Melancholia

The paramedics rushed patients into the medical ward. There were injured men, women and children.

One of the patients who stood out to me had a rod, resembling a drive shaft, transfixed through his left thigh. The impact had fractured the femur so violently that the limb appeared grotesquely shortened.

The paramedics explained that an accident where a bus and a truck rammed into each other occurred at the T-junction, a stone's throw from the hospital.

After stabilizing some patients, I noticed a small disruption. Some less injured patients gathered in a circle around something. After maneuvering and pushing past the crowd for a while, I was finally able to see the cause of the commotion.

Dr Benjamin, an intern, was resuscitating a woman who seemed in her early forties. He pressed her chest over and over again yet her pulse wasn't coming back. Soon later, he seemed to come to terms with her death. He fought the tears that welled and couldn't pronounce her dead, just as he had been taught—just as every intern was taught…

"...check for responses." He paused and checked if I was listening. When he saw that he still had my attention he went on, "shine your penlight into their eyes to confirm lack of pupillary light reflex." He flew to my side and shone his penlight into my eye. I shut my eyes immediately. I wanted to complain but he beat me to speak.

"Feel the carotid artery for…" my senior and also my friend Doctor Femi, talked on and on.

"I will learn that later. I have to do this report now. After all, that knowledge is not needed at this moment. Plus, I have yet to complete my rounds." I complained.

"You never know when you might need it. You'll thank me for this one day."

"Yes! Yes!! I have heard you. I still need to go to room nineteen before I round off," I walked fast to get away from doctor Femi and his teachings.

I got to room nineteen on the second floor and looked through the glass in the door.

There was a sexagenarian woman whom I liked to visit. She was called Mrs. Williams in the ward. Her report confirmed that she was diagnosed with end-stage heart failure (NYHA Class IV), a consequence of years of poorly controlled hypertension. Her condition was dire but with proper treatment, she could live another year.

I placed my hands on the cold metal door knob and pushed the door. Like I usually do on my routine checks, I greeted the patients with a smile, "Hello everyone."

Mrs Williams sat by the window as she fed a pigeon that had become her friend. It perched the pane everyday to meet her. While feeding the bird, she would occasionally raise her head to stare at the lawn outside.

"Mrs. Williams," I called, taking big strides to where she sat. "How do you feel today?"

"I am happy this morning. I saw my husband in the night." I blinked twice. Her husband had passed away. Which husband was she talking about?

Sensing my confusion, she waved her hands, "In dreamland. I saw him there. He held my hands for the first time since he passed and we walked together."

I felt sad. It seemed to me that she waited for death each day.

She said she wanted to sleep so I helped her rest on her bed. She slept, she did so with her hands crossed on her chest. She claimed, "That way, I would know when death knocks at my door."

Over time, she secluded herself from other patients in the ward. The pigeon that paid her visit everyday, became her sole companion.

Her condition began to deteriorate significantly. Any time I visited her I would encourage her and talk with her for a while.

On the third of June that year, one bright and sunny morning, I was going on my routine check again. When I got to the hallway where room nineteen was, the alarm rang through the hospital saying room nineteen needed a doctor.

I ran into the room and found out that Mrs. Williams was having a cardiac arrest. I rushed to her side, positioned myself, and pressed the heel of my hands on her chest. Compressing it two centimeters deep and releasing it alternately and continuously, according to my training.

I performed CPR for thirty minutes, holding back tears, refusing to let her pass. Yet she wouldn't breathe.

I looked up and saw doctor Femi among the crowd of doctors that had surrounded us. He nodded his head and I remembered what he had taught me.

So I stopped the resuscitation. I verified her name on her waistband, and applied deep nail bed pressure.

I examined her pupils with my penlight, they were fixed and dilated. I checked her carotid artery for five seconds longer than was required.

I placed my stethoscope on her chest; I heard no heartbeat or agonal gasp.

I checked the time. "Time of death, 10.43am," I called out loud.

At that moment I looked at the window where she usually sat beside and saw the pigeon there seemingly confused. It kept turning its head in different directions.

I stood up and left there with my head facing the ground. When I got to the hallway, the tears I had succeeded in holding back fell without bound.

For the rest of the day, each time I saw an empty bed, the image of her cold body formed in my mind. It was the first patient I lost, the first time I had called a time of death myself.

The wail of sirens brought me back to reality.

Doctor Benjamin raised his head and his eyes met mine. I slowly nodded once. He lowered his head back. I saw tears drop from his eyes before he sharply lifted his head and pronounced her dead.

I scurried from the crowd to receive the incoming patients. More ambulances arrived at the hospital bringing new patients.

By the end of my shift, when the situation had quelled, I had pronounced five people dead.

I got a burger for dinner before returning to the call room. I climbed to the top bunk and stared at the ceiling, replaying the day.

Somewhere below, Benjamin was probably doing the same — staring at his own ceiling, waiting for the nod he would remember giving someone else, someday.