Soumyadeep Dutta
The fluorescent lights above flickered like tired eyelids, buzzing faintly over rows of rusting stretchers and sweat-drenched bodies. It was 7:58 a.m. when I stepped into the emergency ward of Nilratna Chatterjee Memorial Government Hospital for the first time as a junior resident. My stethoscope clung around my neck like a nervous talisman, and in my coat pocket sat a new blue notepad with clean pages—still innocent of blood, signatures, and regrets. The smell hit me first—disinfectant poorly masking urine, vomit, and something else, something warm and fleshy, like decaying hope. Patients lined up the corridor, lying on trolleys, wrapped in stained sarees, or hunched on benches with saline bottles hanging from iron rods jammed into walls. A boy coughed blood into his mother’s dupatta in front of me. She didn’t flinch. Behind her, an old man yelled at the ceiling in delirium. A nurse rushed past, IV bag in hand, slippers flapping against the floor, shouting something about a crashing case in Bay 2. It was not even 8 a.m. and already the air vibrated with urgency, grief, and noise. I had read about this—about ER chaos in textbooks and articles—but none of it prepared me for the orchestra of human collapse conducted on a concrete floor with no conductor, no script. A resident from the night shift handed me the patient log like a cursed heirloom. “Three referrals pending. One absconded. One stabbing. And two have already died. All yours, Dutta.” He didn’t look at me when he said it. Just vanished into the corridor like a ghost punching out of his haunting. I stood there, unsure of where to begin, until a ward boy with a deadpan face pointed me toward a woman screaming in Bay 3. “Seizure. Start with her, na, doctorbabu.” I walked forward, the stethoscope feeling heavier than before.
Bay 3 was a makeshift enclosure, separated from the rest of the ward by a torn green curtain that didn’t close properly. Inside, the woman thrashed on the stretcher, arms flailing wildly, eyes rolled back, her husband trying to hold her down by the shoulders while crying in broken Hindi. A nurse shouted, “IV diazepam lagao, doctor!” I fumbled with the ampoule, my fingers trembling. My first prescription as a doctor and my hands betrayed me. I drew the medication, injected it, and watched her body slowly quieten, her muscles unclenching one by one like a fist opening after years. The husband whispered something that sounded like a thank you, though I couldn’t meet his eyes. There was no time. A child was brought in next—eight years old, unconscious after a fall. The mother was inconsolable, the father in shock. The CT machine was down, the neurosurgeon wouldn’t be available till 11. I wrote a note to transfer the child to a private hospital, knowing they probably couldn’t afford it. My first moral compromise before breakfast. At 9:45, a man came in with a stab wound in the abdomen, blood pooling under him. We had no working suction. I held his wound together with my palm as Nurse Pushpa, fierce and calm, inserted a cannula. “Hold steady, Dutta. Pressure. Look here. No, not at the blood. At his face.” She taught without condescension. She had done this longer than I’d been alive. When the man was finally wheeled into the OT, I felt like I had aged a year. The next hour was a blur of tetanus shots, dehydration cases, one suicide attempt, and one man who died waiting for oxygen. The oxygen cylinder was empty. No one had checked it. I wrote his time of death and stared at the pen for a long time, realizing that I had just officially confirmed someone’s end with a Bic ballpoint. I hadn’t even known his name.
At noon, I slipped into the back stairwell to breathe. My coat clung to me with a mix of sweat and the stench of disinfectant. I sat on the steps, pulled out my notebook, and wrote: “Twelve patients. Three gone. One transferred. Nothing heroic. Mostly helpless.” Just then, a chaiwala passed by with a steel thermos and a rusted tray of plastic cups. I bought one and drank in silence, my mind still back in Bay 3, with the woman’s eyes rolling white and her husband’s whispered gratitude. I realized I hadn’t eaten since dinner last night, but hunger felt like an unnecessary luxury. When I returned to the ward, the crowd had grown. A political rally nearby had turned violent. Five head injuries. One man with a dislocated shoulder screamed abuses at us. Another spat at a nurse when told he would have to wait. The security guard stood watching from a distance. This, too, I would learn, was routine. As my shift crawled toward the twelfth hour, I saw the sun slant through the broken slats of a dusty window. In that light, everything looked unreal. I stood in the hallway, my shoes stained with blood, the stethoscope still around my neck, and it hit me: this wasn’t a day. This was a war zone dressed up like a hospital. A battlefield where medicine was practiced with tape, memory, and exhaustion. A boy brushed past me, holding his father’s wrist, dragging him toward a stretcher. His eyes were calm, too calm, like he already knew that help here didn’t come easy. I bent down, helped them onto the trolley, and checked the pulse. It was faint. But it was still there. I looked at the boy and nodded once. Then I turned, rolled up my sleeves again, and walked back into the ward.
