The Fifth Horseman(Act 2)

monochrome photography of a woman

Don’t let them tell you

It was still dark outside but the alarm kept blaring every five minutes right by her ear. Her phone screeched reminding her it was another day of hell she had to endure.

Sheila eventually got up, her hair in a mess, her lips droopy with crusted saliva trailing down her chin. Her face, fingers and toes were still asleep waking up slowly.

She dragged her feet to the bathroom when she accidentally kicked an empty bottle of wine right next to the door. The pain was slow to creep in but gave her the push she needed. She blinked a few times till her eyesight was finally focused, turned on the shower, took a good look at the mirror and blew a cloud of mist over her reflection.

Syikin was also starting her day. Recently graduated, she was among a fresh line of new interns about to embark on their long arduous journey. They told her it would be hard, gruelling, painful and sometimes even unfair. She had heard nothing good nor uplifting but was excited nonetheless. It was her dream since a child, to clad herself in a white coat and top that off with a stethoscope around her neck. She kept trying to decide if she should button all the way up or expose a little bit of the top to flaunt the lower frills of her headscarf.

‘Down it is,’ she decided and off she sped to Hospital Puchong for ‘Day 1 of Life’; a common lingo that originated to document the age of newborns adopted as a clever analogy signifying how far long a house officer had been in service. ‘Life’ being this was ‘it’ and that there was no turning back.

**

The Emergency Department was as per usual at top occupancy, from ambulance sirens to patients’ screams, stretchers to wheelchairs, there was no day or night, just 24/7 of running and RESUS, iv lines to CPR, like a scene out of a financial district except with a lot less money for a lot more blood.

Syikin stood frozen with chills and tremors, overwhelmed as a cloud of worry blocked out her conscious mind. She suddenly felt a jolt of electricity spread through her scalp raising her hairs inside the Burkah as a finger snapped close to her right ear, bringing her back.

“Hey, you ok?’ The colleague stared at her. She was beautiful, dark, her eyeshadow even darker, her hair black with a subtly dyed silver fringe in the front. She had a tiny nose ring hugging the wings of her nose above her velvety purple covered lips as well as a tiny tattoo of a dragon on the side of her neck. She boasted a bronze top and a mini skirt barely covering her knees just inches shy of the dress code. Her white coat flared above the countertop where she sat with her legs crossed, clicking her black heels together.

‘Huh?’ Syikin gasped. Sheila smiled back.

‘We all had that look once,’ another male houseman replied adjusting his glasses above his nose.

‘Hmph, maybe you did,’ Sheila retorted.

They were all there watching a scene before them, play out like the second act of stage drama. It was Dr Chris from Orthopedics vs Dr Ranjini from Internal Medicine.

“She was coughing for 4 days, it’s definitely the lungs. You heard it, I heard it. Everybody heard it,’ Dr Chris was convinced it was a medical problem, and hence, not his.

‘Well, we all saw the foot too. You can smell it as well. It obviously came from that wound. Infections spread you know,’

‘The foot has been like this for weeks. It’s not that bad. The lungs though…’

‘I don’t understand,’ Syikin was curious, ‘why can’t it be both?’ she exclaimed in the isolated vicinity of herself and her newfound colleagues.

The other two house officers started to chuckle a little, watching little miss doe-eyed and her naivete.

‘This is hospital politics 101 sweetheart,’ Sheila began, ‘The patient has an unreliable history and she came alone. So, there’s no way of objectively knowing what is causing the infection…’

‘So it’s just a matter of who’s more right,’

‘Sweetie, sweetie, sweetie… You have a boyfriend or a husband or something right?’

Syikin responded with a puzzling look, ‘a fiancee, why?’

‘Tell me, when has it ever been about ”who’s more right”?’

‘Then?’

‘It’s about who’s better,’

Syikin smiled a little from the corner of her mouth.

The intern with glasses folded his arms tight, frowning. ’50 bucks say he’s gonna cave,’

‘I take your fifty and raise you five discharge papers that its gonna be her,’ Sheila replied.

‘Forget the fifty and make it ten discharge papers,’

Syikin noticed the cavalier attitude her friends had about the whole scenario. ‘Were they really passing the patient around like tennis ball? Was it weird that she felt all of this as highly inappropriate? Or was she not supposed to? These people knew what they doing. Right?’

‘Fine, but don’t bother when the foot finally kills her,’ Dr Ranjini conceded.

Sheila smiled. ‘She’s ours. You wanna admit her Syikin? Come, I’ll show you how,’

The other guy sneered in condescension despite losing the bet. ‘Begin admission. You have some paperwork to do,’

‘And you have ten. All by today, I hope,’ Sheila replied before putting her hands around the shoulders of her little self-appointed apprentice and pranced away from the scene.

