“Good evening Mrs A” he said as he swung into the isolation room in the ICU on his evening rounds, the last of his patient visits before he would be leaving.

There she was, ‘lying in state’ so to speak, having suffered from sepsis, a bad bacterial infection in her blood, ---only to embellish the heart, liver, lung and kidney failure that she already had. A tube through her trachea, through her bladder, her stomach, her jugular veins, she was conscious and lucid but hanging in the proverbial space between the earth and the heavens above. 

As he touched the crumpled skin of her hand, she woke up and gave him a wide  beautiful smile, her smile bringing to the fore all the wrinkles on her face resembling waves in the 91 yr old saga of her life.

There she was...in spite of all the difficulties, always  positive in mind, cheerful, smiling as she blinked and gestured with her hands, that she was fine. He smiled back at her, thinking how some people distribute happiness in this world. 

Day in and day out for the past two months, while her condition was waxing and waning, she never let her positivity leave her.

As he wrote down his orders, he thought to himself how adversity is dealt with differently by different people, how some individuals had such a steely resolve to stay positive in the face of so much adversity—was it the adversity that brought the resolve or was it an innate character of some? 

That night he got a call from the hospital- “Code Blue doctor, patient Mrs A, 91yrs, female, ICU” said the voice on the phone in the dead of the night, his watch showing 1: 20 am. As he reached the ICU, the CPR was ongoing, a burly male nurse doing chest compressions, another giving breaths through the ambu bag, team leader shouting orders, nurses scurrying here and there, flat line on the ECG tracing with only the occasional electrical activity of a dying heart,…. 30 minutes had gone by and it was time –she had indeed reached the other side of the proverbial space. 

As he left the room, to declare death to the family, he took one last look at her --she still had that angelic smile on her face that she put on, just for him, every evening.

DR SUNIL J RAO  MD.