The atmosphere in the Casualty was joyous, to say the least. It was an interesting scene. A patient with a perforation in his bowel and contamination of his abdominal cavity with around 2 litres of pus had just been wheeled out towards the Emergency operation theatre and only 2 patients remained in the Surgery Casualty, one chronic alcoholic with bloody vomiting and one with acute left sided pain in his abdomen, most likely due to a kidney stone. The alcoholic had a tube running from his nose to his stomach which was instilling cold saline into his stomach which had successfully stopped superficial vessels in his stomach from bleeding. He would soon be discharged and referred to Medicine for alcoholism and related hepatic complications. His wife, covered in multiple woolen layers, was tired and mostly resigned to her fate as countless others in India. All she was worried about were her kids, whom she had left with a neighbour. The one with a suspected kidney stone had been in complete agony when he had come, half an hour back. When he was calmly given an injection in his butt and did not see the doctor paying him much attention after examining him, his relative created a fuss about the patient's agony, all of which completely disappeared as the new decade rolled in. He was now sitting in his bed, attached to an IV bottle and texting people wishes for the new year, awaiting the completion of formalities for the necessary Xrays and sonography.
After hugging his colleagues and nursing staff, Surendra finally sat down after what seemed like 8 hours. The Casualty had been relatively calm till the early afternoon when 3 'bad' patients, all of whom needed to be explored in the operation theatre had come within an hour of each other. Apart from the other usual patients, Surendra and his colleagues then went about getting these 3 priority patients investigated, resuscitated them with appropriate medications and started getting them ready to be shifted for the required emergency operations. The third had just been wheeled out and now 'his' Casualty was calm again. It was 'his' Casualty after all. He was the ranking surgical resident present there, his seniors comfortably enjoying their New Year celebrations, confident in his ability of handling anything that could come his way during the course of the last Casualty duty of the year. Soon the alcoholic and the kidney stone were 'mobilised' and his Casualty was empty. The attendants had gone out for a smoke. The nursing staff finishing up their tallys and chatting up about some Bollywood star. After the mess and potpourri of patients and relatives from the evening rush hours had cleared, Surendra now awaited the next wave: the drunk head injuries.
They always come in droves. Sometimes, the relatives outnumbered the patients, carrying their fallen, drunken comrade in their hyper acute machoism in their arms, consoling him that they are their for him, forgetting that they, in their own inebriated state, allowed said comrade to go out and drive in the first place. Those with alcohol induced gastritis or pancreatitis would follow in the coming days but the 1st of January belonged to drunkards crashing their vehicles or just plain falling down the stairs. 1st of January was calling upon broken bones and cracked skulls. And the call would be answered.
His own batchmates had gone out to party and by sheer bad luck, 31st December had been his unit's call day. He'd messaged them just before midnight about getting some chicken for him, after a healthy dose of friendly abuses and Rajan had replied in emojis: a kiss, a wink and a thumbs up. Bastard, he scoffed, as he started preparing notes in anticipation of the MLCs, medicolegal cases, as they were called.
Sure enough, around 12:30, he heard the first ambulances screech to a halt outside. 3 friends on a bike hit fell off the bike on a curve. 2 had relatively minor injuries to the face and would not even require stitches but the driver, driving without a helmet, had hit the road pretty hard. Half his scalp had come off with the impact and his right eye was swollen. When he wasn't busy flailing about, yelling incoherent abuses while people held him down, he was vomiting on everybody within a 3 feet radius. Surendra jumped to his feet, assessed his neurological status and check his vitals. He seemed stable enough, apart from his ghastly soft tissue injury. Meh, thought Surendra, I've seen much worse. He expected the patient to be sober and coherent in the morning and discharged if the CT scan revealed no traumatic brain injury.
He had just completed the formalities when another stretcher rolled in, this time carrying a lifeless body. BD, brought dead, explained the Casualty Medical Officer. There was no relative. The police had found the body on the highway, 10kilometers away from the city near a wrecked bike which had driven into a parked truck with high velocity. 2 more MLCs came seconds later, cases of drunken assault. Nothing too serious, thought. Thankfully the RTA was BD, thought Surendra. Resuscitating him and managing him would have taken an hour and then patients had have piled up in 'his' Casualty.
It was 6am. He'd slept on the bench for an hour and now was just counting the minutes till 8am when his duty ended. The attendant had gotten some fresh hot tea. The kidney stone patient was being discharged on painkillers.
'Doctor, should I take beer to get rid of the stone, as they say?' asked the patient.
'Not unless you want to land up like the other guy vomiting blood. Take the medications, drink ample of water and you should be fine.' Surendra rolled his eyes over the therapeautic properties of beer, renal stones not being one application. A few MLCs remained, awaiting their CT reports but he was confident they woudn't require 'manjan'. His stomach grumbled, having survived the night on instant noodles and caffeine.
He was almost dozing when his phone rang. It was Rajan's forever anxious mother. After he was a no show with the chicken, he assumed Rajan had found appropriately receptive feminine arms and was busy having a happy start to the new year. What did the fucker do now?, he thought. Did he not call her yesterday?
'Beta, please tell me Rajan is okay. They must be mistaken. You're there, right? Please tell me it is a mistake? You were with him, right? Hello? Surendra?'
The morning attendants were cleaning the Casualty. A couple of them were moving the BD from the back of the Casualty to the morgue. He was covered in whatever old blanket the Casualty could spare, tied with two strips of bandages. The blanket was already soaked with blood at the base of the skull. On top of the torso, in a clear plastic bag, was the Tommy Hilfiger watch he had gifted Rajan on his last birthday.
The watch was stuck at 11:50.