today


Chapter 1

It was the ringing telephone that woke him up that morning. Dr. George Thomas opened his eyes slowly. For a moment, he was completely lost. Then it sank in. He was in his bedroom. He looked at the clock. It was 5. The sun had not come out yet.
George enjoyed his early morning sleep and hated to be woken up early, especially by the phone chime. Usually, in a physician’s world, the phone rang in disagreeable tidings. The day was not starting well. Grumpy, he picked up the receiver.
’�Hello ’�’�
’�Dr. George Thomas, please?’�
He recognized the hospital receptionist.
’�Oh, morning,’� he was more affable. ’�Yeah, Dr. Thomas.’�
’�Good morning, sir. May I connect the ICU?’�
George jerked up and leaned on his elbow.
An early-morning missive from ICU, an acronym for the Intensive Care Unit, where critical heart patients were treated, was not routine and did not augur pleasant news.
Mercy, his wife, sleeping nearby, moaned.
George recalled the ICU patients. He remembered the patients by bed or room numbers. The staff always referred to the number when reporting. He could recall patient information anytime, but not their names. It was not a good habit. The patients were individuals with names, not numbers. However, the habit was well entrenched. It went far back to his starting days as intern. His ability to rattle off the details about his patients, without so much as a glance at their records, never failed to impress his mentors and teachers. At moments, purely and absolutely private, when he was in the mood, this noted memory was the subject of his fantasies in vainglory.
Basheer, the duty doctor, came online, a bit tired, but alert and efficient, ’�Good morning, sir. Bed six, Radhakrishnan ’�’�
’�What happened?’�
’�Sudden chest pain and breathlessness, severe breathlessness. Given lasix; he’s a bit better. Nitroglycerine is on flow ’�’�
’�LVF?’�
’�Think so. Started suddenly. Lung’s full, wet.’�
Mercy, half asleep, protested, ’�What’s it?’�
’�Excuse me,’� George covered the receiver. ’�Nothing, it’s hospital.’�
She settled down to slumber.
’�Yeah, Basheer. ECG?’�
’�Yes, sir. Suggest fresh injury. I’ve asked for enzymes.’�
’�Hum, I see. Already an extensive MI. Now this!’�
’�Anything more, sir?’�
’�Now, he’s ’�’� George showed off a bit of his impressive memory, recounting Radhakrishnan’s present medications and their precise dose, pausing just for Basheer to verify and confirm. He gave fresh orders.
Mercy got up and left the room. Doctor’s family bore the burdens of the profession.
’�Pretty bad; that guy’s only 26. Yeah. Oh, God, he’s just starting life,’� George was pensive.
Basheer, too young and too tired for metaphysical reflections, did not respond.
’�As we discussed earlier,’� continued George, ’�Must be some underlying cause. How else, at this age?’�
’�Yes, sir. But, we did all possible tests. No risk factors; doesn’t even smoke.’�
’�Yeah.’�
’�Does this ’� now, change our decision? About angiography?’�
George chuckled. Basheer was being polite. The earlier decision was not ’�ours.’� It was entirely his, George’s.
’�Let’s see; yeah, we’ll review during rounds.’�
’�Yes, sir.’�
’�Did you inform relatives?’�
’�Yes, I’ve told his father.’�
’�How’d he take?’�
’�He broke down. I didn’t know what to say. Terrible!’�
’�Yeah, talking to family’s hard. It’s an art. You’ve to learn that too.’�
’�I know.’�
’�It’s not taught in colleges. But it’s an important part of practice.’�
’�Yes.’�
’�You’ll learn, eventually. In the greatest school ’� experience.’�
’�Suppose so.’�
’�Emotional issues are difficult to tackle. Be careful, stay detached. You’ve to deal with patients and families. Help them. But don’t get emotional.’�
’�Sir ’� but how?’�
’�Yeah, it’s difficult. But you’ve to learn. Get insulated.’�
’�Insulated?’�
’�Yeah, avoid personal attachment. Try to help as much as possible; but do not take up patient’s problems personally.’�
’�Oh, there’s a difference?’�
’�Of course, there’s. How much of personal problems can you handle? You’ll get exhausted pretty soon.’�
’�See your point. But it’s not easy.’�
’�Not easy, yeah, especially for sensitive people,’� continued George. ’�I’d the same problem. In fact, still do. But I tell myself, it’s a job to be done, efficiently, properly. If you’re emotional, you can’t do it well. You’re doing a disservice to your patients.’�
’�Understand.’�
’�I actually felt guilty! Guilty that I’m not concerned enough, not caring.’�
’�I can see that.’�
’�Okay. Keep me informed. Other patients okay?’�
’�Yes sir,’� He disconnected the phone.
George wanted to sleep. But, Radhakrishnan kept coming back to his conscience.
At admission Radhakrishnan’s diagnosis was simple, a heart attack, total cutoff of the blood supply to a part of the heart. It was due to obstruction in the coronary arteries, which distributed blood to the heart muscle. Immediate removal of that obstruction was the logical remedy. Some doctors, George among them, preferred drugs. The younger physicians recommended mechanical methods. That started with angiography, a test where the doctor introduced a thin, long tube, a catheter, through a blood vessel in the patient’s leg or arm and pushed it up to the heart. She then injected chemicals through this catheter that showed up and recorded on X-ray-sensitive sine film. Instead of film, present-day methods used digital technology that recorded on a compact disk. By projecting this, much the same way a movie was played, doctors delineated the obstruction in the arteries.
The doctor could employ special catheters, with devices such as balloons at their tip, to remove the obstruction mechanically. Known as ’�angioplasty,’� this technique squeezed down the obstructing material in the arteries, dilated it and allowed free blood flow.
However, angioplasty was not without problems. Many cardiologists, at that time, in the mid nintees, abhorred it for heart attack. Further, evidence was scanty that angioplasty was superior to drug treatment. It occasionally led to heart surgery, a dangerous procedure in the acute stage. The natural delay in arranging the procedure often took away the benefits.
Since angioplasty and bypass-operation were physical interventions, they were ’�interventional treatment.’� In contrast, drug treatment was ’�non-invasive.’�
There was considerable pressure to send Radhakrishnan up for interventional treatment. But George had resisted. Now he was again under pressure. The session with his younger colleagues would be an agonizing ordeal. There was no way he could escape.
George stretched in his bed and then rolled over, came by a comfortable posture and tried to relax. He pulled the thick cotton sheet over his head. The soft hum of the air-conditioner was soothing. He briefly mused over the paradox of artificially cooling the room and then using a blanket to escape the chill. This was his favorite time of the day. Just curl up under the blanket and daydream. However, this morning started wrong. He could not relax.

Chapter 2

Fragrance of South Indian filter coffee wafted in. Mercy came back, cup in hand.
’�Time to get up,’� George heard her saying.
’�Okay, in a moment.’�
Mercy sighed. When it came to getting up from sleep, George was a delinquent child. He felt her coming close and putting her arm around him. Her heavy breasts, within the silk gown, pressed against his cheek.
’�C’mon, get up!’�
’�What time’s it?’�
’�Never mind the time. It’s time to get up!’�
’�Yeah ’�’�
’�What’s the call?’�
’�Remember, I told you. Young chap, with infarction?’�
’�Yes. What now?’�
’�Complications.’�
’�Oh! You said ’� Why’d he get it so young?’�
’�Don’t know.’�
’�Don’t know? Then, how do you treat?’�
’�See, we can diagnose and treat heart attacks. Even if we don’t know the exact cause,’� George’s eyes pleaded for understanding.
’�I ’� You always say that! But, I don’t understand.’�
’�Look, someone’s injured. We treat the injury. The cause, road accident or fall from tree, doesn’t matter. See?’�
’�Oh, I see. So how did you treat him?’�
’�Standard medicines. What else?’�
’�What did other doctors say?’�
’�About what?’�
’�About treatment.’�
’�Some of them recommended angioplasty, yeah.’�
’�Lot of discussions?’�
’�Yeah.’�
’�Lot of attention, ha?’�
’�Yeah. That’s what I hate.’�
’�There you go again. Why?’�
’�I don’t want to be under a microscope.’�
’�It’s not microscope, Georgee. They look up with binoculars, you know.’�
’�Yeah? They scrutinize with a magnifying glass!’�
’�Okay, but why worry?’�
’�They can always find something wrong.’�
’�You’re a very insecure person, you know.’�
’�Insecure?’�
’�Your confidence’s great!’�
’�Yeah.’�
’�I mean your confidence that you’re wrong.’�
’�Oh. I’m realistic.’�
’�Realistic?’�
’�Anyone could blame me. Angioplasty and Radhakrishnan would’ve been cured!’�
Mercy shutdown the air conditioner and opened the window curtains. George was wide-awake now.
’�You shouldn’t worry about what others say.’�
’�I’m worried how this, what happened to patient, affects me.’�
’�What?’�
’�When patient turns bad, I feel awful, yeah. But I’m also anxious how that affects me, my reputation.’�
’�Oh.’�
Mercy opened the window panes. Morning air gushed in. Despite his mood, George noticed how beautiful the morning was; the trees pranced in breeze and the birds chirped.
’�Yeah. Frankly, I’m conscious, my concern’s not entirely for the patient. See, I’m also anxious about my professional standing.’�
’�But, you’re always so concerned about your patients.’�
’�Yeah, yeah. I do everything possible. Make no mistake. If I could cure Radhakrishnan by whatever means, I would. No question. But I also remember my reputation. Isn’t that bad?’�
’�No, I’m glad you’re human!’�
’�When a patient dies, questions come up in mind. If treated differently would he have recovered? If that was not done ’� If this was done sooner ’� If ’�?’�
’�You’re too sensitive.’�
’�That ’�If Syndrome’ is very disturbing.’�
’�Many doctors don’t have that.’�
’�They do.’�
’�Dr. Jayaraj?’�
’�C’mon, he’s just one nut.’�
’�Now, he must be happy, no angiogram for this patient!’�
’�Yeah.’�
’�Did you do that to please him?’�
’�Get lost.’�
She giggled.
George accepted the mug of steaming coffee, dark and strong. The aroma was enchanting; good coffee was compensation for getting up in the morning. After coffee and newspapers, he was ready to face the day.