***
The next morning, I arrived before sunrise. The corridors were dim, haunted by echoes of half-finished conversations, clattering trolleys, and the low, mechanical hum of a ceiling fan that hadn’t stopped since the 1980s. I hadn’t slept properly—not because of the heat, but because of the faces. The child whose CT I couldn’t arrange, the woman with seizures whose name I never learned, and the man who bled out while the ward boy searched for an oxygen key. They sat in my mind like stubborn stains, intruding between spoonfuls of rice and broken dreams. I walked past the waiting room, where families curled up on torn plastic mats, some asleep, some wide-eyed in a vigil. The stale air was dense with coughs, sweat, and the silent prayers of people who knew that healing here was not guaranteed. As I reached the ER entrance, I saw Nurse Pushpa already at the nursing station, sipping her morning tea like a soldier reading war reports. “Neel, you’re early,” she said without looking up. I nodded. There was no need to explain. She understood what it meant when a young doctor began coming early—not dedication, but guilt that refused to sleep. I washed my hands, changed into scrubs, and started flipping through the new admission list. Five cases overnight. One critical. One dead on arrival. Two transfers, one absconded. The usual chaos—but today, a familiar name caught my eye. Rafiq Ansari, age 44, known for showing up every month with a new ailment and the same demand: painkillers. He was a known addict. Most of the staff dismissed him. But I remembered how he had once carried his sister in on his back after a street accident. Today, he was in the observation ward with breathlessness and chest pain. “Must be faking again,” one nurse muttered. I decided to check anyway.
He was lying on his side, shivering slightly, a thin cotton gamchha under his head and his feet dangling off the edge of the stretcher. His face looked older than 44. Hollow cheeks, sunken eyes, and a wheeze in every breath. “Rafiq da, ki holo?” I asked. He smiled weakly. “Bachbo na, doctorbabu. Ebar shotti jachhi.” I placed the stethoscope on his chest and paused. The air entry was poor. Crepitations. Tachycardia. He wasn’t lying this time. It wasn’t withdrawal or another fake episode. It was real—maybe pneumonia, maybe worse. “Chest X-ray. CBC. CRP. Start him on oxygen and ceftriaxone,” I told the nurse. She raised an eyebrow but followed my instructions. Ten minutes later, the power went out. The oxygen flow from the old central unit sputtered. The backup generator hadn’t been fixed since last week. I looked at Rafiq gasping, fingers clutching the edge of the bed like it could save him. I ran to Emergency Bay 1 and grabbed a portable cylinder. It was half-full. I attached the mask and adjusted the flow rate. His eyes met mine—grateful, but dimming. His pulse was dropping. “Get the registrar,” I called out. No one came for three minutes. He convulsed once, then slumped. I tried CPR. One of the interns joined. It was too late. I called time of death. 7:53 a.m. One day after my first shift. One more patient lost. But this time, it wasn’t a stranger. It was a man everyone dismissed, and whom I believed for once—and still couldn’t save. When we zipped up the body bag, no one cried. Not the nurse. Not the ward boy. Not me. Because in this place, grief was a luxury we couldn’t afford every day.
Just as we cleared the stretcher, a new patient was wheeled in—a traffic accident victim, unconscious, blood pouring from a head wound. His wallet said his name was Sandeep Roy, aged 26. The phone inside rang. I picked it up instinctively. “Hello?” A young woman’s voice said, “Dada, where are you? We’re waiting at the function.” I froze. I looked at Sandeep’s face, battered, half-covered in gauze. I didn’t know what to say. I hung up. We rushed him into triage, stitched the scalp laceration, arranged an emergency CT, and started IV fluids. He survived. Barely. Later, I stood outside the ER drinking my fourth cup of sweet, watery tea from the canteen boy who roamed the corridors like a caffeine ghost. I stared at the body bag in the corner, waiting for the morgue staff. Rafiq Ansari had no family. No one had claimed him. He would be cremated as an “unclaimed body” unless someone showed up in the next six hours. I thought of buying him a proper shroud. But the duty bell rang again. A seizure in Bay 4. A cardiac arrest in Bay 2. I tossed the empty cup and ran back in. There was no time to mourn the dead. Not here. Not in a place where the living constantly demanded every last drop of your attention, your energy, your soul. As I pushed open the curtain to Bay 4, I caught my reflection in the glass door. Same tired eyes. Same stained coat. And yet something inside had shifted. I was no longer just witnessing pain. I was part of its machinery now.
