The Silent Screams

It was one of those nights in the emergency Room, when one just could not escape the constant flow of incoming patients. Everyone had their hands full, from the doctors and the nursing staff, to the sanitary staff cleaning up gunk and vomitus from the hospital floor. While the groggy eyed pharmacist blinked multiple times to make sure that he dispensed the right dosage, the lab technician was trying to answer the phone which was ringing off the hook, with doctors and nurses trying to track the lab tests they sent a few minutes back.

The area around the hospital was quite, as if a dark cloak had enveloped the entire town. The flickering street lamps were the only source of light in an otherwise cold and dark night. Moti, the friendly street dog was trying to nestle against a heap of sand dumped beside an abandoned pole. His occasional whines as he tried to get into a comfortable position was the only sound cutting through darkness.

Back in the ER, the scenario resembled that of a battlefield. Every time a new patient was brought on a stretcher, the first line of defense rushed forwards with their respective weapons. Some grabbed on to the BP apparatus while others held on to their stethoscopes as they jogged towards the patient.

As I walked in, I was completely taken aback. It was utter chaos. I could hear an intern on the far end of the room screaming at the top of his voice as he confirmed something with the senior doctor who had his hands full trying to stop a kid from seizing. Someone on bed 7 was constantly retching and throwing up whatever they ate for dinner, and the man next to him was groaning in agony as the orthopedic surgeon tried reducing his dislocated patella back to its place.

Despite everything going on, I had no time to stop and stare. As soon as I entered, I was asked to assist another duty doctor who was assessing the situation in Bed no. 1. As I pulled back the curtains a little bit and stepped inside, I heaved a sigh. It was a young boy, probably only 11 years old. His entire face was covered in blood and it looked like his nose and jaw had been broken.

“Good, you’re here”, the duty doctor said as he removed his gloves and threw them into the bin.

“RTA”, he nodded towards the boy “They brought him a while back. Hit by a guy on a motorbike while he was trying to cross the road. He has fractured his nose and his maxilla from what I can tell. We have called for maxillo-facial surgeon, they’re on the way. He is stable and conscious, just make sure you ask him to constantly spit out the blood that is building in the back of his throat. I don’t want him to aspirate”

I nodded, trying to keep up with everything he was saying. But I’d just then noticed another person along with the patient. Another boy. This one was so small, that I completely missed him earlier.

“Oh, that’s the patient’s younger brother”, the doctor said noticing who I was looking at. “We, tried to get him to leave but he threw a big tantrum, refusing to leave his big brother’s sight. Anyway we need the patient awake, so maybe this little guy can help with that”

I stayed back with them, trying to do my job. The elder brother couldn’t speak. All he could do was scream. Silently. It was heart wrenching to see the smaller brother holding the patients hand, calling him over and over again. “Anna… Anna”, he called his brother, his voice feeble and muffled, with tears and snot running down his face. I could tell that the patient was trying to be brave for his younger sibling and not show his pain. But I could feel his whole body trembling and vibrating from trying to hold in his screams.

Eventually, the maxilla-facial surgeon came and the patient was rushed to the operating room. The ER was also starting to settle in. Most of the patients were either sent back home after the appropriate treatment or transferred to their respective wards.

I was on my way back from the OR, where I’d gone to check on the face trauma patient. I saw his family waiting outside, the little boy waiting with his parents. He was distraught, his lips moving to form the same words over and over again. “Anna… Anna…”

As I trudged back to the ER looking at the white tiles on the hospital floor, reflecting the bulbs on the roof; I couldn’t help but wonder if the human body was even capable of screaming silently. As I dragged my feet on the floor and made by way to the ER, trying to make sense of my wandering thoughts, I suddenly heard someone calling me.

“Madam, Madam… Come here”, I looked up to see our Hospital security guard beckoning me. “Fast, fast”, he urged as I jogged up towards him.

“What happened, Anna”, I asked, confused. He was standing in front of the entrance for the Emergency Room. He pointed at the auto-rickshaw in front of him. “They need a doctor, but they are refusing to come in”

I was even more perplexed. Even though, it has been only a few days since I started my rotations in the ER, I had never seen anyone treating a patient literally on the doorstep.

“Call the mainline in the ER and ask them to send someone else”. I made my way towards the auto-rickshaw, confused more than ever. As I approached the black and yellow vehicle, I could see a few heads popping out of it. I could tell there were four or five people inside the vehicle that at its best was fit for three people. The whispering increased with every step I took towards them.

“What happened?” I asked.

“We need a doctor”, I heard a woman say.

“I am doctor”, I said grabbing on to my stethoscope for more conviction.

“Well, in that case”, said someone else, this time a man. He was sitting in the front seat along with a driver. Half his butt was in the air as he was trying to share one seat with the rickshaw driver. He was craning his neck a weird angle trying to talk to me. “Can you please check my daughter-in-law?”

“Yes, why don’t you get her inside? We will arrange for a stretcher and you can bring her in. What happened, where is-”, before I could finish my sentence, two women stepped out of the rickshaw and it looked like they were trying to get somebody else out. The two women who had already stepped out, were holding the head end of the person, and two more people inside that tiny auto-rickshaw were holding on to the legs of this person.

My jaw dropped open. Before I could even say anything, the man in the front seat, who was still seated said, “We can’t bring her inside. We just want you to tell us if she is alive or dead”

“But, what happened”, I asked aghast.

“We found her like this”, someone from inside the vehicle whispered.

“I can’t check her like this”, I tried explaining. “You have to get her-”

“Please”, one of the women held my hand pleading, “We just want to know if she is alive. We don’t want to get caught in the hospital policies. We know if she is dead, then they won’t return us the body until the cause of the death has been established. We can’t have that. If she is gone, we just want to bury in peace. We don’t want her soul wandering around troubled because of the delay in the burial process.”

