The Fifth Horseman

Do you want to be a doctor?

Sheila sucked in deep anxious bouts of cold air before she knocked on the door and paced her way in.

‘Yes, come in,’ the doctor sitting on her comfortable chair semi-reclined, immediately straightened her back when she saw Sheila come in clenching her stomach.

‘Hi, Dr!’ she smiled.

Dr Julie paused, worried. ‘Why was she here?’ she asked herself, wildly suspicions.

‘So? Why are you here?’

‘Mittelshmerz,’

‘Why don’t you take something from the hospital pharmacy for free?’

‘It’s bad, so I decided to just drop by.’

‘You were fine this morning,’

‘I didn’t happen this morning,’

‘Did it happen in the car, just impeccably timed to when I start my work here? Like what? Did you follow me? Is this even your usual route?’

‘Those questions are not relevant for your history,’

‘And eight words in a sentence doesn’t sound all that painful,’ Dr Julie sneered while she made a mental count.

‘So, you gonna help me or what?’

‘I am a doctor, aren’t I?’

‘Yes, the on-call doctor,’ Sheila watched to see if her archnemesis would flinch in fear. However, now that Dr Julie had her suspicions confirmed, she instead drew a confident eerie smile, unperturbed.

‘So, you are willing to pay about 70 dollars in a private clinic just to call me out. This must make you feel like a great winner.’

‘Yes, imagine what the bosses would say.’

‘Try it,’ Dr Julie challenged her. ‘Let’s see if your stones can pop out more than just painful eggs every month.

‘I should,’ Sheila stood, straightening her back, her pain symptoms miraculously receded.

‘Before you leave,’ Dr Julie stopped her, ‘think about it. Even by the off chance they do believe you – I mean I know you have taken a bunch of photos, you’re not that stupid- think how will that make you look. Because all I see is a problematic intern, desperately fishing to bring her superior down out of spite. Do you think anyone cares?’

Sheila didn’t need her rhetoric to doubt herself further. She was more than adequately desensitized to her insults by now. However, the woman did have a point. Maybe it wasn’t leverage after all.

‘Well, we’ll see what happens.’ Sheila answered.

‘Sheila!’ Dr Julie cried out as her patient busted out through the door.

**

‘Yes, Sheila,’ Dr Satya was pleased that the infamous Dr Sheila Thomas had finally reached out to him. He had only heard unconfirmed rumours of the house officer who smelled of cigarettes and alcohol every now and then. He cleared his schedules as per his custom when it was a staff member and today was no different. She was welcome to all his time. However, little did he know, Sheila promised to meet him but with ulterior motives of her own.

‘Dr Satya, you have a very nice office,’ she sat in the chair opposite his desk and marvelled at the surroundings.

‘Thank you. So how have you been? What’s this new look? Everyone has been raving about it.’

‘Have they?’ she peered up to him with gentle eyes; dry toward the middle, inflamed ducts, and two to three overhanding lines beneath her lids. ‘The eyes of a crier’

‘Yes, of course. It looks good on you.’ He gestured smiling.

Immediately he noticed Sheila stretch the edge of her skirt over her kneecaps. It was time to stop talking about her appearance and move on to something else before things

‘Well, so? Why are you here?’ He moved to the back of his desk.

‘I wasn’t feeling too well yesterday. So, I went to a GP. It was Dr Julie, from Medical.’

‘Oh, you mean she was doing locum outside?’

‘Yes, only that she was simultaneously on-call.’

The psychiatrist raised his eyebrows. It was then clear to him that this girl didn’t come here for herself, rather to tattle on someone else. Dr Satya saw a million red flags, confused on which to deal with first. The man in all his years of experience loved a good puzzle, and he had a feeling that the one seated before him was going to be his greatest challenge yet.

‘You feel the need to lodge a complaint?’

‘Should I?’

‘You need my permission?’

‘I need your consult.’

‘It’s not my place. But there are rules, and the rules are clear. The question is why would you feel the need for my consult? Why does my opinion matter?’

Sheila flared her chest, and Dr Satya noticed her knees unbuckle slightly and her shoulders drop; all signs that she was getting ready to let some walls down.

‘I see what you do upstairs, sometimes in the middle of the night when even the interns are sleeping. Even some of your doctors are not around, and there you are, talking to them, listening to their bullshit.’

Dr Satya was humoured. ‘Bullshit?’

‘Yes,’ she continued. ‘But then, come morning and they go home. They look happier for some reason. It isn’t the drugs, really, but just you.’

‘You ever considered psychiatry as an option?’ Career-wise?’

‘I think I’ll be bad at it. I almost ruined a very good friendship because of something I did.’

‘Do you wish to talk about it?’

