By Nisha Susan
I am in hospital with my mother.
This is my third stint in this hospital with a family member in the last six months. My father had an emergency gall bladder removal. My brother had dengue. I already know what the hospital canteen offers at 2am. Now, the day after Easter, my mother has cracked her femur in two. Her bones are like butter, says the doctor in the hospital that night. So we even speculate whether she broke her bone because she fell or whether she fell because her bone broke. After surgery, she can’t be in any position other than absolutely flat on her back. She’s never been in hospital before except to give birth to two children. She’s utterly mortified that she can’t eat, drink, pee or shit without help. The only thing that’s saving her sense of self is a stream of young women who attend to her without contempt, passive aggression or even dehumanising briskness.
I become obsessed with the one on the night shift.
Ameeta is so utterly serene that she seems to have fallen out of Central Casting. Only she is from Peerumade, a town in Idukki district where my mother tells me (quoting a young participant from a Malayalam reality show) there are only two career options for women: nursing or engineering.
My mother is as fascinated with Ameeta as I am and makes no effort to hide it. “How is she so good-looking!” she exclaims every day. I am fascinated but it’s only part admiration. The rest of it is fear. Fear that those irony-free eyes under the thick 1980s eyebrows can see straight into my sketchy self. Handing out pills, keeping an eye on the IV, examining the dressing, changing sheets, bathing, clearing bed-pans, monitoring blood-pressure, collating all information about patients for the doctors who breeze in and out, feeding patients who can’t eat themselves, shifting the patient to one side, then to the other – the shift is supposed to be 8 hours. It often lasts 12 breathless, ceaseless hours. Meanwhile, I am worrying about whether Ameeta can see straight into my neuroses. Hopefully the thrall will end like a shipboard romance when I stop marking days in nurses’ shifts.
A few months ago, I had become obsessed with the tiny nurse on the night shift when I was in hospital with my father. Unlike Ameeta, Jesina had an air of sheathed power, as if she was a superhero in disguise. My father, a doctor, knows first hand how strong nurses can be but as a patient he is reluctant to lean on a girl who seemingly weighs nothing. Jesina glints tigerishly and helps my father get out of bed with one cool move that leaves him exclaiming: Oh Sister, clearly you are more than what meets the eye. One morning I see her striding out of the hospital after her shift in a hijab, the fabric rippling as if she had her own personal wind machine.
I haven’t seen Jesina this time round, even though I peek at the nurses’ desk on every floor I happen to be on. Last time round she had told me about working in a Chattisgarh hospital. She had left convinced that walking back and forth from her hostel to the hospital in a tiny town full of CRPF soldiers on election duty was more risk than she wanted to deal with. I ask Simi, a twinkling, bespectacled creature whose air of profound amusement at the world invites conversation. “Jesina-chechi? She’s my roommate. I will tell her you asked after her.”
My mother tells me that most of the nurses in this hospital are single women and live either in a hostel or other housing provided by the hospital. “They all eat at the hostel mess though.” I tell her about meeting an Assamese boxer who had consistently picked the narrow hostel rooms of the Sports Authority of India rather than the nice house her Railway job had earned her. “It’s the same with these nurses,” my mother says. “After 10 hours of work here who wants to go home and cook and clean?” We don’t discuss the fact that a lifetime of running her household, all over the world, under all kinds of circumstances, is over after this fall. She is turning 60 this week and retirement has come without the benefit of a party, a speech and a memento.
Every few hours of our first day in hospital my mother mentions Ajitha. I am not really paying attention in the beginning and then I do. Ajitha is a very distant cousin, much younger. Her grandmother and mine were neighbours. She is in Sana’a, says my mother.
A couple of years ago Yemen had begun their uprising against a president who has been in place for 32 years. A president who was in no mood to depart. When protestors at the university in Sana’a called for President Saleh’s departure in 2011, professional snipers skulking on rooftops shot 52 of the demonstrators in the head and neck. Another group of men built barricades to prevent the demonstrators from escaping the bullets and hundreds more were wounded. It’s not clear why Saleh thought this was a good plan because it has ended in thousands of grieving Yemeni protestors flooding the streets, more determined than ever that he’s gotta go. Four years down the line the country is split between people who support Saleh, those who support his replacement President Hadi, and those who back the rebels from northern Yemen (called Houthis) who, in January, marched on the capital. In February 2015 the Houthis deposed Hadi and have been looking since to expand to southern Yemen – which incidentally is home to the strongest branch of the Al Qaeda. Yemen’s large neighbor, Saudi Arabia determined to squash the Shia Houthis, who probably are supported by nemesis Iran, had begun airstrikes in March. Plus there is the IS. What is Ajitha doing there, I ask foolishly. My mother looks tart. What do you think, she asks? She is a nurse.