Chapter 3

At that precise moment on that particular day, Dr. Jayaraj was drinking water, his fourth glass. He was actually forcing it down; he was not thirsty. He will continue until he choked down eight full glasses that morning, and every morning.
His wife, Radha, as usual started nagging. ’�Actually, why are you doing this? Foolish!’�
’�Why you worry?’�
’�’�Cause I’m your wife, that’s why.’�
’�I’m doing nothing wrong.’�
’�But people are laughing at you.’�
’�I don’t care!’�
’�Actually, do you care about anything?’�
’�I don’t worry what foolish people think about me, or what I do. I do what’s right!’�
’�Make a fool of yourself.’�
’�Keep quiet! What’s your grouse?’�
’�Actually, why do you keep drinking all this water?’�
’�I told you, it’s a treatment, prevention.’�
’�You do, okay! But don’t ask others to drink.’�
’�I do what I advise and advise what I do.’�
’�Actually ’�’�
’�Leave me alone!’�
Radha sighed. She was not prepared to leave him alone.
’�Actually, who invented - what’s it - water therapy?’�
’�I did. I’ll publish it.’�
Then he went for his exercise; he walked for 45 minutes and jogged vigorously for another 15 minutes. When he came back, his breakfast was ready.
’�Did you walk with your group?’� Radha never missed an opportunity to ridicule her husband. He had tried to organize his patients into a jogging club. That was not a spectacular success.
Jayaraj scoffed.
’�Breakfast’s ready.’�
Jayaraj ate fruits, uncooked vegetables, onion, garlic, a little barn, honey and goat’s milk. Then he swallowed cod-liver oil and several vitamin tablets.
’�Why are you eating more tablets than food?’�
’�Hum.’�
’�Actually, you’ll have hypervitaminosis.’�
’�Ha, very funny!’�
’�Actually, everyone’s laughing, at you.’�
’�Laughter’s good medicine.’�
’�Huff ’�’� she veered her head.
’�I know our society, what it says. I don’t care.’�
’�Bother! Do you care about anything?’�
’�Yes, I bother about treating properly.’�
’�Actually, everyone thinks it’s improper.’�
’�Ha! What’s proper?’�
’�Tell me! Why are you so much against angioplasty?’�
’�Angioplasty? All interventions are useless.’�
’�’�Cause you can’t do them?’�
’�I can’t? A monkey can be trained to do it.’�
’�Actually, some men are inferior species.’�
’�Anything else? No? Okay I’m going.’�
Jayaraj took out his ancient bicycle and was on his way to the hospital. Radha watched with disgust.
Radha wished her husband had training in catheterization. Then, he would have done it. That would have been good.
To Jayaraj it was an ego problem. The techniques he did not know, simply could not offer better treatment. He went about opposing what he did not do. His mind conceived that as reality. Once he accepted that fiction as fact, he wholeheartedly believed it.



