On Wednesday morning, I watched someone nearly die. It happened like this.
My work friend, Loki, picked me up in the morning in his SUV, and we start driving to Eheliyagoda.
Peter, Loki’s seventy-one year old “driver”, who I had met only the day before, was sitting in the back seat. I say “driver” because although Peter is employed by Loki to be his chauffer, he hardly does any driving. Peter worked for Loki’s dad for twenty years, and now, he is mostly retired. I think Loki employs him out of some sense of responsibility or nostalgia.
Peter is from the old world. He has got grey hair oiled back neatly, a clean white shirt and a white sarong. He wears a Citizen wristwatch, which he has had for forty years. He takes the bus from Malwana to work at Jawatta every weekday morning. On his commute, he reads three Sinhala newspapers daily by exchanging his newspaper with other commuters. Loki gets a run down of the day’s news from Peter.
After ten minutes, I notice Peter coughing. A minute or so later, I notice Peter breathing heavily, almost wheezing. I thought, “Jees, that doesn’t sound too good. Sounds just like Arlin at home when she gets asthma.”
Loki and I stop talking and turn around. Peter does not look at all happy. He wants to get down and stand up straight. We pull up. We all get out. He is holding his chest. He coughs up and spits a globule of thick yellow sputum on to the side of the road.
I suggest taking him to a clinic I know. We get back in the car and race there. We rush out and Loki goes with him to the doctor’s chamber. I hear loud talking. It sounds like arguing. Loki opens the door and the doctor is saying in a loud voice, “I can’t do anything for him here! Don’t call an ambulance! Take him to a hospital!”
Loki thought the doctor just did not want to take responsibility for the patient. That thought might seem weird to some, but I had experienced this kind of thing before in a similar situation, where I was with a lady doctor when she directed a daughter who had come with her father, the patient, to the hospital, knowing full well that the father was already dead. This time, however, Loki was wrong and the doctor was right.
We get back into the car, and by this time Peter has to be supported and helped up on to the seat of the jeep. He can not speak very well, but he tells us to get his pills from his pouch. He takes a pink tablet. I ask him whether he has any pain in his arms. He says no. He thinks its “sema” (phlegm). He has got a history of asthma. I ask him whether his chest hurts. He says yes. The pharmacy girl from the clinic comes out and tells us that they cannot nebulise him because there is a power cut, and to take him quickly to a hospital.
We race to the Sri Jayawardenepura hospital. Loki is driving. We get there in under five minutes. Loki rolls the window down at the gate and asks the security guard where the emergency room is. The guard appears confused. Then, he motions in the direction of the main entrance. We drive there and I rush to the reception. They tell me the emergency room has a separate entrance. I get back in the car and drive to the correct place.
I run in to the emergency room and explain that we have an emergency patient. The attendant wheels a wheelchair to the car. He is quick, but calm. He must be used to this. Peter is now carried on to the wheelchair and then the bed in the emergency room. He does not look good, but I relax. Now they are just going to give him a nebuliser and he is going to be fine, I think.
While a nurse and a doctor attend to Peter, and Loki is parking the car, I am asked some questions about Peter by some person filling in a form. At this stage, I do not have a clue about Peter. I only know his first name. Loki comes back, answers the questions, and then goes back to the car to get Peter’s pouch to show the doctor his current medication. I am asked to remove Peter’s Citizen Wristwatch. I put it in my pocket. After a while, I am again asked some questions about Peter and I am explaining that Loki will be back soon to answer all questions, when I notice some commotion in the room and Loki rushing back, his eyes fixed on Peter’s bed, which is behind me.
I turn around. I see about eight nurses, attendants and doctors around Peter’s bed. Something is clearly not right. Loki stands by me and explains what is happening. He says that Peter has gone into cardiac arrest.
How did this happen? He was fine a moment ago. He was just having an asthma attack. I had seen this before. Or, so I thought.
People are swarming around Peter now, preparing things, doing stuff. It all happens at incredible speed, but at the same time, in my eyes, it all happens in slow motion, while Loki and I are just staring and staring at what is going on just twelve feet in front of us. Nurses and doctors and attendants are swarming around Peter. It is a well-choreographed, rehearsed dance. Each person is performing a different routine, a different function, a different part of the dance. Some are getting equipment ready. One is filling injections with medicine. Some are fixing things on to Peter’s body. Some are removing his shirt. One is tapping the back of his elbow to get the vein to pop out. Some are tying a tourniquet round his arm. One is pumping his chest. It is orchestrated. It is routine. It is dance.
The guy pumping Peter’s heart pumps and he pumps and he pumps. It goes on and on and on. They give him an adrenalin injection.
Loki and I just stand there, watching, staring, helpless. As if it was on TV. We cannot help. So, we watch. After what seems like ten minutes, Loki says, “He’s gone. He’s dead. I watched them doing the same thing to my father for much less time, and it didn’t work.”
I cannot see a heart monitor, but the only time I hear a beep is when they press down on his chest. Peter’s feet look very grey. They seem to have been pumping away without result for what seems like a good ten to fifteen minutes, but it is very hard to say how long it really was, because perception of time gets so altered in at a time like this.
The guy is still pumping his heart, and I cannot see any sign of recovery, but they want to transfer Peter to the cardiology Intensive Care Unit (ICU). I am asked to go pay at counter number one and four so that the paperwork is in order. I go, I rush, and when I take the documents to the ICU, I expect Peter to be dead. I am surprised to find that Peter is not dead, his heart is beating, and he is on a ventilator.
The swarm around him is dispersing. The doctors tell Loki and me that he is in very critical condition. They think his left ventricle has collapsed, and he also has a lung full of phlegm. Maybe, his damaged heart just could not take the intensity of the asthma attack coupled with a blocked lung. That is, if there was an asthma attack at all.
Loki and I contact Peter’s family through Loki’s mother. Peter’s son and wife are on their way. I stay with Loki on a bench outside the ICU for about an hour, and then I leave. I have work to do.
Today, four days later, it is Sunday, and I called Loki to find out how Peter was. Peter is still on the ventilator. He is not breathing on his own; the machine is keeping him alive. When his medication is reduced, his pressure rises again. He is still in very critical condition.
This experience was the closest I have come in my life to watching someone dying. The happiness at the fact that Peter did not die on Wednesday, and that Loki and I contributed in some small way to his recovery, is ebbing. I spoke to a young doctor at Meegaha’s stag night on Friday, and he said that if they were pumping his heart for over ten minutes, then his brain would have severely been affected. Peter is still not conscious, and I am unsure whether he ever will be.
Now, I just wish we had driven straight to the hospital.