Again, she closed her arms and retracted. ‘No. I just want to know what you think.’

‘I think you know the answer, but you are hoping for an alternative response. Are you scared, that if you do, something might happen?’

Sheila had moved her eyes away from him and transfixed all her attention on a mural to his left. He bought it for that exact reason. As she stared at it longer, lost in its enchanting trance, her tear ducts started to swell again, and the moisture returned to the white of her eyes.

‘I didn’t want any of this,’ a tear dropped, blotting her skirt, but she went on careless, ‘I wanted to help people. But, after all this, I don’t even who I am anymore.’

‘Have you heard of the term “existential crisis”?

Shella pulled herself to laugh. He offered her a tissue. ‘You been having some troubles, Sheila? I am here if you need me.’

‘Yea,h but you’re part of it,’

‘Part of what?’

‘This!’ She swung her arms open showcasing the room –serving a metaphor for the hospital, the system and the institution.

‘So, you think you can never confide in us.’

‘The minute I come to you, my licence is in question. I will be on probation, and worst of all, I will only have proven them right,’

‘Right?’

‘That I don’t belong.’ She squeezed her tear ducts with the scrunched tissue and spurted out the excess secretions before discarding it. She wasn’t going to cry anymore.

‘Who has made you feel this way?’

Sheila started to make awkward faces, defensive, struggling with her own inner conscience to speak out.

‘Too many of them,’ she whimpered. She scratched her brow and tried to change the subject. ‘I came here for something completely different. Look at what you made you do.’ She laughed. ‘You are good Dr Satya. I don’t know, you barely spoke, but there’s something about you and this office. They are right. You are a magician.’

The psychiatrist lingered in a gentle smile, he focused keenly at her, watching her fidget relentlessly, crossing and uncrossing her legs alternating sides, shaking her wristwatch and pulling it back repeatedly, constantly massaging her neck, all in a span of just two minutes. She was struggling to let out something, and the walls were coming back.

‘Do you want to be a doctor?’ Dr Satya popped the age-old question.

‘As opposed to?’

‘Answer the question please if you can. It’s a very simple question. Was it something you wanted or was it something your parents wanted?’

Sheila cornered her smile, blowing off some residual vapour. She didn’t think of him as someone that predictable and little did Dr Satya know, in all his years of experience, that it was at this very moment he had lost the missing puzzle piece. He would sit and ponder for years to come if he had not made that assumption or allowed himself to weed in that idea into a conversation, that things might have turned out differently.

‘My mother wanted me to be a singer.’

‘Really?’

‘Yes’

‘Are you any  good?’

‘My teacher once compared me to a gaggle of geese, not a goose mind you, but an entire…’

Dr Satya burst out laughing.

‘Doesn’t mean I didn’t have lessons though. She tried. That, and the gymnastics, and the swimming. “If only you had lighter skin, I would get you into pageants” she would say.’

‘Nonsense. You are beautiful exactly how you are. I’m sure the boys are crazy about you.’

‘Thank you, doctor. But it’s different for men. People actually want tall, dark and handsome.’

Dr Satya humoured her. ‘So, becoming a doctor was your “rebellious phase”? You decided to do the most opposite thing just to upset your mother?’ he chuckled to mask his query in the form of a joke.

‘No, it’s not like that,’ she smiled. ‘It’s what I dreamed I would be. The coat, the arrogance, the spotlight, but with it all, the grace of humility, a shred of respect and honest living.’

‘It sounds like you read that from a quote.’

‘It’s from my Dean’s speech back in college.’ Sheila continued to joke and watching Dr Satya lose his calm demeanour and laugh like a toddler just pleased her a little more.

‘Well.’

‘Well,’ Sheila stopped him. ‘I think I’m just going to go ahead with the complaint. And whatever the backlash, I will deal with it later.’

Dr Satya eyed his wall clock. He wished it went a little longer, but it was a good start nonetheless.

‘My door is always open.’ He answered.

Sheila got up humble excused herself with a nod.

‘Oh, wait,’ Dr Satya remembered. He drew a piece of paper from the desk drawer and handed it to her, along with some crayons. ‘A little exercise. Not to worry, it’s still all off record.’

Sheila accepted it, curious as to the instructions.

**

The wards knew no weekend, like a hillside casino, time was a construct that bared no meaning and come dengue season, it was all day or all night, and nobody could tell unless they found a second to look at their clocks. The almighty on-call roster had paired Sheila with Dr Julie once again for nightshift that unbeknownst to them, would be their most challenging yet.

Nadia and Sheila had finished their night rounds together. Sheila waited for her at nurses station while sipping on hot coffee to keep her eyelids up. Staff Nurse Nadia had promised her stories of recent developments and she was eager to listen.