yester years

Chapter 4

Poonezath Keshavan Jayarajan Nair was born in the year 1932 as the last child and the only son of his parents. They belonged to the Poonezath Tharavad, a prominent family in the Travancore State. That sprawling undivided extended family, with large number of relatives living together, was presided over by the hierarchically eldest member, the Karanavar. He held the key to the coffer.
The family lived in Parur, a hick town at the border between Travancore and its smaller northern neighbor, Cochi. Though superficially sovereign, both states were in fact subordinates of the British. Britain during the seventeenth and eighteenth centuries had systematically tightened its tentacles on the princely states in the subcontinent. Those were the heydays of colonial imperialism and Britain had vast areas of the planet under her control. The then Maharaja of Travancore had accepted British supremacy as far back as in 1795. Travancore had become a British vassal and paid toll every year. The British offered protection against external aggression and retained the right to interfere in its internal affairs.
To the loyal subjects, for centuries, the Maharaja was the undisputed emperor, ultimate justice, provider of bread and arbitrator of life and death. They adored him as a deity. Poonezath Tharavad was among the most ardent zealots of the royal family. Decades ago, the Maharaja had granted them generous privileges, tax-free property holding and power in local administration. Rumor had it that the family even had the right to kill. But the family had been deteriorating slowly and by mid-thirties was a shadow of what it used to be. The royalty was passing under clouds too. The breeze of democracy wafted though the country; royal supremacy came under threat and privileges of aristocracy stood questioned. In a way, wealthy families such as Poonezath Tharavad were the victims of changing times.
The tradition in the Nair families up to the second quarter of the twentieth century was marumakkatayam, inheritance of the properties by the females and their children. A royal decree later changed this. Yet, Poonezath Tharavad, like many others, followed the old practice. They would gradually switch over to makkathayam, inheritance by the males. Jayarajan was born during this transitional period. Sri Chitra Tirunal Balarama Varma was the ruling Maharaja.
Jayarajan grew up in the company of his cousins, boys and girls, numbering well over a dozen. Inevitably, life was a continuous competition among a bunch of aggressive girls and boys. Everyone would survive, but the most competitive survived better. Early in life, Jayarajan developed the determination to fight his way through obstacles on to success and comforts. The family was not poor. However, it did not appear affluent either. They did not struggle for existence, had ample, though simple, food and sufficient cloths. Nothing extra, no frills. Jayarajan never knew if the simple life resulted from relative poverty or miserliness. Financial status was a secret.
The source of family income was agriculture, mainly paddy and coconut. The whole family held the estate and the Karanavar managed it. Every nuclear family in the tharavad had a monthly allowance. Early in life, Jayarajan saw how his hapless parents depended on the Karanavar for their simple needs. His father, Kesavan Nair, was leading a hollow, worthless life.
Every evening when he returned after school, Jayarajan went to his mother. He was glad to be with her. She did not have much time; but she listened; she gave him something to eat.
’�Amma, why do we’ve so many in the house?’�
’�We’re a large family. Why?’�
’�See, Jose has only his brother, father and mother in his house!’�
’�Jose?’�
’�My classmate.’�
’�They’re Christians! Don’t have combined families, live separately.’�
’�Why?’�
’�That’s their custom. We’ve ours.’�
’�Oh.’�
’�You don’t like?’�
’�Don’t know.’�
’�We live together; isn’t it nice?’�
’�Hum. Why Achan’s not working?’�
’�No one in the family works; we’re landlords.’�
’�How do we live?’�
’�How do we live? What’s it?’�
’�Money, where do we get?’�
’�From our property. Valliammavan collects from our property. We get it from him.’�
’�So we’ve to get it from him?’�
’�Yes, but it’s our money.’�
’�What’s Achan doing? Singing all the time?’�
’�They’re reciting poetry. It’s a brainy pastime.’�
’�Just passing time?’�
’�That’s how they spend time. And they play chess, it’s also brainy.’�
’�If he worked he could earn money.’�
’�We’ve money.’�
’�From Vallimmamma, no?’�
’�From our property.’�
’�But we don’t ’�ve enough money, do we?’�
’�We’ve; we don’t starve.’�
’�But do we’ve money to spend?’�
’�We’ve food, clothes, you’ve books; what else?’�
’�Hum ’� see, I wanted a cycle.’�
’�A cycle? Why do you want one?’�
’�I can peddle my way, fast, to school.’�
’�You don’t need one. All our children walk. School isn’t far.’�
’�Jose has cycle. Beautiful, new cycle.’�
Sarojini Amma was silent. She was beaten. They cannot afford a bicycle for their only son.
’�We don’t ’�ve money, no Amma?’�
’�We’re not poor.’�
’�But no money for cycle!’�
’�You don’t need one.’�
’�Isn’t it because of poetry?’�
’�Poetry? Rama Rama! What’s that to do with money?’�
’�Achan and Ammavans go on reciting songs. Do no work. No money, only poems.’�
’�No, no. They don’t work, they’re aristocrats. That’s why they don’t work.’�
’�I don’t know!’�
’�Poetry’s because they’ve time.’�
’�I hate poetry.’�
’�Why?’�
’�I’ve no cycle because of it.’�
’�No Kutta, it’s not poetry! They don’t work. Poetry’s only to spend time.’�
’�I don’t know.’�
’�But it’s changing. See, you’re going to school. We educate you, children. Now you learn well, get good job! No poetry, see?’�
’�They didn’t go to school? No study?’�
’�No, not much.’�
’�Ha! But we’re sent to school.’�
’�Yes, we now know the importance. Study well and you’ll do well.’�
’�Yes.’�
’�We’re glad you study well. Bhagavane! We’ll see you’re well educated. You can be doctor! Or ICS! Your teachers say you can do that.’�
’�Really?’�
’�Yes; promise.’�
Jayarajan felt good.
’�Teachers didn’t tell me.’�
’�They told Achan. See, your sisters and cousins are not able to study well. Only you!’�
’�Amma, you’ve no time for anything but cooking.’�
’�Who’ll feed you?’�
’�But always?’�
’�There’re so many to feed.’�
’�Why don’t Achan do it?’�
’�What! Rama Rama! Achan working in the kitchen? No, no. You know it’s not done.’�
’�You’ve no time for me or Chechies. We do everything alone.’�
’�What? You’ve to study, I can’t study for you.’�
’�Jose’s mother even bathes him.’�
’�You’re grown up.’�
’�Jose also.’�
’�What do you want me to do?’�
’�No Amma. I want you to tell us stories, be with us.’�
’�Oh, c’mon.’�
’�Hoo hoom.’�
Sarojini Amma gave him a dosha. Munching it he asked, ’�Amma, Vallimmamma’s a man, very powerful; has all money. He controls everyone here.’�
’�Yes.’�
’�But other men are useless!’�
’�Shh. Rama, Rama, don’t say things like that.’�
’�Oh. But other men are doing nothing.’�
’�So?’�
’�Is that why they don’t get property?’�
’�No. It’s our custom; goes to women.’�
’�But Vallimmamma’s man.’�
’�Yes. He controls it, because he’s Vallimmamma.’�
’�Vallimmamma and women! Not fair.’�
’�Why?’�
’�Why to women?’�
’�That’s the custom.’�
’�Not good.’�
’�Bhagavane! You change it!’�
Jayarajan developed a gender bias and male chauvinism quite early in life.
’�You got property; what’s use? You work hard in kitchen. Property’s with Vallimmamma.’�
’�Our duty.’�
’�Why not men?’�
’�Custom.’�
’�You hardly go out.’�
’�Custom and tradition.’�
’�I hate that.’�
’�What? Hate custom?’�
’�Yes.’�
’�Bhagavane! Don’t talk like that.’�
’�Why?’�
’�We follow customs, for generations.’�
’�How can I be Vallimmamma? Study hard? And one day I’ll become?’�
’�Why do you want? Ha, ha.’�
’�He’s very powerful. Has all money.’�
The family manor was a sprawling, single-story building with thatched roof of seasoned coconut palm leaves, and walls of limestone and lime-plaster. Wood was used liberally. The interiors were dim and cool. At the center was a big wooden rice barn. Long, narrow, dark and entwining corridors with shadowy nooks and dusky corners stretched the breath and length of the building. The floor was paved with cow dung. There were several rooms, but they provided no privacy. The plan allowed entry from one room to the next, with interconnecting doors.
The house was in an extensive rolling ground, full of coconut palms and fruit trees, predominantly jackfruit, cashew, and a dozen varieties of mangoes. The fruits were for consumption, never for sale.
A small modern toilet, away from the house was added recently. Only some elders used it. The toilet for others was an open ground, surrounded by a fence, in one remote corner, with a pond for washing. The bathrooms were by the side of a big pond. One would take a dip in the greenish pond and then use the bathhouse for drying.
Every year a group of workers, retainers of the family, would dry and clean the pond. It was a ritual. A basket made of bamboo cane literally swept or lug the water out. Long ropes were attached to this basket, along the top rim and at the bottom. The battery of workers by deft movements of pulling and subtly releasing these cords, filled the basket with water in the pond, and pulled it up. As it reached the ground, in a swift, rhythmic, uniform movement, they tilted the basket and drained the water. Pulling the basket up and then after draining, putting it back again to carry more water, was a well-coordinated, rhythmic, team movement. They did it with the poise and beauty of well-trained performing artists. Jayarajan was never tired of watching the black muscular bodies graciously moving like those of ballet dancers. They would sing old, folk songs in tune with the continuous, elegant, fluid movements.
The pool cleaning was a festival for the children. They were allowed to play truant and enjoy the fun, the one big concession for amusement and frolic. Making maximum use, they played in the muddy water, from morning to dusk.
It was usual to pamper and spoil the last child. However, some parents were already tired of the burden of rearing children by the time their last child arrived. When Jayarajan was borne, his middle-aged parents were weary. The strain of living in an extended family had taken its toll too. His parents left young Jayarajan to look after his affairs. However, he did not feel this neglect much; growing up with so many children was fulltime business. In a way, it was fun; but it was also intensely competitive. There were opportunities too, opportunities to lead, fight and win.
’�Amma! I was first in the class!’� declared Jayarajan.
’�Oh good!’�
’�And I won games too.’�
’�Really? But you must concentrate on studies.’�
’�Yes amma; but games are important. Winning’s grand. Boys cheered me!’�
’�But to become big, study’s important.’�
’�Yes, Amma; but I want to win games.’�
’�Not very important.’�
’�But I like it.’�
’�But don’t neglect studies!’�
’�No, I study. But games! Good to win, better than first in class.’�
’�Bhagavane, for future, exams are important.’�
’�Yes, but boys cheer games, not in class.’�
’�But ’�’�
’�It’s great, Amma.’�
’�Yes.’�
’�I’m the captain of the team.’�
’�Oh!’�
’�Captain’s very important. When we win I get the prize!’�
’�Don’t neglect studies.’�
’�Amma, you always say study, study. Nothing else.’�
’�Rama, Rama.’�
’�They, other team, lost and were hooted.’�
’�What else? They lost.’�
’�That’s what I said.’�
One day when Jayarajan went to the kitchen he found an angry Sarojini Amma.
’�What happened in school? What did you do?’�
Silence.
’�I know, Chechi told me. Why did you misbehave? Why did you fight? Tell me!’�
’�No. Other team fowled.’�
’�That’s not what I heard.’�
Silence.
’�You always misbehave when you loose.’�
So his mother knew. No point denying.
’�Good boys don’t do it.’�
Silence.
’�Say you’ll not repeat it. Promise.’�
Jayarajan felt humiliated.
’�Say that ’�’�
’�I’ll not repeat.’�
But both of them knew he would. It was reflex. That same Jayarajan, later in life, would browbeat his critics.
But now he was scared about his mother’s wrath.
’�Don’t be angry! I wouldn’t do it, promise.’�

Chapter 5

’�Jayaraja, come here,’� Kesavan Nair called his son.
’�Yes, Acha.’�
’�What’d you do? Radha has a bruise!’�
’�Bruise? I did nothing.’�
’�Then how’d she get it?’�
’�How do I know!’�
’�You lie, I’ll beat you up.’�
’�Acha!’�
’�Shut up. Why’d you do it?’�
’�Hum hum.’�
’�If I see this again ’�’�
’�No. No.’�
’�She’ll revenge when you two get married!’� Nair laughed.
Jayarajan scooted.
Radha was his aunt’s daughter. According to the custom, she was to be his wife. It was but natural for children, thus betrothed, to become self-conscious and embarrassed. They faced good-natured banter. Later, many of them would be in love with each other. Several of these affairs, nurtured by the elders, would end up in weddings. However, not all had fairy-tale ending. Some ended up in tragedies, one-sided love, rejected offerings, forced weddings and broken-up romances.
From his father, Jayarajan went straight to Radha.
’�Do you think I’ll get beaten? Ah, see, I was beaten,’� he mocked. ’�Hoo hoo hoo ’�’� he feigned weeping.
’�You’re a bad boy.’�
’�Ha, who wants your certificate?’�
’�But I like you.’� She laughed.
’�I hate you.’�
’�Hum, wait. I’ll show you.’�
Jayarajan ran away.
’�You don’t like me? I’ll show you; I’ll beat you till you like me.’�
Jayarajan did not know when he became conscious of his girl. In fact, he did not remember when he was not aware of Radha as his girl. But Jayarajan did not like that. He found the convention, that he should love one girl because of birth, abhorrent.
’�Radha’s such a good girl,’� Jayarajan repeatedly heard his elders say, ’�Jayarajan’s lucky.’�
’�Yes, but he’s a good boy; look how his studies go. She’s also lucky.’�
Then Jayarajan happened to overhear his parents’ conversation.
’�Radha’s not demure,’� said Sarojini Amma, ’�She’s too noisy and rude.’�
’�Yes, she doesn’t act like ladies of aristocratic family.’�
’�Yes, she’s a tomboy. Didn’t matter when she’s a small girl. She’s grown up now. She should be ladylike, quiet and graceful.’�
’�Yes she’s old enough! She’s fighting with boys.’�
’�True.’�
’�But, one thing, she’s playful only here. Outside she’s well-behaved.’�
’�But, here also she should behave.’�
’�Yes, that’s true.’�
Jayarajan was surprised. So they did not like Radha. This affected Jayarajan more than he thought possible. He always believed he disliked her. Suddenly, Radha appeared desolate. In a strange way, he had a sense of loss. Something he had taken for granted was suddenly snatched away.
Jayarajan watched Radha. She was unchanged. She was fond of him. She fought with him. Then she made peace with him. She adored him. To his surprise, now, Jayarajan felt compassion. As time passed, the compassion turned into affection.
Meanwhile, Jayarajan overheard his parents’ conversations here and there. One day he heard a little too much.
’�Have you thought about Jayarajan’s future?’� Sarojini asked Nair.
’�Future? What future? He’s studying, isn’t he? Too young to plan future.’�
’�Oh? His school? Is it good enough?’�
’�Yes, he’s regular to school. Teachers - I talk to them -they’re satisfied. His marks are good.’�
’�Bhagavane! So you’re satisfied. His future will be great?’�
’�I don’t understand. You’ve something in mind? Say clearly.’�
’�This school here. It’s no good. Send him to good school.’�
’�Send him! Where? How? All our children from Tharavad go there. That’s our school. Ever since we started that school our children studied nowhere else.’�
’�Ha! See what happened to all children? Anyone got a good job? One doctor? They’re all loafing around, doing nothing useful. Just eat in family kitchen.’�
Nair was silent. It was true. He was part of that truth too.
’�See, Jayarajan’s a bright boy. Don’t let him grow up as useless ’�’� The silence was eloquent.
Humiliated, Nair remained mum.
’�No child here’s as bright as my Jayarajan. I know what teachers say. He can go on to be doctor or engineer, even ICS.’�
’�Oh, yes. But, he’ll start college after years.’�
’�Don’t be stupid. For future he’s to study well, in a good school.’�
’�How can he go to another school? All other children are here.’�
’�Other children’s not your concern. Our daughters study here. They’ll continue; they wouldn’t study well. They’ll be married off. For Jayarajan we’ve to do something.’�
Nair sighed. ’�If you say so.’�
Experience had taught him when his wife set her mind on something it was as good as done. He also knew that time will prove her right.
’�Yes.’�
’�What do we do now?’�
’�We’ll send him to the Boarding School, next year.’�

Chapter 6

Just about when Jayarajan started his schooling, George Thomas was born into an upper-middle class Orthodox Christian family. His father was the scion of the Murippalathu Family, a wealthy but otherwise undistinguished dynasty. The old-styled family mansion was in a palm-fringed costal village along the western seashore in the Southern Indian Peninsula. George was the only child of his parents. Naturally, they pampered, over-protected him.
The family traditionally avoided using the family name with their names. George’s father was Thomas and grandfather, George. So George’s father was Thomas George. However, people called him Thomas Muthalali, roughly translated, ’�rich owner.’� George inherited his grand father’s name. His full name was Murippalathu Thomas George, but officially, ’�George Thomas.’� This had one advantage, as George found out later. He could use ’�Thomas’� as the surname. Having a praenomen and cognomen was important, especially in societies used to ’�first name basis.’�
Murippalathu Family lived in the kingdom of Cochi, a small patch of mostly agricultural land tucked in between the princely state of Travancore on its south and the District of Malabar, under the British, on its north. These three provinces together formed the narrow land strip called Keralam, with the Arabian Sea on the west and the mountain range of Western Ghats on the east, united by a common language, Malayalam. Despite the political diversity, the shared language fired the imagination of its people for a united Kerala State.
When young George was old enough to start school, Muthalali asked his wife, ’�Georgekutty’s getting old, ready for school.’�
’�Eeshoye! True.’�
’�What do we do?’�
’�Send to school.’�
’�Yes, but ’�’�
’�What?’�
’�Should we?’�
’�What? No education, Eesho! What’re you saying?’�
’�No, you dimwit! He’ll study! But which school?’�
’�Let it be June.’�
’�But we’ve to decide now.’�
’�Our school, Government Primary School here.’�
’�Do you ’� should he go to that school?’�
’�I know it’s not good. But where else?’�
’�Yes that’s what!’�
’�Oh, he’s very young, Eesho! Do you want to send him away to boarding school? Poor Georgekutty.’�
’�No. Yes, he’s young.’�
’�Then?’�
’�I’m thinking.’�
’�Tell me. I’m scared. Eesho.’�
’�He shouldn’t go away, no hostel. And not this school. Then what?’�
’�You tell me; what you’ve in mind?’�
’�Let’s teach him here, in our house!’�
’�You’ll teach? Eesho!’�
’�No, silly. Private masters come here and teach.’�
Until about the age of nine, George grew up with little understanding of the real world outside. He had a lonely childhood.
George seldom had playmates. He was an imaginative child and devised simple games to overcome boredom. He roamed the vast compound with sticks. His imagination turned the trees and bushes into humans. The trees with flowers were women. He assigned responsibilities and tasks to those tree-men and women. He would beat up the trees that misbehaved or disobeyed, his imagination going wild. However, most of the time, he was pensive and struggled to be contended in his lonely world of fantasy.
George did get opportunities to play with children when his cousins visited. He would then realize what he was missing. That saddened him. Nevertheless, often the boisterous cousins frightened him. George was not used to loud and rude behavior, common in the playfields. Occasionally other boys bullied him. He would be at the verge of tears. That would excite the boys to taunt him further. George, with tears running down his soft cheeks, would run to his mother for consolation.
’�Georgekutty, you’re a big boy. Be brave. If you’re bold they’ll stop teasing. Don’t weep; that’ll only make them happy!’�
George would sit in her lap, lean against her body and relax in her bosom. Despite her advice to be brave and manly, she pampered him. She cuddled him.
George loved his father. However, the relationship was stiff. Muthalali was reserved, stern and emotionally cold. But, he dotted on his son and indulged in giving him presents. Most often, his presents were books. From very young age, George became an avid reader. Loneliness and reading became a great combination and they played a major role in George’s character formation.
The struggle for independence that raged in the British ruled India was not a major mass movement in Cochi. Some politicians demanded people’s rule. The maharaja yielded some powers and a popular government was elected. Even these subtle upheavals made little waves in George’s village. Part of an island, his village was isolated from the mainstream life. Even the subtle struggle for independence in the relatively secluded land, distained to be Kerala, did not reach his village.


Chapter 7

The school in question was the nearest private residential school. It was too far away for commuting daily. That transformed Jayarajan’s life drastically. He had to live in the hostel.
Jayarajan’s parents approached the Karanavar.
’�Ammava, Jayarajan’s a good student,’� Nair said.
’�Good. So?’�
’�Our humble request! Send him to a good school.’�
’�What! Our school’s not good?’�
’�No, it’s good.’�
’�Then?’�
’�A better ’�’�
’�No. Good’s good; no better.’�
’�But ’� He study well. If he’s sent to Boarding School his chances will be better. He could become doctor. Please ’�’�
’�Alright! Send him wherever. bUT you find money.’�
’�No, please ’�’�
’�No. Where do I get money? I don’t harvest money from trees! To send all children to Boarding School!’�
’�But ’�’�
’�I’ve nothing more to say. If you’ve money send him!’�
As days went by, Jayarajan’s parents were increasingly worried.
Nair kept asking his wife, ’�How’re we going to raise money? Jayarajan’s got admission. But, fee, huge amount! What’ll we do?’�
Jayarajan felt pity for his father. A male was asking his wife the means to educate his son. What a shame!
’�God will show us a way. It’s for a good cause!’�
Now, Jayarajan was sure that his mother had already found a way. He knew that his father also knew that.
Again and again, Jayarajan heard his parents’ worried and anxious talk. His mother put pressure on his father, knowing that he would fail. Perhaps she wanted to make that failure obvious. What a clever woman!
’�Alright, we’ve no other means,’� Jayarajan overheard Sarojini.
Jayarajan was alert now. Perhaps they were dropping the idea.
’�You didn’t find a way. Rama Rama! Now, take my jewelry. All this gold. You sell it. Or, maybe you can pawn it. I’m getting old. What’s jewelry for me?’�
Nair did not speak.
’�Our daughters, they’ll have no gold! Pity. Bhagavan will show us a way!’�
Jayarajan was surprised. Touching! But, what he saw affected him such more. His father was in tears and quite spontaneously, took his wife in his hands for a passionate hug.
’�Oh, what’re you doing? Someone might see. Hush, we’re not children.’�
Yet, she made no effort to stop him or to move away. Instead, she just moved a bit closer and submitted her body in his hands. Such show of emotion was not part of that family life. But, they thought they were alone.
A moment’s delay and she tried feebly to push her husband away. With unusual demureness, she said, ’�No, no, someone ’�’� Privacy was not the strong point of that house. Reluctantly they stood away and passionately looked at each other.
’�No, no. We can’t do that,’� said Nair.
’�What?’�
Sarojini suddenly moved away.
’�We can’t sell ’�’�
’�Oh, ornaments! Why not? They’re mine, aren’t they? You take it and get money.’�
Nair was emotional both from the physical contact and from her offer. In his society, a woman considered gold her own private possession. It was, after her chastity and the family, the most prized possession. Giving up gold was a near-supreme sacrifice.
’�No! I’ll sell our share of property. That should give us enough money.’�
’�Don’t be stupid. Impossible! You know it. Property’s not even divided. Do you think Vallimmamma will give our share? How’ll you sell when we don’t have it? Don’t even know what we’ll get. Even if you’ve it, it’s not easy to sell. It’ll take years! If you sell it, how’ll we live?’�
Jayarajan saw that his father was defeated. It was a pathetic sight, the helplessness of a beaten man.
’�Right, if you say. But, I’ll get them back for you, you’ll see,’� even he was not convinced.
Jayarajan again felt pity, a contemptuous compassion, for his father. He vowed that he would never be so powerless a man. He also promised that when he grew up he would get ornaments, more than she was giving away, for his mother.
Next morning Jayarajan heard his mother warning his father, ’�Be careful with what you carry. And take good care of money.’�
Again, a thoughtful and forlorn Jayarajan watched the pathetic figure walking out. He was now sure he was going to the Boarding School. He ran, and on the way, bumped on to Radha.
’�Soon I’ll be going off!’�
’�Who cares?’�
’�You!’�
’�Hum!’� But she was pleased.
’�You know, hostel’s great.’�
’�What’s great?’�
’�Friends, playgrounds, everything.’�
’�Yes? But you’ll miss parents, uncles, everyone.’�
’�But I come see them here.’�
’�Only during vacation.’�
’�Hum.’�
’�Teachers beat students, you know.’�
’�No, no. That’s a lie. Who told you that?’�
’�You’re scared, see!’�
’�No.’�
’�And pond cleaning! You’ll miss it, see!’�
All of a sudden that became an icon of what he would miss.
’�You’re a bad girl. You just want to hurt me.’�
Radha ran away.
Jayarajan panicked. He was leaving his house, parents, cousins and playmates. He was bubbling with self-esteem one moment but was apprehensive the next second. The carefree days were over.
Then Jayarajan went to the completely different world of the new school and dormitory. The year was 1944.