***
It was around 2:30 p.m. when the tea in the canteen turned more bitter than usual. Maybe it was the aftertaste of the last death, or maybe the air had thickened with monsoon humidity pressing down on the hospital like an invisible weight. I hadn’t taken a real break in sixteen hours—just snatches of breath in stairwells, a few notes scribbled in my pad, and a cold samosa left half-eaten in my coat pocket. The ER was unusually silent for ten minutes, and I knew better than to trust the quiet. Silence in a Kolkata government hospital was never peace—it was tension, paused. Sure enough, the doors flung open with a bang, and a man staggered in carrying a woman in his arms, both drenched in red. Not just blood—vermillion, too. Her mangalsutra hung broken from her neck, twisted into her blouse. The man shouted, “Train accident! Salt Lake station! Please save her!” I rushed forward. Her left leg was gone below the knee. A sari blouse was wrapped tightly around the stump as a tourniquet, but the bleeding had soaked through. She was barely conscious. Someone brought a stretcher. We laid her down, began fluid resuscitation. I called for O-negative blood. None available. I checked the register. “Try Beniapukur ward blood bank,” said Nurse Pushpa grimly. I called. No response. “We’ll have to stabilize her long enough for surgery,” I muttered, mostly to myself. The husband kept repeating her name, “Parul, Parul, Parul,” like he was trying to will her back into the body. I saw the ring on her finger. She was newly married. Probably returning from a visit home. One step on the wrong track, and her world had unraveled.
I stitched the laceration on her arm while an intern tried to stop the bleeding from her thigh. The saline ran like a river, but so did her blood. Her pressure dropped again. “Another bolus,” I said. The monitor beeped erratically. The power blinked once. I could feel the room watching her die in slow motion. I turned to the husband. “You’ll have to arrange blood. Fast. We need at least two units. Go now.” He nodded frantically, dropped his bag, and ran toward the blood bank like a madman. We did what we could—kept compressing, kept injecting. We wrapped the stump tighter and elevated it. She blinked once. I said softly, “Stay with us, Parul. Don’t give up.” But I don’t think she heard me. Thirty minutes passed. The husband returned—empty-handed. “No blood,” he gasped. “They said no stock. They told me to try a private place. I don’t have money…” His voice broke. He fell to his knees in the hallway. That’s when it hit me, hard—what truly breaks people in this system isn’t just injury or death, but the helplessness. The cruel arithmetic of survival in a place where what you need is available—just not for you. Not unless you’re someone. Not unless you pay. We used volume expanders, kept her stable for another half hour. Finally, a visiting NGO volunteer who overheard us called someone, pulled a string. Two units arrived just in time. We transfused. Parul made it to the OR, barely alive. I watched as they wheeled her away, and I realized I was gripping the edge of the trolley so hard my knuckles had gone white. A nurse touched my shoulder and said, “That’s the fourth railway amputation this month.” Her voice was flat. Not cruel—just numb. In this place, the shocking becomes ordinary, and the ordinary becomes invisible.
I stood alone in the stairwell afterward, eyes closed, forehead resting against the cool wall, and I thought about all the things that bled today—and all the things that broke. A leg. A man’s voice. A promise of a new life. The illusion that I could fix everything with knowledge and effort. I thought about Rafiq Ansari, whose unclaimed body had likely been burned by now. I thought about the motherless child in Pediatric Bay, clutching a crayon but not crying. I thought about my own mother, who still packed my lunchbox even though I never had time to eat. And I thought about my hands—shaking slightly, not from fear, but from the weight of holding too many stories I couldn’t carry. I scribbled into my notebook: “Today, I helped someone live. But it doesn’t feel like winning.” Down below, I could hear the sound of another trolley being rushed into Emergency. Another life, another wound, another page. There was no ending in this place. Only continuations. And me, caught in the middle—between what I could do, what I wanted to do, and what the system allowed me to do. That night, I didn’t go home. I stayed on call. I sat by the window in the resident duty room, looking at the sodium lamps outside flickering through mosquito nets. And I promised myself: no matter what breaks, I won’t stop showing up.
***
There’s a silence that screams louder than any monitor beep, louder than wailing families or angry relatives at the triage desk. It’s the silence of patients who can’t speak—those whose voices have been robbed by trauma, by stroke, by despair. That morning, as I walked into the ER at 6:45 a.m., before even the first tea had been poured, I saw that silence waiting on a broken wheelchair, tucked in the far-left corner of the hallway. A boy, no more than nine, sat with a vacant gaze. His head was wrapped in white gauze, his left arm in a makeshift sling. Beside him stood a woman—silent, too, her face blank, covered in dust, her dupatta damp with sweat. A junior intern came up behind me and whispered, “They were pulled out of debris. A house collapsed near Tiljala. No known address. No paperwork.” The child hadn’t said a word since he arrived. No cries, no answers to questions. Not even a name. We took him inside. No visible spinal injury. Vitals relatively stable. A small fracture in the arm, concussion likely. But that silence worried me more than any wound. He didn’t flinch during dressing. Didn’t blink when I shined a torch in his eye. He just stared at the ceiling, eyes wide and dry, like they had seen too much in one day to cry about it.
