The Long Drive When Eyes Opened, Even Briefly Contd....

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Gasping for breath, the technician sprinted back with the blood bag and thrust it into the nurse’s hands. She rushed it through the line with urgency. Sharanya scrubbed up in seconds, assisting the ER physician in placing a subclavian line — their movements sharp, synchronised, precise.

I stood at feet away from the foot end of the trolley, watching the scene like a conductor who suddenly must trust the orchestra to play without him.

Dr.Prem, my neurocritical care colleague, arrived and immediately joined the resuscitation. Everyone’s pulse was racing faster than the monitor, but every second had meaning.

Cherrisma coordinated with silent intelligence — suctioning the airway, handing over equipment, anticipating needs before they were spoken. The ER technician tightened the ventilator connections. Two nurses adjusted infusions, trembling but determined.

Everything ran in parallel, a controlled storm, all fighting for one purpose:raise the blood pressure, restore oxygen, protect the brain.

A severely injured brain cannot afford hypotension, one crash in perfusion could push it beyond salvage. I wasn’t yet operating with a scalpel, but my battle had already begun  through them.

Their skill. Their hands. Their will.

Once the blood was rushed in, noradrenaline began flowing through the new central line. Numbers on the monitor slowly crept upward. A fragile victory.

I stepped away not out of avoidance, but because my presence had already set things in motion. Now they needed space to execute.

The counselling room was eerily quiet,  a stark contrast to the chaos behind me. Yet the weight here was heavier. Lives break not only in the body, but in the hearts that wait outside.

I knew I had to speak to her family.

Their eyes had already told me a story of fear and guilt.

I asked security to bring the son-in-law.He arrived almost running, chest heaving, sweat clinging to his skin. His T-shirt was stained with blood. Scratches and bruises lined his arms and neck. He too had been thrown by the accident, though his pain was far deeper than the visible wounds.

He looked at me!Curiosity mixed with terror, and a blank helplessness that only guilt can carve.

I placed a hand on his shoulder.“Please sit,” I said gently.

I took a moment not to find words, but to gather courage. How do you tell someone that death is already in the room?

She was deteriorating.Everything was crashing.We were fighting for her life with our bare hands.

I was also acutely aware of something else.

They had come here because it was the closest hospital. They could afford corporate care. They could have driven her to a bigger centre. And now, their trust in this building, in these strangers, in me had to hold.

Credibility in crisis is not granted, it must be earned in seconds.

I switched on the fan, the humming sound filled the silence between us.

I met his eyes and asked softly,

“Don’t worry, sir. Do you want anybody else from your family to join us for this conversation?”

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He was trembling. Breathing shallow.

Palpitations visible even through his blood-stained T-shirt. His eyes searched mine not for reassurance, but for verification. He didn’t want to trust me blindly. He wanted proof. A second voice. A second doctor. A second chance.

For a split second, my mind drifted back to my days as a Chief Resident in CMC Vellore — where relatives begged for ICU beds we didn’t have, and we stood holding the power to admit or refuse. I remembered being the one who decides, not persuades.

But tonight, I was in a 3-year-old private medical college hospital.

A place still growing its bones.

A place I had chosen to build advanced neurosciences from scratch.

18 exclusive people in our neuro team..Nurses, technicians, juniors… all looking up to me… waiting to prove we were capable of saving lives.

Even here!

But for this man, this son-in-law….this place was deserted, quiet, unfamiliar.

His mother-in-law was the only critically injured patient in the ER.Silence created paranoia.

Tonight, the challenge was not just clinical.It was credibility.

He swallowed hard.“Sir… I will call my brother also.”

A few minutes later, a stout, fair, bearded man walked in shoulders firm, eyes steady. There is always one relative who becomes the decision-maker.

Tonight, he was that man. At least, he can influence the decision strongly.

I offered him a chair. He sat.The fan hummed overhead, filling the silence.

I looked the son-in-law in the eyes, they held mine like a magnet. Then I shifted to the brother’s gaze.

They braced themselves.

“I understand you are panicking,” I began.

“But I want you to listen to me.I am Dr. Muralidharan Vetrivel, the Neurosurgeon taking care of her.”

I continued, slowly:

“She was brought in extremely sick. Unconscious. Unable to breathe on her own. The ER doctors intubated her. Her heart rate, oxygen, and blood pressure were initially stable…”

I saw the relief, a tiny sigh of hope passing between the brothers.

I noticed something else:They had left his wife, the patient’s daughter outside.

Shielding her from the emotional collapse.

I wasn’t done.

“But…” I said.

Both men instinctively leaned forward…chairs scraping, knuckles tightening against the table.

“Just when we thought she was stable enough for a CT scan, her blood pressure crashed. Heart rate shot up. We rushed emergency lines — directly into major veins of the chest. We are transfusing blood. We have started strong medicines to prevent further collapse. Our Neurointensivist is also here. Her condition is extremely fragile.”

I used we deliberately.Trust is not built on individuals — but on teams.

Their hope shattered like glass under pressure.

I kept going….because truth in medicine is often a knife, not a cushion.

“Right now, we don’t even know the full extent of injuries. We must regain blood pressure control before shifting her for CT scan to see how badly the brain is damaged… and if any other internal injuries are present.”

Their eyes hollowed!

Trust flickered!!

The son-in-law whispered:“Sir… you are giving too much information. I can’t process. Please… wait. I want to talk to other relatives.”

“Of course,” I said quietly.“I understand.”

Then he delivered the blow:“We came here only because it was nearby.”

His meaning stung, They didn’t believe we were enough.

A karma reversal! In CMC, they would beg us for admission.Here, I was begging for trust.

But I couldn’t blame him.The healthcare market  in India especially metro cities has conditioned people to believe that only large corporates can save lives.

Yet I needed him to trust us!Not for ego.Not to prove a point.

But because she was too unstable to move.

He nodded and stepped out with his brother.

 Both their phones already on dialling, praying someone would answer at this hour.

No call at midnight is casual.

Except those sugar CBG  calls from nurses - the curse of neurosurgery  first year residents!

But this wasn’t about insulin tonight.This was life. 

I returned to ER.

Sharanya’s face was flushed.

Cherrisma was restless.

The ER consultant anxious.

But the monitor finally showed stability

HR: 92SpO₂: 97%BP via arterial line: 110/60.

A long plastic tubing running from the left wrist of hers to a small board fixed on the metal stand which was in turn connected to the monitor.

A thin thread of hope reappeared.

Sharanya shouted orders:“Call the CT room! Arrange attender! She’s holding on.”

“We need imaging NOW. Inform blood bank for another unit. Start tranexamic acid!”

The relatives paced outside the ER like cats protecting newborn kittens.

Phones glued to ears, desperation rising.

I walked ahead to CT….to make sure the technician is primed.

Mere presence of me at times get the things done because no other superspecialist consultant will be there except me. I had that aura and addiction.  

Because…if she had a large EDH or SDH, we needed to rush directly to OT.

The corridor was long, dark, almost spooky.

Only one or two flickering lights guided my path towards the Radiology.Then….. a sudden bright glow.

A green board reading…..

CT SCAN WITH BLOCK WHITE ARROWS.Department of Radiodiagnosis.