Chapter 8

Jayarajan found his new school serious and intense. The rivalry in the classrooms and playfields was fierce. It had no comparison with the calm and slack life in his old school. The discipline was strict, zealously enforced.
Jayarajan had difficulty keeping up the pace. In the tests, he was not at the top, a blow to his ego. To his chagrin, he could not bully his way through games. There were tougher boys; and the teachers supervised the playgrounds. Homesickness, failure to top in studies and defeat in sports made life miserable. He missed his old school, his playmates and his house.
After a few weeks, Kesavan Nair visited school. In the visitor’s room Jayarajan broke down. He wept unashamedly.
’�Acha, it’s so difficult here.’�
’�What’s difficult?’�
’�I’ve no friends, no one to play. I don’t win games.’�
’�See, you’re here to study. Study well, everything will be good.’�
’�Even exams are difficult!’�
By the time Nair was to leave, Jayarajan started crying again.
’�Acha, I want to come with you. Don’t want to study here. I’ll study in our school.’�
’�How? We’ve spent lot of money. Your mother will be angry.’�
Nair was not good at consoling. If he could affectionately pacify and support his son then, he might have earned his son’s affection and respect. That was a talent reserved for gifted people; obviously, Nair was not that gifted.
Jayarajan cursed his parents for being so cruel. He doubted if they loved him. If they did, they would not have left him in these cruel clutches.
In this frame of mind, Jayarajan reached home during his first vacation. His sisters and cousins received him with warm affection. Yet, strangely, he felt like an outsider.
Radha was coy and reserved. She still talked to him freely, but the fight was gone. He was loosing his childhood, a bit more rapidly than was natural.
Jayarajan knew he had to go back to school. One moment he was angry with his mother. Then he remembered that he was her blue-eyed boy. His sisters and cousins were not good at studies. For that precise reason, they were enjoying life at home. At the same time, Jayarajan knew he was privileged.
’�Amma, let me stay here, with you,’� Jayarajan pleaded. ’�I want to live with you and Achan.’�
’�You’re a good boy. You’re doing well in school, we’re so glad and proud.’�
’�But, I miss you, Amma!’�
’�I miss you too. See, I bear it. It’s for your future. Become great man. You must study. You’re not like other boys. You’re good.’�
She was playing games. Jayarajan was already feeling happy.
’�Cleaning of pond, Amma. Can I come?’�
’�I would’ve allowed. But, teachers. They wouldn’t.’�
’�But, we always did that. We always took leave.’�
’�That’s school here. But, we sent you out because it’s not good. Your school’s different.’�
’�Then, can cleaning postponed? Vacation time?’�
’�You know our traditions. It’s to be in season, Mone.’� They looked at each other for some time. She hugged him, and said tenderly, ’�Mon, you study well. I, we, your father too, want to see you great man. You study well.’�
Jayarajan was angry and disappointed. He showed his anger by not talking to her. He sulked. One moment he felt affection towards his mother but the very next moment he was irate and frustrated. He would not respond when she called out his name. During the night occasionally, his mother would join him in his bed. Usually he responded by hugging her tightly. Now he turned to the other side to show his anger. He spurned his mother’s hug; and tried to brush her hands off.
’�Mone, you angry with me? Why? I’m doing everything for you only. Can’t you see that? I love you so much.’�
Sarojini Amma was proud of her son. She was also pleased that he was closer to her than he was to his father. That was part of her private conceit. Now she could not bear her son’s wrath. If only it was directed to his father. She went on consoling him; then she started sobbing. That touched Jayarajan. Reluctantly he turned towards her and hugged her lightly. She in turn held him close to her bosom. They both dozed off in each other’s arms.
Jayarajan remained morose throughout the vacation. He seldom went out to play. He ruminated about his past ecstasy and brooded over the anticipated misery.
’�Have you noticed Jayarajan? Bhagavane! He’s very gloomy,’� Sarojini told her husband.
’�Yes, I notice. But, why? What’s wrong?’�
’�He’s angry; he doesn’t want to go to school.’�
’�Doesn’t want to go? That’s a joke. What does he want?’�
’�He wants to live here. Rama, Rama! He doesn’t like his school.’�
’�It’s your idea. How much money we spent!’�
’�It’s for him! Don’t now blame me.’�
’�No, no.’�
’�He’s now angry! Bhagawane, why’s he angry!’�
’�He’s a spoiled brat! Don’t appreciate what we do. He should be grateful.’�
’�Yes, it’s true. But, he’s a small child, isn’t he? He’s homesick.’�
’�Hum.’�
Insensitive parents did not realize that a young boy had a mind of his own.
Jayarajan tried one last chance. ’�Amma, I don’t like that place. Everyone’s against me. No one likes me. I’ve no friends.’�
Sarojini Amma’s heart ached. ’�You’re imagining. Try, it’ll work. Just once more. You’ll be happy.’�
’�How do you know? You haven’t even seen my school!’�
’�I know it.’�
Rancor replaced the bond he thought existed between him and his mother.

Chapter 9

’�You know, Georgekutty, education’s the best wealth, nothing’s greater,’� Muthalali told him, ’�You know why?’�
George kept quiet.
’�No one can steal it. Once you’ve it, none can take it away. You can give it away freely. By giving, you only increase your knowledge. And with knowledge you can find ways to make wealth.’�
With a triumphant air, he looked at his son. Occasionally his mother piped in her worldly wisdom, ’�Everybody’ll respect learned; only needy pay respect to wealthy and only at time of need.’�
With minor variations, these sessions recurred through his childhood. Throughout life, George remembered their sermons.
Secluded in his house, George was socially awkward, with none of the graces life demanded. His parents were interested only in conventional education.
Murippalathu family had several servants, men and women. Many of them, from time to time, doubled as George’s playmates. Naturally, they obeyed his commands without question; George took it as normal. A different response upset him; he would panic and withdraw into the shell.
His parents did not advise George directly. Instead, they talked to each other or to someone else in his presence. He was not sure if they did it intentionally. But, the effect was unequivocal. He understood what his parents expected from him.
One day a neighbor came to his house to gossip. While talking, he dropped a bombshell: A youngster from an aristocratic family was having an affair with a girl of different cast from a poor family.
’�Raman Nayarre, don’t blame someone unless you’re sure,’� objected Muthalali, ’�Verify first! I know that boy; he’ll do no such thing. And, that family! Direct descendents of the royal family! Olden days, they’re virtual rulers. Don’t say things that’ll displease God.’�
’�How do you know it’s not true? Eesho,’� his wife intervened, ’�Nair wouldn’t say if he’s not sure, would he?’�
George listened silently.
’�Yes, I’ve seen with my own eyes,’� said Nair. ’�I saw them talking secretly. Meet regularly at temple. I’ve seen them together several times. I’ll not say if I wasn’t sure. You may not know, but the whole country knows it.’�
A bit of exaggeration was acceptable during such discussions. The ’�whole country’� meant a good number of people in the village.
’�Does his family know?’�
’�How do I know? Who’ll ask them! Or, tell them! Who wants to get murdered! I don’t know. But, if they knew, Shiva, Shiva, a big hullabaloo.’�
’�But, if true, it’s their own fault.’�
With an innocent look on his face and an innocuous tenor in his voice, Nair asked, ’�Why? How’re they responsible?’�
’�Simple. His parents should’ve brought him up properly. Then he wouldn’t go astray. Now, look at our Georgekutty. He doesn’t even look at a girl’s face.’�
George was intrigued. They talked as if he was not there.
’�He’s too young for all that!’�
’�Eesho! Just look at him! We know how he’s growing. Needn’t look far ahead. Character shows even at tender age. Eesho! You’ll see how we raise him!’�
With a firm, vigorous shake of his head, Muthalali concurred.
That was another tutorial for George. He shall not look at a girl’s face. He filed it in his mind, yet one more commandment. He was a good student, an obedient son. He will not disgrace his parents.
Even when playing with the servants, George avoided women. It was not a conscious act. His society was straight-laced. Later, in outside world, he noticed how spontaneously his friends and colleagues established friendship with women. But then, he could not forge deep friendship with anyone, even men, easily. George simply panicked in adult company.
When George was a bit older, his mother chose to advise him directly.
’�You know, Georgekutty, you’re a very fortunate boy.’�
He wondered how he was more fortunate than the other boys. It was not a good boy’s lot to question the elders.
’�You’re the only child! You’ve caring, loving parents. You’re intelligent, rich. Eesho, God’s kind to you. To us too, because our ancestors were good, they did many good things; they’re God-fearing, said prayers and went to church. We continue. What we reap is what our ancestors sowed. We live for our children.’�
George did notice that the reference to offspring was in pleural. It was a generalized statement; not just about his parents. He was grateful for the little mercies.
’�Eeshoye! See, now, many want to share it or even steal it from you. How do I say?’�
She was embarrassed, but continued.
’�You know, the easiest way to get rich is to marry a fortunate boy. There’ll be many girls! They try to hook you. Eesho! Don’t fall into their trap. Don’t let anyone take advantage.’�
She stopped abruptly and walked out of the room.
Later, George realized that his parents were very, very possessive. They did not want to share him. However, that realization came later.
When India ultimately became independent in 1947, George’s household hardly took note of it. George remembered his father’s comment.
’�See, the English’s going from here. That’s, the Englishmen. But, English language will stay on. You’ll see.’�
No one contested that. George continued his schooling at home oblivious of the changes. However, his father made sure that his son learned English well.