The woman, possibly his mother, eventually whispered one word—“Rinku.” That was the only thing we had to write on his file. The rest was guesswork. I ordered a skull X-ray and an MRI referral, but the machine was out of order again. The technician shrugged, “You can try SSKM, but they’re booked for days.” We kept the boy under observation, started antibiotics in case of internal injury, and gave mild sedation. Still no reaction. When I returned after two hours, Nurse Pushpa was sitting beside him, humming a Rabindra Sangeet under her breath. She looked up. “Sometimes it’s not the injury. It’s the shock. The mind shuts off. Stops processing pain.” I nodded, remembering a boy I’d once met during my internship who hadn’t spoken for six weeks after witnessing his father being lynched. The body knows how to protect itself—in silence. Later that day, a police constable came by for medico-legal paperwork. When he asked the boy’s name, I simply said, “Rinku.” He didn’t ask more. Just noted “Unverified identity – male child – approx 9 years.” As he walked away, the boy flinched at the sound of his boots. Just once. It was the only movement of fear I’d seen from him all day. Not for pain. Not for blood. But for authority. That evening, I asked the woman if they had any relatives to contact. She shook her head. “Sab chhori diye chole gelo. Ghar-u nei, manush-u nei.” I didn’t ask her more. Some stories shouldn’t be forced out with questions.
Toward the end of my shift, a private hospital ambulance arrived, offloading a gasping senior patient into our hands—a common ploy when patients are declared “unsalvageable” elsewhere. He had an end-stage respiratory infection, comorbid with untreated diabetes. His son tried to push for an ICU bed we didn’t have. The intern told me, “Sir, they said we’ll be blamed if he dies here.” I stood still for a moment, staring at the man on the stretcher. He was already in a coma. There was nothing we could do beyond comfort measures. I explained it gently to the family. The son screamed at me. Called me a murderer. Called the hospital a graveyard. I didn’t respond. We put the man on a nasal cannula and made him as comfortable as we could. That’s all we could offer. Sometimes, the hardest thing is to accept that medicine cannot save everyone. That night, as I prepared to leave, I passed by Rinku’s bed again. He was asleep, his breathing steady. I looked at him one last time, unsure if he would ever speak again, unsure if I’d see him the next day. I wrote in my notebook before heading out: “The ones who don’t speak often carry the loudest pain. And sometimes, the ones we cannot diagnose are the ones we remember longest.” Then I stepped out into the hot, damp night, where the honking from the street outside sounded like a different kind of emergency—one I didn’t have to answer.
***
The hospital was already awake before the sun rose. Sweepers dragged mops across bloodstained tiles, nurses scribbled vitals onto paper clipped to rusted clipboards, and the smell of burning phenyl filled the ER like incense before a ritual. It was 6:25 a.m. when I stepped in, the sky outside still a deep cobalt, and the ward already looked overwhelmed. A burn case had arrived at dawn—a young domestic worker, half her face and neck covered in blackened blisters, skin peeling like paper. “Gas cylinder burst,” the employer claimed, but something in the girl’s glassy eyes said otherwise. Her name was Anju, and she barely spoke above a whisper. Third-degree burns on 35% of her body. I ordered fluids, analgesics, called the plastic surgery registrar, and shifted her to a high-dependency bay. The man who brought her paced outside, giving instructions on the phone. I overheard him say, “Yes, yes, everything under control. Don’t worry.” I watched him for a few seconds too long. Sometimes you could feel the lie before you heard it. I walked back inside. Anju flinched every time someone touched her, even gently. Her pulse raced at the sight of a male attendant. I made a note for psych evaluation, though I knew no psychiatrist would come today. Not here. Not for her. Outside, the man had disappeared.
By noon, we were six cases deep and spiraling. A boy from Hooghly came in unconscious—suspected pesticide ingestion. A college student collapsed with a ruptured appendix. An old man with dementia wandered into the triage area asking for his wife—dead five years now. And through it all, the rhythm of protocol kept us moving: insert line, order tests, scribble notes, call next of kin, fight for blood, explain, argue, repeat. But beneath that rhythm was something more frantic—something no protocol addressed. I could see it in the way the new intern’s hands shook while suturing a forehead, in the way Nurse Pushpa snapped at a relative asking too many questions, and in the way I paused just one second longer before signing a discharge. The body obeys protocol. The mind does not. Around 2 p.m., Dr. Priya Mukherjee walked in mid-shift, her face pale, her hair tied back in an almost angry knot. She had just come from the women’s ward where a postpartum hemorrhage case had died waiting for a surgeon. “She kept bleeding and bleeding,” Priya whispered as she changed her gloves beside me. “They were arguing over who would take responsibility while her blood soaked through two mattresses.” She didn’t look at me when she said it. Just pulled the mask over her face and went to check vitals. There were no words for this kind of fury.