This week the Indian government is trying to bring home over 2000 nurses. As was the case of the Malayali nurses in Libya I spoke to a few years ago, they are distinctly reluctant to come home. The money is better for nurses in the Gulf and so is life in general. Ajitha must be in the middle of trying to decide what to do as well. Grit their teeth and stay, leave for good like the Malayali nurses after the IS took over Iraq in 2014, or leave for a bit like the nurses who went racing back to Tripoli and Benghazi in 2012?
Over the next few days I join my mother in wondering whether Ajitha has returned home. My mother wants to call Ajitha’s parents but is afraid of adding to their concerns while they wait. Bit by bit, I learn about Ajitha. How she married a fellow nurse. How her husband went to Israel to work (keeping his fingers crossed that Israeli immigration would not stamp a visa straight into the passport which would make him persona non grata anywhere else in the Nurses’ Promised Land) and she went to Yemen. How they had a baby and brought the newborn straight back to Kerala for her parents to raise.
We talk about all the nurses in Ajitha’s family, and all the nurses in ours. My aunt M, plain and tall, who married a good-looking wastrel (He is a year or two younger than her. This detail is always repeated as if it confirms her great self-indulgence) who at least knew the deal: Keep house and look after the three children while I make the money in Oman. My aunt M, who retired as head nurse and lives in Kerala, who has just this month sent her husband to Delhi so that her airline steward son and nurse daughter-in-law can take care of him through chemo and radiation. Meanwhile she is in charge of her 87-year-old father-in-law who may be dying of cancer himself but it’s hard to tell since even 6 months ago he was cycling around town, milking the occasional cow and driving a hard bargain over the milk.
We talk about my friend Benson’s mother, Mary. Mary is very ill. She is on an oxygen machine most hours of the day. Two months ago she was taken to the emergency ward in St. John’s Bangalore, because she couldn’t breathe. The nurses were distracted when the room suddenly filled with accident victims, all bleeding and moaning in pain. One of the nurses gasped in shock when she saw Mary jump out of bed and cauterise a wound. “I am a nurse,” Mary told them making everything all right.
An aunt calls to ask after my mother. I have a vague memory of her when we visited her in Buraimi, a town on the border of Oman and the UAE. She has three daughters, doesn’t she? Yes, the older one is a nurse and is moving to Ireland. Her husband is in Germany, of course, my mother says. Of course, I say. And the middle sister is just wrapping up her nursing course is in Coimbatore. The younger sister has rebelled by becoming a pharmacist.
Every conversation we have seems to have a nurse in front, middle or skulking in the periphery.
I complain to my mother about the sudden death of a good, solid character with great hair in Grey’s Anatomy. She guffaws about the equally ignoble departure of a female actor who had a ‘mother role’ in a hit Malayalam TV show. The actor asked for time off for a couple months and got killed unceremoniously. “And it wasn’t like she could postpone the break. She had to go to London to help her daughter with her pregnancy. The daughter is a nurse.”
Four days into our hospital stint, no news of Ajitha. My mother thinks it’s okay to call her parents and steels herself to do it, terrified that Ajitha’s father will cry on the phone.
And just like that I think that I can place Ajitha, out of a passel of small cousins. One summer when I was a teenager visiting my grandmother, one of the men in the house next door had climbed on the roof and declared that he would jump. He had been dirt poor, gone to Saudi when he was 18 and worked for decades. Somehow he managed to become a drunk in Saudi Arabia and come back (pause for a brief episode when he had sent his family a telegram faking his own death). He stood now on the roof he had raised and repaired, saying, “Mother, I will jump. I will.” The village gathered to watch the fun. His mother cried. His wife gritted her teeth. Through the crowd’s legs came wandering a little girl –
6-year-old Ajitha come to see what her uncle was up to. After a while we heard her clear treble: Jump Upappa, I will catch you. And we all stared at the child with her arms stuck out to save the man on the roof.
Was that Ajitha I remember? I ask my mother. Perhaps, she says.
The next day we hear that Ajitha is back in Kerala.
We have already figured that it takes roughly five people to do all the work she used to do. My father, two days after my mother’s fall and having had a taste of her usual schedule, pronounced that it wasn’t rheumatoid arthritis that got to her joints, it’s overwork. Now that she’s back home we need two people to make her comfortable and move her without endangering her bones. On day one, she moans with embarrassment every time I help her with a bedpan. The first time I find myself slipping into the infantilizing voice of medical professionals and then resolutely ward it away. I am surprised that I am not repulsed by pee and shit, since my gross-out threshold is fairly low. My vipaasana-loving, vipaasana-living friend recently told me that becoming neutral towards shit-cleaning was one of her long-standing (and since-achieved) ambitions.