‘He WHAT?’

‘Yes!’

‘And you said?’

‘I said I needed time, and once he was out of here, I MIGHT go out with him. So… I gently told him to take his mother’s ring back.’ Nadia chuckled in excitement.

‘I taught you said he was an old creep. Bed 6 this and Bed 6 that. Oh My God!’

Nadia playfully slapped Sheila’s shoulder, cowering in embarrassment. ‘Well, it’s just nice to have someone look at you that way after all these years you know.’

‘Lucky old Bed 6. I have catheterized him before, you know. He isn’t all that bad down there,’ Sheila joked.

‘So have I,’ Nadia couldn’t stop giggling.

‘You’re a bad girl, aren’t you? Wow, seriously, lucky old geezer.’

He has a name, Sheila,’

Sheila almost chocked on her coffee. Nadia burst into laughter, with a sheet over her face, hiding her embarrassment.

‘Oh, does he?’ Sheila sarcastically remarked.

The announcer awoke the quiet night. ‘BEEP, BEEP! Code Red, Ward 8, Code Red Ward 8’

‘That’s upstairs,’ Sheila relieved, adjusted her aching shoulders and yawned.

‘Do we have to go?’

‘They’ll handle it. Why?’

‘Bed 6 is upstairs now, Sheila.’ Nadia gave a pressing look.

Sheila took out her phone and checked her messages. ‘Nothing from Julie. But yeah, there’ a CPR going on.

‘WHO?’

‘Not sure.’

‘I think I’m just going to pop my head up there for a bit. You can take care of things, right?’ Nadia pleaded with her.

‘Hold on,’ Sheila kept skimming through the flood of responses coming in over her phone. ‘Mr Shamsuddin,’

Nadia slapped her wide-opened mouth and started hyperventilating.

‘Alright, Nad. GO!’

Nadia ran as fast as she could to the stairwell. Meanwhile, the night shift house officer kept scrolling through the updates, just in case she was ever needed. Dr Julie replied something.

‘I need atropine stat. Who’s anaesthesia on-call? Call them now. Tell them it’s urgent. We need an ICU bed.’

‘Oh great, Julie to the rescue.’ Sheila mumbled.

‘Excuse me, NURSE?’ a shadow loomed over Sheila in the counter. Sheila pretended to look around. ‘Me?’ she answered an old patient in his dishevelled hospital gown.

‘Can you tell me where the bathroom is?’

‘There,’ she pointed East to the end of the corridor, holding her breath trying not to accidentally take a whiff.

Another message beeped in fast, ‘Hemorrhagic Shock. He bled out of nostrils and is actively choking on fresh blood. Surgical noted. They are readying the scope. Currently ongoing a pint of blood, and lots more pints to go. Housemen on alert. Standby for Resus, labs, blood and surgery.’

Suddenly, the phone started vibrating and it was Julie calling her. ‘Why, BITCH?’ she mumbled before picking up.

‘Hey, you there? Julie asked. There were echoes of beeping monitors all around her, muffling her voice, that and her heaving between sentences showed clear distress.

‘Yep,’

‘I need you to do something,’

‘What?’

‘I got 2 more CPRs and everyone else is busy. You’re the senior after me tonight, so find the family of Mr Shamsuddin and tell them it’s over. I don’t have the time.’

‘It’s over?’

‘Yes, I discussed the whole thing with Infectious Diseases. It’s not dengue, it’s AIDS. I know, I’m equally shocked. So, yeah… get on it.’

‘GET ON?’ Sheila was overwhelmed.

‘Get a DNR, you idiot!’ and the call dropped.

Sheila’s shoulders started aching again. ‘Poor Nad.’

Coincidentally, the limber little nurse slumped her way back in, her face horror-stricken, eyes in tears. ‘I’m sorry,’ Sheila said.

Nadia wiped off her tears while behind her were a much older woman and a man about the same age as the patient, in ruffled up clothing, equally as distressed and upset, approaching the nurses counter.

Sheila stood up. It was her first time, and she had no idea how she was going to do this. She had seen it being done countless times before, and when the Medical Officers did it, there was usually drama, sometimes violence, but assuredly some form of turmoil. Nothing made it predictable, every situation different, and Sheila with all her usual confidence was shaken to her core. She blamed it on the coffee.

‘I assume you’re the family.’

‘Yes, Doctor,’ responded the man while he hugged the old woman, weeping, putting her weight on him. ‘This sweet young nurse told us to meet you. What’s this about?’

Sheela flared her chest and sighed aloud. ‘Nad, could you give us a minute?’

‘It’s OK Sheila, I’ll stay…’

‘Please, Nad. NOW!’

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