asked her again about the same – why does she want one if husband is not coming back for next 5 years or so. But then I realised that it was not the wise question to ask in such a context. She replied, any way I do not want it now, I cannot allow anything to happen to me till he is out of jail, because my children need me. I am afraid that surgery might be dangerous for my life. One waiting for her deliverance from the context of abuse….

Stories of unmarried, early married and late into marriage from women from a part of our nation…..
Why these stories? Just to be reminded, Women’s days come and go but life’s go on as usual for many women…..in our nation….

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