At 5:40 p.m., I found myself beside an old man in Bed 4—retired tram conductor, 72, brought in with bradycardia and dizziness. I held his wrist and counted the pulse manually. Weak, irregular, barely there. He looked up at me with watery eyes and said, “Beta, will I die tonight?” I paused, unsure how to answer. Then I said, “Not on my shift.” He laughed—a dry, crackling sound. “Good. Because I still haven’t told my daughter where I kept the old letters.” We hooked him to a temporary pacemaker while arranging a referral to cardiology. He kept murmuring the names of tram stops in his sleep. I stayed a few minutes longer than needed by his bed, listening to the soft beeps of the monitor. When he stabilized, I stepped out and leaned against the wall outside the ward, trying to catch my breath. Priya joined me moments later, holding two cups of tea. “We’re not machines, Indranil,” she said quietly, her voice low enough that only I could hear. “We treat people like numbers because it’s the only way to survive here. But some days… the numbers cry back.” I nodded. We drank in silence, surrounded by the noise of stretcher wheels, screams, announcements, and the never-ending clatter of life on the edge. I looked at the crumpled notepad in my coat pocket and wrote just one line: “Pulse: 36. Pressure: Low. Humanity: Still present.”
It began in the summer of 2015, on a day so hot that the walls of Calcutta Medical College sweated like bodies. I was a second-year student then, still awkward in my scrubs, still unsure whether I belonged among these future gods in white coats. It was the first time I had real hospital duty—an assistant observer on the casualty floor, just a nameless boy in the corner holding clipboards and pretending to understand things I didn’t. The emergency room back then was smaller, more chaotic, filled with patients who had waited too long and staff who had given up trying to wait at all. That day, I remember, they brought in a girl about my age—seizures, foaming, eyes wide open in sheer terror. Her mother screamed her name again and again—“Riya! Riya!”—as though that could bring her back. The senior resident barked orders. Diazepam, IV access, vitals, CT pending. I just stood there, useless, frozen in the corner, notebook in hand. The nurse couldn’t find a vein. Her hand trembled. The patient convulsed again. And I remember the way the resident didn’t wait—he just grabbed a syringe and injected directly into the thigh. Later, he would say, “Sometimes you don’t wait for perfect. You go with what you’ve got.” That sentence would stay with me forever.
Riya died twenty minutes later. Aspirated. The CT never came. The trolley got stuck in the lift and the oxygen tank valve was faulty. The death certificate said “Status epilepticus – uncontrolled.” But I knew it was something else. It was a system that ate time and gave nothing back. I walked out of the ER that day into the hospital courtyard, found a bench behind the canteen, and cried. Not for Riya, whom I didn’t know. But for the helplessness I had just witnessed. For the sheer machinery of inaction. That night, back in the hostel, while everyone else talked about orthopedics or neurosurgery or exams, I opened my dusty first-year anatomy book and wrote on the flyleaf: “I want to be there when it’s hardest. I want to be the one who doesn’t freeze.” That decision stuck. Even when I hated the long hours. Even when my classmates picked more glamorous specialties. Even when my own father said, “Why waste your life in ER? No one gets famous treating poison cases and stab wounds.” But I didn’t want fame. I wanted to be present when others ran. I wanted to make sense out of the chaos, even if it meant losing sleep, losing comfort, losing innocence.
Years later, now standing with blood on my cuffs and a stethoscope that had seen too many deaths, I still thought of that day often. I never told anyone—not even Priya—that Riya was the reason I chose this. She became a ghost in my memory, a silent teacher. Every time I saw a patient gasping alone, or a mother screaming a name that wouldn’t come back, I heard Riya’s mother echoing through the ER walls. And I remembered what it meant to freeze—and how I promised myself I never would again. There’s a strange strength that comes from breaking once, early on. It cracks you open and then seals you with something sharper. It makes you reach for the mask, the gloves, the file, even when your hands are trembling. That strength is not courage. It’s compulsion. It’s memory. And sometimes, in the moments between triage and trauma, I still feel that helpless med student inside me, still scribbling in margins, still watching, still learning how to fight against a system that never quite lets you win. But I’m here. Still here. Not frozen. Still choosing this.