Chapter 10

When Jayarajan left home after vacation, he was sad, but wiser. He had learned a serious lesson. Being good need not ensure comforts; privileges were not always pleasant. But, then he might do better in life; but that ’�better’� might not ensure comforts. His determination to succeed was a shade less than it was before.
Hostel rules set apart specific study time. Sincerely, Jayarajan sat in front of the books; but his mind wandered. He read; but he did not understand. When he thought about the wasted time, he felt guilt and disappointment. Inability to study, even when tried earnestly, was a serious thing. This never happened before. He panicked. That rekindled his anger, with the embers glowering like midsummer sun.
But after a few days of slump, his mood would be normal. He could study. He worked hard and caught up. However, he spent more time worrying about lost time. He did not understand these cycles. He wondered if others had the same problem. Jayarajan sadly realized that he had no one to talk freely to.
One night Jayarajan, one of the 12 boys in the dormitory hall, was sitting at his desk, trying to read. Unknown to him, someone was watching.
Koshisar, the warden, was an aged teacher. He was in reality, but not in records, well past his retirement age. Now he walked slowly to Jayarajan. He realized that Jayarajan was not concentrating on studies. He stood behind Jayarajan for some time.
After a few minutes, Koshisar tapped Jayarajan’s shoulders. He woke up with a start and stammered something. But Koshisar stopped him by a wave of his hand. A spontaneous ripple arose in the hall. Koshisar gestured Jayarajan to follow him to his room. That was strictly against regulations; but Koshisar was beyond rules.
Koshisar made Jayarajan comfortable in a chair. However, Jayarajan was distressed. Then, slowly in a kindly voice the old teacher asked, ’�What’s bothering you?’�
Relieved that the silence was over, Jayarajan started to say something, but could not.
’�I’ve been watching. You sit by the books, but study nothing. ’�m I right?’�
’�Oohm,’� burbled Jayarajan.
’�What?’�
’�sir, ha, at times I can’t remember what I read; I can’t study.’�
’�Oh, that’s serious. Why?’�
’�Don’t understand.’�
’�Strange.’�
’�Oohm.’�
’�What?’�
’�Hoomhoom.’�
’�You’d this difficulty before?’�
’�Hoom hoom.’�
’�What?’�
’�Never before. Only after coming here.’�
’�Started here?’�
’�Oohm.’�
’�Do you’ve friends, here?’�
’�Oohm.’� he started to say ’�yes,’� then changed, ’�Hoomhoom.’�
’�Hum. Not good. Did you’ve friends there, old school?’�
’�Lots, sir. And many cousins at home.’�
’�Tell me about them.’�
Jayarajan became voluble. In about an hour Jayarajan bared his past, only occasionally, and that too towards the end as he became increasingly confident, spicing his account with superlative exaggerations. Koshisar just listened.
’�You miss your friends, your home?’�
’�Oohm.’�
’�Good boys talk. Don’t just grunt.’�
’�Oh, I miss home and my school.’�
’�My school? This is your school! No?’�
’�Hum, yes sir.’�
’�Why no friends here?’�
Jayarajan did not answer.
’�Try to make friends. There’re good boys here. Maybe they’re looking for friends. They’re there; you just ’�ve to reach out.’�
Again silence.
’�Who knows, you might help them; they need support.’�
’�Oh, I didn’t know!’�
’�Now you know.’�
’�Oohm, I mean, yes.’�
’�Good.’�
’�I didn’t know. Didn’t think that way.’�
’�What way?’�
’�Others need friends.’�
’�Yes, yes, it’s true. Friendship’s a two way street.’�
’�Yes!’�
’�So you try.’�
’�Yes sir.’�
Jayarajan already felt better. The ’�helping others’� bit was intriguing. In his short life, none had put it to him that way.
An elated Jayarajan walked into the hall. He attempted a smile.
Next a few days, he tried to befriend boys. It was not easy; response was not spectacular. It was impossible to change attitudes overnight. Jayarajan had a change of heart; but other students did not know!
The best thing was not the friendships Jayarajan cultivated. It was his deep bond with Koshisar. The warden became a father figure, filling the void that grew ever since he left home.
Eventually Jayarajan succeeded in forging some friendship. However, he had difficulty sustaining them, because of his tendency to argue furiously. Confronted with anything unacceptable, he reacted fiercely. Friend or foe, his rejoinder was vehement and loud. He was pedantic.
Arguments among friends were common. However, Jayarajan could not disagree with civility. He turned every dispute a personal fight. Intelligent and logical, he often could outwit and baffle his friends. He won the argument but hurt the friendship. Later he might regret, an empty victory in a worthless argument spoiling friendship. But, he never mended his ways.
Though he expected his friends to take the debates as part of normal life, he seldom took them as such. As in the playfields, in arguments too, he could not take defeats, not even differences of opinion, gracefully.
Nevertheless, his friendship with Koshisar was sustained. It was more respect than love. Therefore, he dealt Koshisar with diffidence. When opinion differed, Jayarajan contained his views.
Jayarajan did not always heed to Koshisar’s advice; he only feigned acceptance. There was a difference between the teacher’s affection and parents’ love. Koshisar had no stake; his love was Platonic without any expectations for future. His parents had hopes about his future, maybe good performance, good job or wedding from wealthy family.
The bond with Koshisar was no substitute for friendship. But, Jayarajan developed much-needed confidence. Koshisar acted as a catalyst.

Chapter 11

Next summer Jayarajan reached home determined to brag. He had reconciled.
’�We’ve beautiful playgrounds! Separate for each game,’� he told his cousins.
’�What games?’�
’�Football, basketball, badminton, volleyball ’�’�
’�Real football field?’�
’�Yes!’�
’�It’s big?’�
’�Yes it’s. Next year we might have hockey and cricket.’�
’�What do you play?’�
’�Football; sometimes basketball.’�
’�You in the school team.’�
’�I’ll be in class team next year.’�
’�Oh!’�
’�But it’s not like here. Team’s very good. Real champions. Our class team’s better than school team here.’�
’�Which team?’�
’�Every team!’�
’�But we’ve only volleyball team.’�
’�That’s what! Our school team’s very good.’�
Radha was a silent listener. But she caught him up alone later.
’�You’re bluffing, no?’�
’�Bluffing what?’�
’�About games, teams.’�
’�No, no. Who told you that?’�
’�I know.’�
’�You don’t know at all.’�
’�Don’t bluff to me. I know you well!’� She looked at him mischievously. ’�I know everything about you! I’ve seen your mind!’�
Jayarajan’s parents noticed the change.
’�Jayarajan’s happy now,’� said Nair.
’�I think he adjusted in school,’� responded Sarojini. ’�Thank Deities. Bhagawane!’�
’�Yes, good.’�
’�But, I’m not sure if he’s happy.’�
’�Why? I think he’s happy.’�
’�Hum, he’s, sort of, detached; not the old boy any more!’�
’�I didn’t notice any change!’�
’�You’re not sensitive. You don’t understand him. Anyway, he’s not very close to you.’�
’�Why you say that?’�
’�He’s sort of scared of you.’�
’�Scared of me? That’s a joke! Anyway let it go!’�
Awkward silence for some time.
’�Anyway, he’s close to me, my darling. This time I noticed changes.’�

