Why I Operate?

It was a Saturday evening. I stepped out of the hospital lobby just to take in the beautiful sunset. The sky was neither gloomy nor bright a quiet orange glow draped over it and a flock of white birds cut across the horizon like a moving brushstroke.

Behind me, there was a burst of laughter.

Naveen and Cherrisma were cracking jokes, juggling words and teasing each other.

Nufi walked beside me, asking what our plan was for the night.

“Are we going to Madipakkam?” she nudged.“Aman has already gone down to plan,” she added with a playful grin.

The four of us strolled over the gravel in the parking lot, unhurried, hoping for a quiet night. We kept repeating to ourselves no cases tonight, ICU would surely be calm.

It was a dangerous wish to even think about.

We boarded the car casually, the kind of casual that comes only when you believe you’ve earned a break. I drove us back to the quarters. Once inside, we all collapsed into the familiar comfort of the sofa.

As usual, Cherrisma stretched out on the long divan, scrolling through Instagram with an absent smile. Aman was darting around the hall like a wind-up toy, while Naveen murmured sweet nothings to his girlfriend over the phone.

For a moment, with the ICU closed and no emergencies expected, a glass of wine felt like a reward I could afford. But exhaustion got to me first, and I drifted into sleep.

Time passed. Naveen slipped away to his home after tea and biscuits.

Cherrisma left for her hostel around 19:00 hours but not before, we set a dinner plan.

“What do we order?”“Dhaba?”And so it was decided: 10 rotis, two portions of Andhra chicken, tandoori, and dal tadka — enough to treat our sense of security.

A little later ‘ting-ting’ Nufi’s phone buzzed with the delivery alert- THE ZOMATO GUY. The quarters were set back from the gate, and the walk through the dark with the local dogs barking was never pleasant.

Sharanya was in the ER that night. She said she’d take a short break and collect the order on her way.

She came dropped the parcel and left back to ER instantly…

Aman’s excitement was unmatched seeing the food parcel. He rushed to spread newspapers across the floor like a ceremonial feast. Containers opened, stickers peeled, spoons arranged,  the aroma of dal tadka filled the air.

I took a bite of tandoori chicken, the spice and char worked their magic instantly and my mouth was just beginning to celebrate when my phone screamed to life.

I answered.“Sir, I am the consultant ER physician. We have a head injury patient. We’ve intubated her. Looks like they are well-to-do… Pupils still reacting, but her arrival GCS was 3/15. Can you come?”

WELL TO DO is a surrogate signal that they will not get admitted… will go away from the teaching hospital to a corporate hospital.

My stomach dropped and twisted, the tandoori turning heavy.

I was still in casual trousers and sleeveless hoodie.

I shoved one last piece of chicken into my mouth a desperate attempt to finish the moment and rushed to wash up.

“Check her vitals. Full trauma examination,” I instructed sharply.

“Don’t assume head injury alone. Strip and examine head to toe.”

Cherrisma dashed out the door ahead of me, calling out,“Bye Aman! Bye ma’am!”

The night had begun.

If someone you loved suddenly needed emergency brain surgery, what would matter most to you?

• The surgeon's experience
• The hospital's technology
• Honest communication
• Cost of treatment

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The Long Drive

When Eyes Opened, Even Briefly

I drove through the dark, the gravel crunching beneath the tires as I pulled into the nearly empty parking lot. Three… maybe five cars. Quiet.

Too quiet for the tension I felt rising inside.

Near the parking entrance, a small cluster of people sat huddled together. My headlights caught a young man tall, dark, bearded, a gold chain catching the faint light pacing anxiously. Beside him stood a fair young woman with wet eyes, clutching his arm like she might collapse if she let go. The silent panic in their faces told me everything before a single word was spoken.

The ambulance was still at the ER triage entrance, rear doors open like a mouth that had just spit out a tragedy.

I stepped out. The air felt thicker now.

As I walked up the steps into the ramp of the ER, the security guard stiffened into attention.

“Good evening, sir!” he barked with a salute ….more fear than formality.

The chief security officer rushed ahead and tapped his card against the sensor.

The chief security officer is a guy in stiff safari coat and a walkie talkie… a bossy guy who has a feel who controls the territory of the hospital campus. They hardly smile… I guess their motor cortex lost its connections with the emotion centres in their brain.

Beep! The door unlocked, and I entered the main corridor.

Hospital staff always grew tense when I walked in,  I was the surgeon who pointed out mistakes, who demanded precision. Some called me a Hitler behind my back. Maybe they weren’t wrong — I believed fear sometimes kept patients alive.

Inside, I spotted Sharanya leaning on the nurses’ station, writing her case sheet. A mobile screen stood around the patient’s trolley, shielding the scene.

Beneath it… two pale feet.

Fair, swollen, callosities on the lateral malleolus, and streaks of dried blood staining the toes.

The ER consultant greeted me with a proud smile.

“Good evening, sir.”His eyes beamed with the sense of victory — he had intubated her.

A job well done in his world.

“She’s okay, sir. Do you want to speak to relatives?” he asked ceremoniously.

“Let me look at her first,” I replied, already scanning the details he might have missed.

Cherrisma noticed my presence — she quickly slid away from the computer screen where she was reviewing scans. She and Sharanya joined me as I approached the trolley.

Two nurses hovered there, visibly trembling as I neared — the kind of nervousness that comes when your actions are about to be judged.

Behind us, chaos continued unabated:A man screamed in agony — “My stomach… do something!”A nurse tried to soothe him — “Sir, please lie down, injection is already going in.”

A cleaning helper passed by carrying a jar of urine toward the sluice room.

Emergency medicine is never quiet… just uneven.

I moved the screen aside.

There she was.

A woman in her late fifties, draped in a blood-soaked saree. Vermilion still bright on her forehead despite the blood.

Obese — her body spilling over the narrow trolley edges. Hands dangling helplessly. An endotracheal tube protruding from her mouth. Oxygen probe blinking on her right thumb. Two IV lines dripping, a urinary catheter hanging awkwardly over her thigh.

The monitor told a deceptively reassuring lie:HR: 89/minBP: 140/70 mmHgSpO₂: 98%

Everything looked stable.

Cherrisma began briefing:“Sir, 56-year-old female, known diabetic and hypertensive. Alleged history of RTA, brought in gasping 2 hours post trauma. They were returning from a temple — birthday celebration of her in-law, who is on the next trolley… fully conscious, asking about the patient’s condition from everyone crossing her…”

She continued, “Hemodynamically stable and intubated here to protect the airway…”

Before she could finish—

Beep… Beep… Beeeeeeeeeep.

The monitor alarms shrieked. On the screen, her saturation plummeted. Blood pressure dropped to barely 100 systolic.

Sharanya, always calm in crisis, rushed to the fluids, squeezing the bag aggressively.

“O negative! Call for O negative blood!” she shouted.

The nurse sprinted to the phone, dialling the blood bank in panic.

The ER technician shoved the crash cart closer.

Tension flooded the room like a silent explosion.

The night had just taken a sharp turn.

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