Syikin had basically shadowed Sheila the whole morning. She marvelled at how confident she was around her patients and their visitors, the nurses and medical assistants. She watched and learned how quickly she would set iv lines and draw out blood, how she would take quick histories and perform examinations and how fast her fingers were with a pen on paper.

‘Sheila!’ A voice would call from the North. ‘Sheila!’ Another from the opposite end and she would run to help with whatever she could, Syikin following right behind taking notes and helping out.

‘Sheila!’ A thick folder was slammed in front of her on her desk. ‘Trace these notes. Call all the hospitals required.’

Sheila commanded the hallways in her high heels clomping away as she headed for the records department. Syikin trailed behind her trying to memorize her notes.

A door opened from the side of the hallway and another intern came out in scrubs wheeling a cot with a newborn in it. There was a tube sticking out of its mouth and it seemed to have been connected to an artificial respirator.

‘Hey Dames!’ Shiela and Damia waved at each other. ‘RESUS?’

‘I did it this time,’ Damia replied proudly.

‘We should celebrate,’

‘Yup, not today though. It’s date night,’

‘That’s what you always say,’

Syikin smiled at Damia as she was leaving. ‘You guys seem close,’ she expressed.

‘From the very first day. You don’t have anyone else who came with you?’

‘I did. 7 of us actually. But we didn’t really talk much. Who’s here to make friends anyway right?’

‘You couldn’t be more wrong, sister.’

Sheila approached the front desk of the records department. She rang the bell and a tired old lady approached. ‘How can I help you, Doctor?’

‘Need some help with these files. I think there’s some missing. Mind taking another look?’

The clerk gave a loud sigh and grabbed the file from her. Syikin noticed some animosity in the clerk’s expression. ‘What’s with the attitude? I noticed that with some of the others as well. And it’s only toward you.’

Sheila turned a dismal glance at her new colleague. ‘Soon you will be doing that too, sweetie,’

Syikin found herself offended by that response. ‘What does that suppose to mean?’

‘Ask around. Know the whole story first. Then make up your mind.’

The lady came back with additional files. ‘Sorry doctor, there was more at the back. I hope that’s enough.’

‘See. She was just tired. Everybody is.’

Sheila collected the files and headed out. She then passed them to Syikin after she realised the time was nearing lunch. ‘Well, I go to go, sweetie. Got something to do. I got a line to set in Bed 32. Mind handling that for me? Keep this back in the ward and have yourself a good lunch. I’ll see you later. That OK?’

‘Sure thing boss,’ Syikin replied with a friendly salute.

**

Sheila cherished lunchtime. It was a very important period for her, but not to hit the cafeteria though. No. Ever since that day, she always kept going back up, just to visit, like an old friend. She had made it a point at around 1 pm every day to head up to that roof, lay her back on the wall right next to the exit door and puff a hot cigarette or two. She would peer at the horizon, blowing smoke just to mock it, reminding herself and the earth on how foolish it was that it never took her when it had the chance.

The door opened and slammed shut abruptly behind a moderately built figure. It was Ram. He laid his back against the closed door and pulled out a cigarette from his pack of ten. They lazily nodded at each other. As he took out a lighter and lit it, she noticed that she was finishing hers and so dropped it the cement floor and put it out with her heels.

Sheila then nudged at him for another. She made sure to only carry one a day with her and keep at the rest at home as a form of hindrance exercise so she doesn’t carry on the habit.

‘No!’ He sternly replied as he continued to blow.

‘Come on,’ she flung her arms toward the pack still in his left hand.

‘I said No.’ Ram moved away. ‘We agreed. Only one.’

‘Look it’s not like…’

‘I’m not gonna…’ Ram kept pushing her hands away.

‘What’s your problem? I see you share with other dudes that come up here. What is it because I’m a girl?’

‘NO!’

‘Or worse. Is it a race thing?’

‘No’ and kept pushing her hands away. ‘Stop!’

‘What are you doing Ram? Come on. Just one for a friend. WHAT’S YOUR PROBLEM?’

‘Look I… I… CARE about you, OK?’

‘I don’t need your pity OK?’ She quickly snatched the packet from him and grabbed a stick for herself before giving the rest back.

‘So what’s all this then? All the clothes, all the makeup, all the sass? When did this happen? Tell me it isn’t some juvenile need for attention,’ Ram scowled after shouting at her.

Sheila stared away into the horizon again, placing the bud between her lips. ‘Fuck off Ram.’

He grabbed the door handle and just when she was about to light the cigarette, he moved his fingers toward her face and flicked it off her lips.

The bud flew far into the distance, landing on some dirt.

‘Wah?’ Sheila flinched.

‘Only one,’ Ram reminded her before he left through the door.

**

Syikin came back to a busy ward. She dropped the folders to the desk and quickly headed to Bed 32. She prepared her trolly, made sure every equipment was set and wheeled it to the patient. She put on her gloves, took the patient’s consent and began to palpate his forearm.

