Why

It is gradually settling down. However prepared you might think you are, the chaos is overwhelming and it takes time to find your footing. One of my new mentors says he takes this as an opportunity to practice patience. Because, he says, anger does not seem to be the right solution. 

Practice patience indeed. I am certain it takes a lot of it. My mentor must have sensed the ambitions and phantasmagoric footing of a young idealist.

Especially overwhelming is the rapidity of events in this chaos. We just lost a patient, a young girl in her teens from somewhere remote. She came ravaged with tuberculosis. It had spread everywhere: lungs, stomach, brain perhaps. She was passing blood in her stools. Prostrate in the bed, she barely had energy to respond. Her father was worried she was not eating anything. We put a nasogastric tube and started feeding "Sanjibani", a locally prepared nutritional solution. She was getting medications for tuberculosis. 

Next day, during morning report, resident on-call overnight reports that the patient passed away. 

The force of this declaration is stunning, rattling. First off, you have seen this patient once, on a rushed rounds. You have not known this patient, as a good physician should know. Secondly, you don't know how this patient was handled once she started going down the path of death. It is likely that there were signs of deterioration before she entered the point of no return. But in this chaos where the hospital is laden with sick patients like her, who knows how long it took before it came to the attention of nurses or physicians on-call. How would her father know if her oxygen saturation was dropping, blood pressure was low or heart rate was high? He had a sick child, until that child remained no more. 

You are left with several questions, surmises, an achy heart, and restlessness. Why should a young girl die in a hospital bed from a disease of overcrowding, filth and poverty?