***
It was 7:40 a.m. when the stretcher came in—two constables, one patient. Male, mid-thirties, handcuffed, bruised, bleeding from the forehead. “Encounter injury,” the constable muttered, eyes half-lidded from sleep. “He tried to run, fell into a ditch.” I didn’t respond. The man on the stretcher was groaning softly. His shirt was torn, and there were what looked suspiciously like belt marks on his back. I asked his name. He didn’t answer. I asked again. He looked at me, through me, then away. His left arm was fractured. We began cleaning the wounds, noting the injuries. The constable hovered nearby. “Just fix him up enough for court,” he said. I turned to him slowly. “He’s not an exhibit. He’s a patient.” The constable grunted. “You people always forget what these men have done.” I didn’t argue. I’d stopped arguing about right and wrong in this place. All I saw was the body—broken, bleeding, human. We stabilized his arm, stitched his head, and gave fluids. I asked for an X-ray. The constable said, “Don’t need it. We’ll take him in two hours.” I overruled him. A wrist fracture left untreated could cost someone their hand. Whether or not they were innocent.
Outside, the ER was overflowing. Two patients on one bed. A woman vomiting blood in Bay 2. A child with dengue in the corridor. A man wailing on the floor outside the toilet, no one noticing. I checked vitals, signed requisitions, reviewed ECGs. Priya was managing a woman in post-eclampsia, soaked in sweat and fear. The air smelled of heat and chlorine and hopelessness. Midway through, I realized I hadn’t peed in nine hours. I hadn’t drunk water since sunrise. I kept moving. Every time I slowed, a voice cried out—a patient, a nurse, a call for oxygen, suction, pressure, help. A pregnant woman was brought in semi-conscious. No prenatal care. “She just collapsed,” said her sister. We found the heartbeat. Weak. I called gynecology. No beds. Called again. No response. I looked at the nurse. “We deliver here if we have to.” She nodded grimly. We prepared a temporary delivery bay using curtains and gauze. I’d never led a delivery in emergency before. But I had no choice. We worked in a swirl of shouting, sweat, and improvised instructions. Forty minutes later, a baby was born. Not crying. Purple. I suctioned. Stimulated. Then—finally—a cry. Weak, but there. We wrapped the baby in surgical drapes and laid him in the mother’s arms. She smiled, faint but real. I stood there, chest tight, unsure whether I felt triumphant or just completely drained.
By 10 p.m., I had lost all concept of time. My shift was supposed to end hours ago, but I was still there—charting a death, explaining a prognosis, calming a man screaming about an injection bill. I looked around at the stretchers. So many of them carried bodies. Living ones, barely. A boy from Howrah with gangrene in his foot. A girl with failed kidneys and no money for dialysis. A vegetable seller who collapsed on the tram with a silent heart attack. So many stories collapsing under the weight of a system stretched too thin. Priya passed by and handed me a biscuit. “Eat. Please. You haven’t stopped in fifteen hours.” I took it without a word. The taste of glucose and guilt melted on my tongue. I glanced down at my notepad and wrote: “There is no such thing as the end of a shift here. There is only the moment you surrender and someone else takes over.” But tonight, no one was coming to take over. We were it. The front line. The back end. The break. The breakdown. And as the monitors beeped and the doors kept opening, I realized—I was still choosing this. Even when it consumed everything.
***
They handed me the baby like I knew what to do. As if this was normal. As if bringing a life into the world in the middle of chaos, with torn curtains for privacy and blood on the floor, was something I’d trained for. I wasn’t even supposed to be there. It was Indranil’s shift. I’d only stopped by to sign off on a file. But then the pregnant woman came in, semi-conscious, pressure dropping, no obstetrician available, no one picking up. I saw the panic in her sister’s eyes and something in my gut kicked in. We moved fast—pushed fluids, set up a drip, arranged gloves, masks, tried to make space in the corridor where the only light came from a flickering tube. Indranil said, “If we have to do this here, we do it.” His voice didn’t shake. Mine did. I’ve done internships in OBGYN wards. I’ve seen births. But this felt different. This felt like we were stealing a birth out of the jaws of the system that had already failed the mother a thousand times. When the baby came out—limp, purple, quiet—I felt my stomach twist. I held my breath the way mothers do when their child is coughing in the next room. And then… the cry. A small, broken, defiant cry. That was all we needed.
Afterwards, we cleaned the mother, taped her IV line, and wrapped the child in surgical green. The woman whispered “thank you” without moving her lips. Indranil stepped back and stared at the floor. We didn’t say anything to each other for a full five minutes. What was there to say? We had just played gods with empty hands. I walked away eventually, past the line of families sleeping in the hallway, past the intern who was crying quietly in the bathroom. I found a corner near the canteen, sat on the floor, and started breathing again. I thought about my own mother, who still believes I work in a “clean office building,” who doesn’t know that last week I delivered CPR to a man whose intestines were in his lap. I thought about all the babies who never made it to that first cry. And then I thought about the women—women like this new mother, whose name I don’t even know—who survive childbirth by accident in this city. Not because we are brilliant. But because we are desperate. And desperation is its own kind of midwife.