The woman’s eyes were bloodshot, her hair falling off her bun. She looked on the edge of a nervous breakdown.

“Just check and see if she has a pulse”, shaking the young girl’s hand in front of me. “Please” she wept, “I just want to know if my daughter is go-gone”

“But I-”, I tried explaining the distraught mother. I looked at the girl’s face, which was still nestled between both women’s hands.

All I could see was her face. Her head and the rest of her body was covered in religious black clothes. She was beautiful, her skin pale and translucent. I could make out the veins under her skin, even under the flickering yellow street lamp. Her eyebrows were the perfect shape and even her winged eyeliner looked undisturbed. A few tendrils of hair had escaped her scarf and were framing her face. She looked like she was in deep sleep, unperturbed by everything around her. As her mother shook the girl’s wrist her head bobbed ever so slightly and a few more tendrils escaped. She looked so serene and peaceful.

I was almost in a trance, staring at her face, when her mother thrust her wrist on to my hand. I wasn’t even thinking when I grabbed her hand…

All of a sudden it was as if a curtain had lifted. The girl’s hands were cold and clammy to touch. Before I could even feel for a pulse, I heard footsteps behind me.

“What’s going on here?” It was the duty doctor from earlier. I got startled by his voice and dropped the girl’s hand and it hung down oscillating like pendulum before stopping. The girl’s mother explained the whole situation to the duty doctor.

“I’m sorry”, he tried explaining to her calmly. “But we can’t declare someone dead, when half their body is hanging out of a rickshaw. Please get her inside, we will need to do a series of tests before arriving at any conclusions. Even though it may look like she is not breathing, she could be in severe shock. If you get her inside, we will do everything we can. But you’re running out of time.”

The mother buried her head in her hands as she heaved. It seemed like she was reciting a prayer, her body trembling with grief.

Before she could say anything, the man sitting in front, stepped outside. He was very tall, and he towered over the doctor as he asked him, “Can you tell us if she is dead or alive?” His voice was cold and emotionless. “If you don’t… we will go to another hospital that will”

“I am sorry”, said the doctor firmly, “we can’t tell anything like this. There are some tests we need to do before declaring someone dead. Please get the patient in-“

“You, and your god damn tests”, the man mumbled angrily.

Chalo, chalo”, he told the other two woman and tried shoving the other two woman back into the auto-rickshaw. This proved to be difficult since half of the girl’s torso was hanging out. Hurriedly they got back in, the girl’s head hitting the sides of the rickshaw as they tried fitting her inside the small vehicle. I didn’t even want to imagine at what angle the poor girl’s body must be bent in, mushed alongside all those woman. The man angrily got back in the auto-rickshaw muttering as to how there are other and better hospitals in the town.

Their auto-rickshaw left trotting on its three wheels and we barely exchanged a sigh of exasperated confusion, when another auto rickshaw rolled in front.

“What now?” the security guard exclaimed. I’d almost forgotten that he was also there, witnessing the crazy that just happened.

This auto was empty, but we were still wary when the guard approached the driver.

“Did some people come with a dead girl?” he asked. “Did they come inside?”

The security guard looked back at us, wondering what to say. We shrugged back, we were as confused as him.

“No, they didn’t come in”, the guard replied. “What happened? Are you with them?” he asked hopeful that we finally might get some answers.

“What? No!!” He was disgusted and angry that the guard would even suggest something like this. “They had gone to another hospital before, demanding a doctor to tell if that girl was alive or dead. When the doctor refused and asked them to get the patient inside, they left. I was dropping another patient when I witnessed the scene. I smelt something fishy, so I followed them.”

The guard informed him that they had already left, and driver left trying to catch them before he loses sight.

There were no words to describe how strange and confused I was feeling. Who was that girl? What happened to her? What did she go through? Was she really dead? I had not gotten a chance to feel her pulse. And why were they being followed?

These questions were still on my mind as I walked back to my hostel after my shift, thinking about that poor girl. I sincerely hoped she was checked in to a hospital. With her body covered head to toe in clothes, it was difficult to infer if she had been hurt. I couldn’t get her face out of my mind. She had looked so peaceful as if she were resting after a long and tiring day and couldn’t be bothered with anything else.

I felt drained, emotionally and physically. I tossed and turned in my sleep that day. I was having vivid dreams.

The girl in the black clothes was in my dreams, but she was lying on the hospital bed, in Bed no. 1 to be exact. Her eyes were still closed and she looked like she was sleeping. The small boy was sitting beside her, tugging at her hands weeping for her to wake up. As I approached her, the small boy wept harder and I could tell that the girl was taking gentle breaths. Her chest moved slightly. I approached her even closer. She still looked so peaceful, it was as if her whole body was glowing. I was still looking at her when everything vanished, the little boy, the hospital bed. Everything.

She was levitating midair. Her clothes flowing in the wind. Her scarf had come undone and her long beautiful hair flowed in the wind. I couldn’t help the temptation. I really wanted to touch her. Was this true? I stepped closer, and I touched her hands lying crossed, resting on her abdomen. This time around, her hands were warm. Too warm, as if she was warming them by the fire. I looked at her face again. Her eyes were open and she was looking at me and smiling. But her eyes… there was something wrong with them. They were clouded.

Before I could tell her anything I heard sound of gravel and shovel. Someone was dumping soil on her. She still kept looking at me, her eyes open a lazy smile on her face; but I saw her body being covered bit by bit. When it covered her face, I could tell she was having trouble breathing and she wanted to scream at them to stop, but she couldn’t.

I woke up, drenched in sweat and out of breath, as if I ran a marathon. I couldn’t remember what I was dreaming about, but for the second time that day I found myself wondering. Are we capable of screaming… Silently.

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