By midnight I am exhausted. My father tells me to go to bed and that he’d take over the night-shift. I have a moment of dithering. My father is a great diagnostician but not my first choice for nursing care. I squash my conscience and go to sleep. The next morning my first glimpse of her face makes my heart shrivel. She looks like she was beaten. And in a sense she had been. My father had dealt with his own misgivings about this new situation with a continuous, bruising patter of wisecracks at 2am, 3am and 5am.
That was the worst day but since then we all figured out various things. How she could move back and forth in a bed. How to help her sit up. What she could eat and what she was grossed out by. How to keep track of 20 different medicines. How to take her back and forth from the hospital. How she could move into a wheelchair and off. How to wash her hair when she was lying down. How long she could sit in a chair, wheelchair or on the bed. How the skin on your feet changes rapidly if like an astronaut your soles have not touched the ground in weeks. How not to talk like an idiot to your mother. How to be a thin, watered-down version of a nurse.
It’s been over 50 days since my mother fell. No, not fell. It was more like she sat down hard but she broke her femur, what should be the strongest bone in her body.
This week we are back in hospital because the surgery didn’t take. A bump the size of the screw-head has appeared on the surface of my mother’s thigh. Is that the screw, I ask my father in horror. No, but it means the screw has moved. And sure enough, the X-ray shows that the screw holding the two pieces of my mother’s thighbone together has started to slip out, like a nose-stud with a pin too thin, like a nail in a crumbling wall. Her bone density is 30 percent of what it ought to be at her age, the doctor said.
She cries when she hears that the surgery has to be redone, the recovery has to be redone. The surgeon looks ready to cry too. Over the next week he is depressed every time when we see him. Except the time immediately after the second surgery, when his relief is transparent.
He had been mugging the previous day and has now deployed a different kind of contraption: a plate that runs along the length of her femur and a cluster of screws that reminds me of the Frankensteins my brother and I knew from the cartoons, who had a screw sticking out of their neck and lisped Yeth Marther. This contraption should work, we all hope. It seemed too extreme not to, we hoped.
I came home for a shower after meeting the surgeon. In a couple of hours my brother calls saying come as soon as you can. What is it? He doesn’t want to say. Come to the hospital. I try not to cry in front of my nephews and then throw myself into the car and make incessant small talk with my husband.
On the first floor of the hospital, my father looks at me with a mixture of bitterness and rage. The first words that come out of his mouth are “Kismat. What else is it?” I don’t know where my father knows this word from. It’s not from a workaday Hindustani – he doesn’t have any. In his mouth it’s exotic, Victorian and convincing – more kismet than किस्मत . What else could it be that my mother sat down hard the day after Easter, broke her leg and has now had two major surgeries and apparently, a post-op cardiac arrest.
A couple of hours and an angioplasty later, we troop in to see her. She is in surprisingly good cheer, and insists she was responsible for saving her own life. They were wheeling her from the post-op observation room to the ICU when she felt a peculiar heaviness in her chest. To the nurse who said, don’t worry, she was adamant: I must see a doctor now.
Over the last six months among a cluster of pieces about gender and science, one fact stuck out for me: the symptoms of cardiac arrest in women are so different from the left-arm-clutching movie cliché of men’s heart attacks that more women die of heart attacks every year than men. Medicine has rendered the symptoms of male health and illness as the normal and the standard. If your illness looks different, then too bad. The next morning I feel very pleased with my mother’s self-confidence but right then, immediately after hearing the news, I only think of a shawl-covered movie cliché of my own: heart patient.
That doesn’t last very long. The next morning my mother tells me in the brightly lit airy Cardiac Care Unit that the doctors say her heart is as good as new. She also boasts of how friendly she has become with the nurses. A day later she is back to reporting snippets.
One Male Nurse tells another Male Nurse that he is romancing a B.Sc nurse in Delhi. It is a truth universally acknowledged that the nurse who has a B.Sc degree – an expensive, four-year programme that can cost as much as Rs 10 lakh – rather than a nursing school course is a superior creature. Male Nurse 2 warns Male Nurse 1: She will boss you and boss you and boss you to death. Male nurse, unruffled or perhaps ruffled by love says: So what if she bosses me?
My mother adds her editorializing to this field report: The women nurses here really do boss and boss the men around. It’s all eda-poda, do-what-I-tell-you and quarrelling. She says, “I asked one of the women about the quarrelling and she said: it doesn’t last long. We are all friends.”
The male nurses I meet in this hospital are all warm with a glint in their eye. In the cardiac care unit they look deeply into our eyes, smile gently and assure my mother that the nausea will pass soon. They are chatty and glide into our highly truncated gossip sessions – I only get to see my mother twice a day for ten minutes at a time. These guys are good at their job when they get around to it but really lazy, my mother says later.
