I failed to keep my promise

I was adamant that if a promise is made, it must be kept. In insurance, in friendships, in family matters- jo vada kiya tho nibhana padega. One must live up to one's own promises.

I got away largely, though accidentally or by design, I might have broken few promises of less import. But the one I failed now, hurts me no end.

I grew up in this languid seaside city of Vizag, where life mostly was a breeze. We were a family of five- my father, a civil servant, my mother home maker, my sister and my brother- students of Sciences. I was the odd man out who strayed into Management Studies, believing Management was as important as Medicine.

But I secretly envied my brother. He was taller and more handsome than I, he would wear white overalls and fling his stethoscope casually, walking in the shiny corridors of his medical college, while I would goof around in the next door college, in the dingy class rooms of Accountancy and Business Management. For fun sake, we would exchange our places. I would wear his white coat and sneak into the medical school while he would languidly sit in the last bench of my auditing class- a break out time from the intensity of medical  studies. He would be seen more in my college campus than his, consequentially he made more friends in my college than perhaps in his.

We would play Badminton and Chess together- the latter game became an addiction for him. He would challenge me to a quick game of chess just before his all important medical exams, to relieve the stress and bring his mind back to the monstrous books he had to master.

Soon we graduated out of our colleges- he did his MD, I did my MBA. We got our first jobs in the same city and moved mostly in the same social circles. He had immense fascination for IAS, he would urge me to try it out,   which I did. Reluctantly first but intensely later, I went hammer and tongs over Civil Services Exam choosing Economics as my Major. My brother was excited when I cleared Mains and got some top grades all over. But as luck would have it, for some unfathomable reason, I was pushed down the rank making me ineligible for IAS. The set back hurt my brother the most, he wanted me to challenge it, but litigation did not help. By the time my case was rejected, I moved to Mumbai to start a new career in corporate world, that in course of time, propelled me to be CEO of Insurance companies. My brother felt somewhat happy that at least,  I could head an organization if not a Government Department, though in his eyes, IAS alone is the hall mark of success.

He never left the city of his choice, but grew up in his medical profession. Overtime, he became one of the most popular doctors in the city and his close circle of friends, naturally were mostly IAS Officers in the top echelons of the Government. He became an exceptionally gifted doctor - a vast network of patients would trust him from anywhere in the world for his instant medical advice. To earn at least some place in the hierarchy of our family honors, I later did  Ph.D, to add the coveted prefix Dr to my name, albeit  less deservingly.

I never imagined my Dr prefix would one day, push me to mask my identity in a PPE suit to venture into the ICU to watch over the monitors recordings of the  fast receding pulse rate of my brother.

About three weeks back, I got a distress call from the hospital where my brother was admitted as COVID patient.

I flew in to be at his side as the horror story began to unravel. It was the most painful period of stress, frustration and anguish,  witnessing the near collapse of the health care system, the city was so proud of.  

The second wave of COVID has been a living nightmare India might never forget. As a Doctor on Special Duty at the Government Designated COVID hospital, my brother won accolades for his exemplary work in saving the lives of scores of COVID patients during the first wave last year.

The Government in a rare honor, extended his services that were to end in May, by offering to elevate him to be the Director of the Hospital, He took his job with an intensity of purpose. He brought method into the madness, expected of a COVID patients' infested Hospital. Like a true captain in a war, he fought in the frontline  against the pandemic, doing his continuous check in the wards and doctors' duty rooms.

On that fateful day, a horde of ambulances carrying gasping patients arrived at the driveway creating utter chaos. Seeing the struggle his staff were having in clearing the rush of patients,  - instead of instructing from the comfort of his corner office, he dashed to the driveway to personally guide the ambulances disgorging patients at the triage counter. In the course of that event,  a heavy viral load  hit him. He did not mind being in the frontline, he felt safe as he was already vaccinated twice and had immense faith in the efficacy of the COVID Protocols.  

But his lungs a few days later showed the deadly infection -still confident, he casually walked into the next door hospital, as beds were already full in his, to get himself admitted.

The nightmare then began, the hospital went through a horrendous time of shortage of staff as nearly 40% of them got infected, it's essential life saving drugs supply chain broke, impacting the rigor and discipline expected in a critical COVID care facility.

Expecting the worse, we set up a war room outside the hospital, connecting with friends and some of the best doctors in India and across the world. In the next three weeks, we did intense search for every piece of information that could be of use in our fight against the odds. Air lifting medicines, searching for air ambulances, flying  to and fro Delhi to Vizag several rounds for life saving drugs, arranging emergency rush of medicines through special arrangements with Airport Operations, seeking Government help in the release of medicines for emergency use, rushing plasma from blood banks - we tried all, in the midst of lockdowns and curfew.

We used every data point to research the deep ocean of intensive care medicine against the shifting sands of time, as my brother slipped from mild, moderate, severe to critical stages of the infection. We watched in horror as his D-Dimer, Ferrtin, CRP, RR, NLR SpO2, FiO2 deteriorate as he slipped from masked Oxygen to HFNO to NIV to Intubation.  

As time passed, I watched helplessly the slow motion collapse of India's health care system. Each day a friend or a family member would send SOS for a life saving drug or a hospital bed with Oxygen to our war room. We could arrange for some, while others breathed their last, before help arrived.

It was a malfunction of the Management, the course I studied, not that of medical science, a subject my brother mastered. Medicines, vaccines, beds and oxygen were all available somewhere but not at the places where patients were dying. It was a pathetic failure of Planning, Organization,  Direction and control- the key functions of Management. Not just in the higher echelons of Government, in hospitals, in insurance companies, in regulator offices, in municipalities, in graveyards, in households, in WhatsApp groups, the mess is palpable everywhere.

Sometime back when my mother was on deathbed, I promised that I would always take care of her dear son, my brother. I repeated that promise to my babhi on that fateful day,  when I saw my brother gasping for breath at his hospital bed. I believed that using our management skills, we could turn around things and get him safely out of danger. But I was no Doctor, I was more like Munnabhai in the movie Munnabhai, MBBS trying desperately to save a life, against a tidal wave of unforgiving pandemic.

On this Eid day, Allah took my brother away to Paradise. My brother like a true soldier died fighting front line against the COVID war. If he were a soldier, his body would have been draped in National flag and bugles would have sounded the last post. Instead he was wrapped in plastic cover and a lone ambulance delivered his body at the unthinkably crowded crematorium.

I feel along with my brother, a part of me had also died as I burnt in eternal shame seeing the failure of management, the faculty I vainly believed in. It so happened, on the same day, two more doctors of my brother's medical school also died of COVID while in duty, though they were fully vaccinated. It's No Country For Doctors.

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