I’m writing this now in the duty room. It smells like Dettol and cold rice. I can hear the ambulance backing up outside and someone coughing down the hall. I haven’t changed my clothes. There’s blood on the cuff of my kurta. I want to shower but I’m too tired to move. I looked at Indranil when I passed by his desk earlier—he was asleep, head on the table, pen still in hand. He doesn’t know this, but sometimes I think he’s the only reason I haven’t broken. He shows up every day like the system hasn’t beaten him yet. And when I feel like leaving medicine altogether, I remember his face the first time we lost a child together—how he stood still afterward, notebook open, as if writing something down could undo the dying. Maybe that’s what we both do. We try to document the collapse so it doesn’t disappear. I don’t know if that’s brave or foolish. But tonight, a baby was born who wasn’t supposed to be. And I was there. And that will have to be enough.
***
It was 3:17 p.m. when the baby in Bay 2 died. Not suddenly, not dramatically—just slowly, like a candle drowning in its own wax. Eight months old. Severe dehydration. Admitted two nights ago with viral gastroenteritis. We had given fluids, oxygen, everything we could. But sometimes the body slips through despite your best attempts to hold it in. When I walked over after hearing the alarms, the monitor already showed a flatline. The mother was screaming—no words, just that primal, rising cry I’d heard before. I checked the vitals, nodded to the nurse, and then gently pulled the sheet over the child’s face. I stood there for a moment. Motionless. And in that moment, I didn’t think about textbooks or case reports or what to do next. I thought only about the silence. The stillness. How quickly life leaves when it decides it’s done. It doesn’t argue or wait. It just slips away while you’re still reaching for the syringe. I turned to the intern beside me and said softly, “Make a note of time of death.” Then I walked out, hands shaking just slightly, toward the wash basin.
Outside, the day was thick with noise again. Ambulance sirens, relatives shouting, vendors selling fruit on the street, auto-rickshaws revving like impatient lungs. I didn’t want to go back in. But I did. Because someone else was gasping now in Bay 4. And another man in triage had collapsed on arrival. A woman was sobbing in the corridor—her son’s surgery postponed again. A diabetic was arguing with the pharmacy. A ward boy was being scolded for missing an entry in the oxygen logbook. Around me, small tragedies bloomed like weeds. And somehow, none of them were enough to stop the day. I saw Priya across the hall, handing a prescription to an old lady who kept calling her “beti”. We exchanged a look—tired, wordless, familiar. The kind of glance you give someone who’s also quietly holding back the ocean. We hadn’t spoken since the delivery. But I think both of us knew we didn’t need to. There are conversations in the ER that happen without sound. Just the passing of gloves. The tightening of a tourniquet. The scribble of a case file. The weight of being still, when everything is bleeding.
By 9:15 p.m., I had written two discharge summaries, one postmortem referral, and signed three forms I didn’t even remember reading. I was numb. Not from lack of sleep—but from too much seeing. A hundred small deaths had passed through me that day: dignity lost, trust eroded, promises broken. Some patients leave the ER with prescriptions. Others with bandages. But many leave with less than they came in with—less breath, less faith, less time. I sat in the staff room finally, sipping tea that had gone cold an hour ago, and opened my notebook. “Today: Baby girl. 8 months. Flatline. Mother’s scream lingers. We go on.” I stopped. Couldn’t write more. There are days when even words refuse to form. I looked up. Priya had come in. She didn’t say anything. Just sat beside me. Two cups. No conversation. Just shared tea and silence. And in that moment, that felt like medicine too.
***
It was a Sunday evening—the kind that wrapped the hospital in a quiet only slightly less cruel than weekdays. No sirens screamed for a few minutes. No stretchers rushed down the hallway. The emergency ward was caught in a brief lull. I looked at the clock: 7:45 p.m. My stomach growled before my brain reminded me I hadn’t eaten anything since a dry Marie biscuit at 10 a.m. I slipped out toward the ground floor canteen. The place smelled of overused oil and reheated dal, but I loved it like one loves a childhood bruise—it hurt but felt familiar. I stood in line behind the glass counter, watching an attendant slap thick slices of bread on a hot tawa. “Two egg toast, extra onions,” I said without thinking. And then—“One more, same.” I knew she’d come. She always did when things got too quiet in the ER. Sure enough, a few minutes later, Priya walked in, hair tied loose this time, face scrubbed clean but eyes still clouded with the day. She didn’t say anything. Just nodded. We took the corner table near the shuttered window where the bulb always flickered. It was our table. Unofficial. Undeclared. Ours.