A fashion-forward friend who visits my mother in hospital says she feels sorry for the male nurses because of their clothes. Is it because it’s pink, I ask tentatively. I’ve heard my share of nudge-nudge-wink-wink about a distant male cousin who grew up poor and trained as a nurse. After bumping into him at a wedding, my relatives described him as ‘so girlish because of spending so much time with women tee-hee’. Recently he married a woman from a comparatively affluent family. In his latest CV, rumour has it, he has erased his brief nursing past and perhaps made up a couple of degrees to land his fine prospect. No one is saying anything about his being girlish anymore. Now the description is more guarded, but also less contemptuous.
I dislike the male nurses’ clothes but not because they are pink, says my friend. It’s cut for women. The collar is all wrong, she complains. I am relieved.
A couple of weeks ago, after surgery 1 but before surgery 2, when my mother wasn’t strong enough for a wheelchair, we ferried her to the hospital in an ambulance. The nurse in the ambulance is round-faced, round-bodied with a kind of genial moustache that reminds my parents and me instantly of the 90s Mallu actor Maniyan Pilla Raju. In the 8km ride we all chat each other up incessantly. My knowledge of Kerala geography is dubious but I too participate in the ritual asking of where he is from – nadu evida, nadu evida? I once tried to interview the Kerala-based chairman of a Rs 500-crore company after he had donated his kidney to a truck driver. His assistant asked nadu evida before he asked which magazine I was from. In the ambulance, the Maniyan Pilla Raju lookalike wants to know where I practice journalism. I want to know whether he learnt Bengali in his first stint in Kolkata. Yes, but now I am forgetting it as I learn Kannada, he says.
I am continuously amazed by the nurses’ in-built Duolingo app — the speed with which they learn the medical register in different languages at each job. (The story about the Mallu nurse trying to explain enema in Kannada is one for another day.) This time round in the hospital, it is someone else’s linguistic ability that gives me uncontrollable giggles at a point when we are all feeling gloomy. This morning they are taking my mother back into the cardiac care unit. The blood-thinners that can help my mother’s heart after the cardiac arrest doesn’t help my mother’s leg recover from the orthopedic surgery. Her haemoglobin count has dropped dramatically. She needs blood transfusions but a blood transfusion might induce another clot and perhaps another cardiac arrest. It’s now three days since the heart attack so the risk is much lower and so off she goes to get B positive. My mother is feeling anything but positive at this point and is shockingly pale. The bespectacled cutie Simi–smart, brisk and kind–is supervising her move from the room back to Cardiac Care. She emits a continuous series of instructions to the good-looking wardboy Jahid, all in Malayalam. Move the wires, change the sheets, empty the drawers, she says in Malayalam to him. Don’t worry, Ammachi, you will feel better soon, she tells my mother. Kudichyo, kudichyo, she says encouraging my mum to drink some of the watermelon juice I am trying to tempt her with. Kudichyo, kudichyo, repeats Jahid with a giggle.
Then as they roll my mother out into the corridor he says (unprompted) madhi, madhi to Simi. As in enough, stop, don’t roll this bed further, in Malayalam. My mother lying in the bed they are wheeling is glassy-eyed and looking the worst she has in in this two-month stint but Jahid’s gleeful self-tutoring makes me sputter and laugh. Nurse Simi does not laugh. Not because she has no sense of humour but because her mind is on my mother’s file and the highlights that she has to convey to the nurse in Cardiac Care. Simi speaks Malayalam, Kannada and Tamil, I know. Jahid speaks very good Kannada. Does she speak Hindi, which Jahid speaks? Doesn’t matter because the international language of nursing is Malayalam so Simi doesn’t care and Jahid gets with the programme.
Our ears are so tuned to Malayalam in the hospital that waiting in the corridors that ring with Chechi-Chechi, my husband who speaks not a word of Malayalam hears two nurses talking about something monosulphate and hears ‘Onam Sadhya’ instead.
What’s the news about Ajitha, I ask my mother. She has got a job in Bangalore, says my father who grew up next door to Ajitha’s father. What, really? What about the baby and the nurse husband, I ask, knowing full well that geography is the smallest factor in my relatives’ decisions about work. My first cousin, an engineer, works in the IT department of a nationalized bank. She lives in Thrissur, her husband, two hours away in Alwaye and her baby in Alapuzha, three hours away.
On the day before my mother is discharged I call Ajitha. “You got a job in Bangalore?” “Yes, Chechi. But right now I am in a bus to Kerala. I will be back soon.
Photo: Frida Kahlo painting in bed.