The Long DriveWhen Eyes Opened, Even Briefly.... Contd 2

I pulled the rolling chair toward me in the CT console and sat down, leaning forward with my elbows on the desk, eyes fixed on the blank monitor waiting to flicker to life. The technician sensed the gravity and disappeared into the gantry room. Moments later, he opened the patient-entry door wide so the stretcher could glide in without delay.

The corridor was silent — until I heard a faint rolling sound approaching, the Doppler effect of an approaching stretcher.

Then Sharanya’s voice sliced through the stillness:“Brother, watch the cylinder! PLEASE be attentive!”

Her tone was sharp, commanding. Her eyes locked onto the paramedic —“The tube is OUR responsibility.”

Even from the console, I felt the tension tighten like a knot.

Through the glass, I saw them wheel her in:

Sharanya at the head end, guarding the endotracheal tube and bag with her life.

The nurse gripping the ventilator tubing.

The attender in his maroon uniform, pulling the stretcher at the foot end, sweat soaking through his collar.

Outside, the son-in-law sat frozen, drenched in sweat and dried blood streaks on the arms, talking into his phone in half sentences. His fear had its own pulse.

Inside, I heard the familiar call:“One, two, three… shift!”They moved the lady onto the gantry table, limp and heavy.

The paramedic switched the oxygen source from cylinder to wall supply.

Sharanya’s eyes never left her hands — one slip, one disconnection, one kink, and everything could end right there in the CT room.

The technician made precise adjustments, ensuring the head lay perfectly straight. The paramedic stood beside the gantry door with a lead apron, rhythmically squeezing the Ambu bag — facing radiation to give this woman every breath she couldn’t take herself.

It struck me how healthcare workers absorb harm silently so patients can live.

Finally, the table began to slide in.

The slices began to appear — flickering, grey-white, ghostly images of her brain.

My mind had only one question:Is there something I can reverse? Is there something to save her?

The slices completed. Reconstruction began.I leaned closer.

Nothing.No large clot.No mass effect.No midline shift.

For neurosurgeons, midline shift is everything.It tells us whether the brainstem — the core of life — is being strangled.

A shifting brain is urgency.

A shifting brain is actionable.

A shifting brain gives us something to FIGHT.

This… didn’t.

A brain without shift but with widespread injury is like a battlefield with no single enemy to attack.

Cherrishma stood behind me.

She saw it too.“Nothing to operate, sir… diffuse axonal injury. Some small bleeds… let’s check abdomen and thorax.”

Her voice was steady, but the disappointment was unmistakable.

Operating is hope.

No surgery means limited control.

We began the thorax and abdomen scan.

The moment the thorax reconstructed, a large dense white shadow filled half the screen — compressing the right lung.

A massive haemopneumothorax.

Finally — an answer.

The reason her blood pressure wouldn’t hold.

Sharanya immediately grabbed her phone:“ER! Shift her DIRECTLY to Neuro ICU. Prepare for chest tube. Call blood bank.”

She didn’t wait for the call to end before dialling Prem.“Sir, massive hemopneumothorax. Nothing surgical in the brain. We’re shifting her up.”

My hope of saving her through surgery evaporated.Gone.Diffuse axonal injury doesn’t give you a scalpel target.

It gives you time… and time kills.

But I had to face her family — give them hope but not delusion, truth but not cruelty.

A contradictory, impossible balance.

Sharanya’s voice rang again:“Switch back to cylinder — ready to shift! ONE, TWO, THREE… SHIFT!”

I stepped out.

The son-in-law ran to me instantly, desperation in every movement.

I began with the one piece of news that wouldn’t crush him:

“Her CT brain has no major bleed or shift that requires immediate surgery.”

He whispered “Appa…”

A sigh of relief escaped him, the fear of skull opening momentarily lifted.

But the truth was far harsher.

If it had been a big clot, I could have taken her to OT.

Removed it.

Saved her.

Those patients often walk out of the hospital.

Diffuse injury is a slow storm.

Unpredictable, merciless lingering!

I gave him a brief pause….a breath he didn’t know he needed…before I continued.

“But… there are multiple small injuries on both sides of her brain, including the midline structures and brainstem.”I saw his relief die instantly.

“This means the injury is severe. The drop in her blood pressure earlier may have worsened the brain damage. But, we found the reason! Her right lung is torn and filled with blood. We’ll insert a tube to drain it.”

His face crumpled!

The arc from hope to devastation completed in seconds!

The daughter clutched his arm and broke down, leaning onto him.

I could feel their world collapsing.

I continued softly:“Her condition is critical. She may take a very long time to regain consciousness…if she does. Blood pressure drops can cause irreversible brain damage. We will ventilate her, transfuse blood, support her blood pressure, and drain her chest.”

It felt like I had built them a sandcastle of hope only to let the waves wash it away.

He stood paralysed.

His phone slipped from his hand.

The beautiful young woman beside him bent with grief, sobbing into his shoulder.

They trusted me….but the truth was too big to accept.And I knew, in some corner of their mind, they wondered if an older doctor, a larger hospital, a corporate logo, or a shining lobby would have delivered different words.

But I also knew this:

Our conscience was clear.Our effort was absolute.Our unity was uncompromising.

We controlled what we could.We fought everything we could fight.

Now…fate would decide what remained of her.