She made several attempts. Each time the patient winced and retracted she apologized and tried again. She could see that his patience was wearing thin. ‘You sure there isn’t anybody else that can do this?’ he politely asked.

Another colleague moved the curtains and quickly walked in approaching her side. ‘Let me try,’ he decided to take over. Syikin felt despondent but she didn’t retaliate. She saw him gear up a lot quicker and get the line in on his first try. The patient glanced back at Syikin as she looked away embarrassed.

The curtains flapped open again. In came an intimidating figure. Dr Julia yelled at the intern who just helped Syikin. ‘Shouldn’t you have done that aeons ago? He has a laparotomy planned in the next 5 minutes, and Surgical is breathing down my neck.’

‘Sorry boss, it’s done,’

‘I’m sorry too. I had a little trouble trying to…’ Syikin mumbled.

‘And you are?’ Dr Julia asked.

‘Oh, I am sorry Doctor. I’m Syikin, first posting, Day 1 of Life, graduated from University of…’

‘Where the hell is Sheila?’ Dr Julia turned back to the boy.

‘Been asking that myself.’ the intern kept his face down, without expression, while trying to clear the trolly of sharps and used items.

‘Tell her to meet me after work.’ Dr Julia stormed out, the curtains whooshing behind her.

**

‘Meet her where?’ Sheila asked only sparing half her attention toward the messenger. The rest was on infusing a cocktail of medications for her favourite inpatient Deena. She insisted she would handle it herself rather than the nurse in charge just so she could spend more time having small talk with her. Deena and Sheila had become quite well acquainted and she only trusted her of all interns for iv lines in her tiny frail cachexic body.

A group of interns had gathered around the bed. Sheila noticed Syikin had kept her head down the whole time with a disappointed look. Dr Julia stormed in later after pulling the curtains apart abruptly like she was going to break into a musical number in a stage show. This woman knew how to make an entrance.

‘There she is. Our hero. You mind telling us why you let an intern set an iv line unsupervised on the first day of her job?’ She yelled at Sheila.

‘Isn’t it a medical officers job to supervise her?’

‘Oh! So your saying I didn’t do MY job?’

The room was tense. Most of the house officers were shocked to see Sheila answer her so abrasively. Why was she antagonizing this woman?

Sheila glanced at Syikin at the corner, but not in a threatening way rather she nodded and smiled. ‘Told ya,’ she whispered, and she knew by the look of guilt of Syikin’s face, she understood what she meant.

‘She had set a few lines today, all by herself. I left her alone because even I was alone on my first day. And I did just fine. Wouldn’t you agree?’

‘No Sheila. I wouldn’t,’ Dr Julia pressed on, ‘you know girl, you keep going this route and I can make things really bad for you. You don’t wanna mess with me.’

Sheila looked toward Deena who had a very confused and awkward look about her, trying to avoid any form of eye contact especially of Sheila’s. The frustrated intern thought back of how she couldn’t enjoy her second cigarette, her fight with Ram and how regardless of all she did today people only found reasons to blame her. Syikin was right to call it out. It really was different for Sheila than anyone else, all because of one mistake. He survived and went home but it wasn’t enough for them that she had to live with it for the rest of her life. No. It wasn’t enough that she constantly dreamed of those kids growing up without their father. No. What else did Julia want from her? Wasn’t it enough that she had to endure the embarrassment of a staying in the rotation for an additional 3 months, having extra assessments, judgmental looks and the 3rd-degree treatment? Now she was questioning her every move and threatening her?

Sheila looked up, angry, upset and exhausted. They locked eyes. Using a very low voice, solemn but menacing, she went, ‘you’ll try Doctor.’

Dr Julia pulled back. It was a first for her. A full-blown rebel had challenged her ego, in her own ward at that and she was not going to have it.

‘Then it’s on…,’ Dr Julia moved her lips without uttering the word, ‘BITCH!’ and she was certain Sheila understood because she was finally quiet and giving her Medical Officer her full attention.

Dr Julia quickly marched out and the others knew to follow her for evening rounds. Syikin disappeared with the crowd wondering if Sheila would ever trust her again. The rebel intern though stayed by Deena’s side to finish the infusion.

Deena reached for her friend’s hand shaking as she tried fixing the mouth of the syringe to the intravenous catheter. She gracefully nodded while patting Sheila’s wrist, admiring her courage and the brave face she was putting on for her.

‘I know who you are. You know who you are. Don’t let THEM tell you.’

Sheila smiled.

Deena’s small cell carcinoma eventually killed her but those words always stuck by Sheila, getting her through the toughest of days all the way to the final hours of her own. However, she realised on that day that she was not alone in this. All Sheila needed was some courage to persevere and if it was a war that Julia wanted, then a war she would have and she would regret the day she started this.

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