We ate in silence for a few minutes, chewing through hunger and exhaustion. Then she looked up and said, “You know what’s strange? That even the worst days still end. They shouldn’t, but they do. The patients die, and still the city keeps going. Metro trains run. People laugh in cafes. Instagram scrolls forward. It feels… obscene, sometimes.” I nodded slowly. “Maybe that’s how life protects itself—from the weight of empathy.” She sipped her chai, staring out toward the parked ambulances. “That girl—the one who gave birth—I saw her today. She remembered me. Smiled. Called me ‘doctor-didi’. Made me want to cry.” She wasn’t smiling. Neither was I. These were not stories you told with laughter. These were stories you carried like sharp stones in your chest. I looked at her and asked, “Why do you still come back?” She shrugged. “Because I’m afraid if I don’t, no one else will.” Her voice didn’t shake. But her fingers trembled around the cup. I reached across, touched her hand briefly. Not as a gesture of comfort, but acknowledgment. She didn’t pull away.
The canteen clock ticked to 8:15. The rice boy behind the counter yawned. A stray cat wandered in and curled under a bench. The city outside roared on, uncaring. I leaned back and said, “Sometimes I think we’re like that ECG line. We keep jumping just to prove we’re still alive.” Priya smiled faintly. “And what happens when the line goes flat?” I thought for a moment. “Then someone else takes over. Someone younger. Someone still stupid enough to believe they can fix everything.” We both chuckled, quietly. It was the first laugh we’d shared in weeks. Maybe months. Before we left, she said, “I hope if I ever collapse in that ER, it’s you on duty. Not because you’ll save me. But because I know you’ll try.” I looked at her, surprised, then said, “Same.” No other word could hold what we meant. We stood up, cleared the table, and walked back toward the emergency block. The brief quiet had ended. A red van was pulling in, and the stretchers were rolling again. As we stepped into the fluorescent light of the ER, I thought: Sometimes, healing doesn’t come in syringes or saline. Sometimes, it sits quietly across a metal table, holding chai and listening.
***
The last day began like any other—unremarkable, overstretched, thick with humidity and the sour smell of iodine—but something in the air felt final. Maybe it was the early morning silence, or the way Priya handed me my tea without a word, both of us knowing this would be the last full shift before my transfer letter took effect. “Ward 3A, General Medicine,” the posting read. A slower corner of the hospital, less noise, fewer emergencies, more paperwork. I hadn’t asked for it. I wasn’t even sure I wanted it. But after three years in the Emergency Room, the system had decided I had “served enough”. I looked around the ER—the peeling posters on the wall, the crooked chart above Bed 6, the familiar squeak of the stretcher wheels—and wondered if I’d really grown into this place, or if it had grown into me. The day unfolded with its usual rhythm of chaos. A diabetic coma. A motorbike accident. A six-year-old with a high-grade fever who wouldn’t stop crying. I moved through them like muscle memory, efficient but detached. Still writing vitals. Still checking pupils. Still lying gently to grieving relatives—“We tried our best.” Only this time, I was counting my steps, memorizing the floor tiles, committing everything to the private museum of my memory.
Around noon, a patient I had treated two months ago returned—not on a stretcher, but walking. Rinku, the ten-year-old boy from Howrah whose leg we saved after a train platform fall. He came with his father and a steel tiffin box. “Baba said to say thank you,” Rinku said shyly. I smiled, stunned. I couldn’t remember the last time someone had returned just to say that. I took the tiffin out of politeness, but when I opened it later in the staff room, I sat down and cried. Inside was luchi, alur dom, and a folded note that said, “You didn’t just fix his leg. You made him believe people still care.” I stared at the words for a long time, unable to explain even to myself why they undid me more than any death I’d witnessed. Because that’s the thing about the Emergency Room: it rarely gives you closure. You save, you fail, and the story vanishes the moment the stretcher is pushed out. But today, for once, something came back. Something whole. It reminded me why I had stayed. Why, despite the blood and bureaucracy, I had kept showing up. Because here, in this chaos, sometimes kindness came back full circle. Quiet. Unannounced. But powerful enough to pull breath into a tired chest.
By 8:45 p.m., I was finishing my notes when Priya came and sat beside me. She didn’t ask if I’d packed, or how I felt about leaving. She just handed me her pen—the one she always used to sign off case sheets. “Take this. You’ll need it to scribble in new margins,” she said softly. I smiled, tucked it into my coat. “You’ll be fine without me?” I asked. “Of course not,” she said, eyes warm. “But we keep going. That’s what we do.” I stepped out into the hallway one last time. The lights buzzed overhead. A nurse walked briskly with an oxygen cylinder. A man wept quietly into his phone. The ER was still alive, still breathing, still demanding. I felt its pulse in my feet, its weight in my shoulders, its history in my blood. As I left, I placed my old notepad on the shelf near the nursing station—a small, frayed book full of incomplete stories, names half-remembered, lines that ended in ellipses. Someone would find it. Or not. It didn’t matter. What mattered was that I had been here. That I had held the line while I could. Outside, the sirens still howled. But for the first time in years, they faded behind me. And I kept walking.
___