’�What changes?’�
’�I told you. He’s not the old boy. Suddenly, he’s grown up! He’s distant, aloof. He’s, sort of, artificial.’�
’�But, why?’�
’�Maybe he’s growing up fast. Managing things on his own, isn’t he? He’s independent.’�
’�That’s good for him!’�
’�Why? Yes, maybe. Anyway we can’t do anything now.’�
’�But, I think he’s happier now; he’s cheerful.’�
’�I’m not sure. I feel he’s putting it up. He’s unhappy; he’s angry.’�
’�He’s angry? With us? Because we sent his?’�
’�Possibly. He wanted to stay back. Last vacation he pleaded with us, didn’t he?’�
’�But, it’s for his good.’�
’�At this age he wouldn’t understand that.’�
’�Then, what do we do?’�
’�Rama, Rama! Nothing. He’ll get over. We can’t do anything now.’�
Jayarajan played and frolicked with his cousins. Radha was aloof. She was growing up fast. He missed her fights.
Jayarajan went back to school without fuss. He still found the school life demanding and hurting. But, slowly he came to terms. He, without knowing it fully, had worked out the relative merit paradigm. He could be first among an undistinguished crowd or way down in a more elite group. His fate was not his choice. Now his parents tried to define his destiny. Ultimately, fate would decide what he had to be. Because his parents, rather than fate, were responsible for his present plight, he was angry with them. That was a source of conflict. In his culture, parents and teachers had a place close to God.
India, a heterogeneous conglomerate of numerous semi-independent royal kingdoms, British-ruled provinces, diverse cultures and a maze of different lingua, eventually became independent. It was a miracle that this checkered socio religious cultural behemoth could be conceptualized as a single nation. The native kingdoms were integrated into the Union. Thus, in 1947, both Travancore and Cochi became parts of the new India.

Chapter 12

’�I think,’� said Muthalali, ’�He should go to school.’�
’�Yes. Eshoye, it’s time,’� agreed his wife.
George was nine years old and past the primary school stage.
’�Where?’�
’�You tell me.’�
’�I? Where? Boarding School?’�
’�Eeshoye! He’s never been to school. Fist time, and send him away?’�
’�Isn’t he grown up?’�
’�Still a small child.’�
’�He’s going to be 10.’�
’�Do you think he’ll adjust?’�
’�Why wouldn’t he?’�
’�He’s always lived here. Eesho, never been away!’�
’�Let’s think about it.’�
’�Hum. Yes, you decide.’�
George sensed the developments. He did not ask. As an obedient boy he waited.
’�Georgekutty,’� his mother started, ’�This year, you know, you’ve to go to school. Eesho! You’re growing up.’�
’�Yes.’� His heart was pounding. He did not want to go, not to the Boarding School.
’�You know which school you’re going to?’�
’�School here! Where else?’�
’�Boarding School! It’s better.’�
’�Amma!’�
’�Eesho! Why shout?’�
’�No, no. Don’t. I want to ’� I can’t live without you, please!’�
’�Eshoo. You’re a big boy!’�
’�Oh! Please Amma!’�
’�Let’s see.’�
George was confident. His mother would not send him away.
Meanwhile political changes again shook up the country. George was vaguely aware that Cochi with its larger southern neighbor became one state, Travancore-Cochin, locally known as Thirucochi. The Maharaja of Travancore became the figurehead, Rajapramukh. The unassuming, courteous Maharaja of Cochi turned nobody overnight.
That first-of-June morning was an everlasting memory for George. He wore new, expensive cloths, but no footwear. Muthalali may be snobbish and possessive, but he was aware of the local ethos. Later, George would be grateful for this. None in that school wore footwear. If George did, that would be unusual, a conspicuous breach of custom. That was the last thing he wanted.
As usual, monsoon had stared. In poring rain, Muthalali walked his son to the school. Though comfortably rich, they had no car. There were no motor vehicles in the island.
Walking in the rain was not unpleasant. At another occasion, George would have enjoyed it. Now he was frightened. He clung to his father’s hand. His face was pale and eyes were full. When he was lead into the school office, he was sobbing. The formalities of admission over, Muthalali led his son to the classroom.
Malathyteacher, George’s class teacher, was a kindly soul. She knew Murippalathu family and understood the boy’s discomfiture.
’�Teacher, George’s in school first time.’�
’�I know.’�
’�He’s a bit scared. Shy, not used to school’�
’�Don’t worry. We’ll take care. He’ll be alright.’�
George looked pathetically at his father walking away. Surely, he felt, had it been his mother, she would not have left him there and gone. Years later, he was amused at his confidence in his mother! How unrealistic! A nine-year-old boy should have realized that. The year was 1951.
George sat on the front-row and listened to every word the teacher said.
’�George,’� Malathyteacher asked, ’�Have you studied all these? You know the alphabet, aha, ahaa, all of them?’�
’�Yes sir.’�
The class laughed; George was surprised and upset.
’�No! Silence! You call me teacher. You address masters as sir. Understood?’�
’�Yes sir.’�
Again laughter. The teacher too smiled. George panicked.
’�No. Teacher. Yes teacher!’�
The class went wild. Malathyteacher let it go. She had no cane in her hand.
’�So you learned all these at home?’�
’�Yes, teacher.’�
When the teacher left after the class, some curious boys gathered around George.
’�He’s Muthalali’s son!’�
’�So he’s Kochumuthalali!’�
Derogative laughter.
’�What’s your name, Kochumuthalali?’�
But to George’s relief the class resumed. Later in the day, Malathyteacher caught a boy for some mischief. The boy was the oldest in the class.
’�Thomas, stand up! What’re you doing?’�
’�Nothing, teacher.’�
’�Were you listening to me?’�
’�Yes.’�
’�Tell me what I taught now!’�
No answer.
’�How many times you failed in this class?’�
’�Only once.’�
Students laughed. But Thomas was unconcerned.
’�How many time in last class?’�
’�Twice, teacher.’�
’�Still you don’t study! No attention!’�
Then she took out a cane from the drawer.
’�Show your palm.’�
The slashes were not severe. Malathyteacher, though angry, was still gentle. Thomas did not wince.
’�Now you stand up on the bench.’�
That was the ultimate classroom punishment. George seeing the third-degree almost fainted. But the victim was unconcerned. Canes and slashes were common in the classrooms those days.
During the break, students gathered around Thomas. George noted that several of them were older than the average student. They must have failed before.
’�Hey Thomma, how’s the cane?’�
’�Oh, nothing. How can women beat? No force.’�
His friends laughed.
’�No pain?’�
’�Mosquito bites!’�
’�C’mon, don’t bluff!’�
’�No! Only Madhavanmaster can thrash. He’s terrible; like whiplash!’�
’�You’re well experienced!’�
’�Yes! I’ve seen them all. Can take anyone but Madhavanmaster.’�
’�He’s a devil.’�
’�Hush. He might hear!’�
’�You seen his cane?’� Thomas showed his thumb, ’�Really this thick!’�
’�He regularly oils it, perfect!’�
George was horrified. Later, much later, George realized that the sadism was more with the students than with the teachers. Madhavanmaster just happened to be a strict disciplinarian.
George confided his fears to his mother, ’�Amma, you know, teachers are cruel.’�
’�Cruel! Easoye.’�
’�They beat up students.’�
’�Only bad boys.’�
’�No, everyone.’�
’�Anyone beaten you?’�
’�No, not yet.’�
’�See! Only bad children.’�
’�Not sure.’�
’�Yes, it’s.’�
’�One thing, you’re right! Boys are real bad.’�
’�Why, how bad?’�
’�They fight, shout, ridicule!’�
’�Don’t make friends with bad boys.’�
’�I wouldn’t. But girls are, well, sort of, decent.’�
’�Ha, they maybe not rowdy. But be careful. Boys shouldn’t, no friend with girls.’�
’�Why?’�
’�That’s how it’s.’�
’�Too bad. Some are real nice.’�
’�But, careful.’�
The boys and girls were segregated, sitting on either side of the aisle. Girls hardly talked to and never played with boys. The teachers enforced the barrier.
One day, as the class gathered, George noticed some girls chewing.
’�What’re you eating?’� George asked the girl sitting by the aisle.
’�Tamarind,’� whispered she.
’�Tamarind? Bitter, no?’�
’�No, it’s sour, but good. Want some?’�
The conversation attracted attention. Her friends pulled the girl as she tried to pass it to George. Boys started shouting. They teased George and the girl. George then realized he acted improperly. He was frightened. He remembered his mother’s warnings. The whole day he worried about possible repercussions. But, apart from some ridicule nothing unpleasant happed.
’�Hi, Malathyteacher is on leave!’� Thomas shouted one morning.
’�Ayeo, who’ll come then?’�
’�Hope it’s not Madhavanmaster!’�
Right then Madhavanmaster walked into the class. That was George’s early experience in terror. The cane-wielding tall man with a thick mustache was not a reassuring sight. During the class, he used the cane when students misbehaved or failed to answer questions; George shivered. He was not worried about pain; humiliation was distressing. His sensitivity tortured him more. Agony was to deserve punishment. He escaped the cane; his answer was right. Yet, Madhavanmaster tapped the desk; George thought Madhavanmaster was disappointed.
The end of the class came as a big relief. Later in life, George often wondered if adults, including he, ever realized how their seemingly simple actions caused agonizing anxiety to a child. That day he did not understand the intricacies of terror. He only experienced it. He decided that he would do everything possible not to sit in Madhavanmaster’s class again.
That evening George was particularly amiable as he sat close to his mother. He leaned against her and caressed her palms. She stroked his head. He tried to relax, but did not quite succeed.
’�Amma, school’s harsh, you know?’�
’�Harsh?’�
’�Very strict.’�
’�Oh. That’s natural; discipline’s important.’�
’�Teachers beat boys.’�
’�Only bad boys. I told you before. Anyone beaten you?’�
’�Hum, no! I saw them beat. Malathyteacher’s very nice.’�
’�You like her?’�
’�Yes, very much!’�
’�Good.’�
’�But, other teachers aren’t so nice.’�
’�You don’t like your school?’�
’�No, yes. I mean it’s good.’�
’�You’re not happy!’�
’�No, no! I’m, I’m.’�
George was worried. He started scheming ways to escape Madhavanmaster’s class. He realized his parents would not help.
One day George asked, ’�Amma, if I fall ill, what do I do?’�
’�Fall ill? Eesho! Did you feel ill? We take you to our doctor.’�
’�No, no, no. Not now. Only, to know if I’m ill?’�
’�Just tell us!’�
’�In school?’�
’�Oh, just tell your teacher. Simple. But why ask?’�
’�What’ll she do?’�
’�Why are you asking this? You’re ill!’�
’�No, no. Just to know!’�
’�They know what to do. They’ll send you to the hospital, or ’�’�
’�Hospital?’� Worse than Madhavanmaster, he thought.
’�Or, they’ll call doctor. No, they simply send you home.’�
’�That’s all?’�
’�Why are you concerned? Must be something. Tell me!’�
’�Nothing.’�


Chapter 13

’�Do you think Jayarajan is,’� whispered Sarojini Amma. ’�Is he fond of Radha?’�
’�What?’�
’�I asked ’� Are you hard of hearing?’�
’�Oh Radhamol?’�
’�What ’�mol?’� She’s Radha.’�
’�Okay, Okay, whatever you say.’�
’�You’ve no pet name for your son. Plain Jayarajan! But, she’s Radhamol! Your darling.’�
’�Just habit.’�
’�Habit!’�
’�Does he really like her?’�
’�Think, liking’s one thing! My fear’s, are they ’�’�
’�Ho, no. He’s too young!’�
’�Don’t be stupid. Bhagvane! It can start quite early.’�
’�Oh?’�
’�You’ve poor memory. At his age what’re you doing?’�
They giggled, a subtle, shy yet contended laugh.
Jayarajan, overhearing, was home during vacation.
’�It shouldn’t be allowed. Should stop now, before it’s too late.’�
’�Why? You think?’�
’�Oh, Rama Rama, have you any sense?’�
’�Sarojini!’�
’�Right, right, you’re my man. I’ve to show respect.’�
’�Yes!’�
’�Shall I say what I think?’�
’�Yes.’�
’�See, Jayarajan will become doctor or big officer. Can’t he get rich girl from good family? Good for him. And for us! Improve our status. Think of wealth we, er, he could’ve!’�
’�You’re right.’�
Jayarajan was angry. How could they discus relationship in such a scheming way? They were just about ready to sell him off, waiting for him to grow up to a marketable age!
Jayarajan saw Radha as an abandoned girl. After kindling hope, this now was betrayal. He would not abandon her.
The popular concept about love affairs included exchanging letters. Never mind that they met and talked every day or lived under the same roof. A letter and a reply were the final proof of abiding love! Jayarajan decided that it was time to write one. He pondered over how to start, what the salutation should be. He found nothing satisfactory. Finally he started, ’�My dearest Radhamol,’� The literal meaning of the word ’�mol’� was daughter. But, it often doubled for dear. He went on to tell her how deeply he loved her, how painful it was to live away from her, and how he craved to take her in his arms. And he signed off ’�Your ever loving,’� Here again he thought a good deal. He settled on more personal ’�Jayettan.’� He folded the paper and, at an opportune moment, simply pressed it on to her hand.
Jayarajan had taken a risk. If Radha protested consequences would not be pleasant. However, Jayarajan was sure that Radha would not rebuff. He was right. There was no protest, no hesitation and no indifference. Radha accepted with uncharacteristic timorousness. Then he waited.
Same evening, with her gaze fixed at the floor, Radha handed over to Jayarajan her response, written on a shabby paper torn out of a notebook. Radha was shy, an emotion so far difficult to associate with her. He had an urge to take her face in his palms. He felt he was on fire. In the dark, he could not see her face well, but the sparkle was unmistakable.
Radha’s letter was not as emotionally intense as his was. She wrote practical suggestions about their future life. Later, he would reflect that even this early she was more pragmatic than romantic. Her romance had a practical touch.
The ’�affair’� continued uninterrupted through the school years. It was not love in the true sense, maybe mere acceptance. It was a new sensation, an accelerating experience.
Radha was ecstatic. She was not sure how she enticed Jayarajan’s interest. All these years he fought with her. He seemed interested in humiliating her; he derived delight from disgracing her. She was not sure which was real, the present or the past. She thought, as in the romantic movies she watched, the hostility was the mask of love. He hardly ever ignored her. She was ready to spend her entire life with him; she would gladly surrender.
When Jayarajan was in school he could not write to Radha. Paradoxically, they could write when they were together. Jayarajan was not sure what he enjoyed more, the love affair or its clandestine nature.
’�Jayarajan, are there girls in your class?’� his mother probed.
’�What! Don’t you know?’�
’�Yes. Just asking.’�
’�Yes, there’re girls.’�
’�They live in separate hostels, don’t they?’�
’�Amma! You’re ’� What you think?’�
’�Yes, yes.’�
’�How many?’�
’�What?’�
’�How many girls?’�
’�Not many.’�
’�You’ve a bright future. Don’t spoil it. You get entangled with girls, any girl, before time, your future will be spoiled. You understand?’�
’�Yes.’�
’�You know your father; he doesn’t talk much. But, he also wants ’�’�
Silence for some time.
’�Do you - are you fond of anyone? I mean any girl, here. You know, in this house?’�
’�No.’�
Jayarajan did not consider a lie, in life-threatening situations, improper.
Every vacation Jayarajan heard this advice.

Chapter 14

George found his classmates unfriendly. After the initial distress of adjustment, he tried to make friends. But, his classmates were suspicious; his efforts met with sarcastic comments. He was surprised. He had noticed the camaraderie in the class. But they excluded a few. George was an outsider and clearly unwelcome. He initially thought that his late entry was responsible. But there was more to it. The economic disparity was a social force even among children. The majority of students were from economically backward families; indeed, some of them had their parents work for Murippalathu family. The cloths they wore and even the pencils they wrote with stated this difference. They excluded him from the club.
Unlike George, his rich classmates were haughty. That did not help. George was sorry, but could hardly help. The relationship had already gelled. He was meek. His timidity and efforts to befriend the whole class made him an outcast from the wealthy. George was sad.
’�Ho, Malathyteacher’s on leave,’� shouted someone.
As George saw Madhavanmaster walk towards the class, he pressed his forehead and winced.
’�What happened?’� asked Madhavanmaster.
’�I’ve headache.’�
’�You’re not well?’�
’�Yes, sir.’�
’�Now Raju, go with George; take him home.’�
’�Me?’�
’�Yes, go with him.’�
Raju was pleased. But he showed displeasure at accompanying the wealthy boy.
’�You seem well enough now.’� Asked Raju as they reached George’s house.
’�Yes, I feel alright.’�
’�Headache?’�
’�Almost gone.’�
’�Coming back to school?’�
’�No, no.’�
’�Madhavanmaster, ha!’�
’�Georgekutty, what happened?’� his mother asked, ’�Ente Eesho! You’re back early?’�
’�Amma, it’s nothing!’�
’�Tell me, what happened!’�
’�I’d a headache, told sir.’�
’�You not well? You’ve fever?’� She put her palm on his forehead.
’�But I’m alright now.’�
That day, the matter ended there. But only that day. Malathyteacher took leave again after a few weeks. George fell ill promptly.
George was getting special treatment. Normally, students were not escorted home when ill. He understood the other students’ resentment.
When the recurring headache was taken seriously, George pleaded, ’�I don’t want to go to doctor!’�
’�But you aren’t well,’� Muthalali said.
’�Only headache.’�
’�But you’ve it frequently.’�
’�It’s nothing.’�
’�No harm seeing Kunjandoctor.’�
’�No.’�
’�Yes! You come.’�
’�Amma, you too come.’�
’�Why?’�
’�I’m scared.’�
’�What? Why scared?’�
’�Injections. You’ll tell doctor, no injections.’�
’�Ha, ha. Right, I’ll.’�
Dr. Kunjan, the popular GP, received them with a smile.
’�Georgekutty, what’s the problem?’�
’�Headache, only occasionally.’�
’�Let me see.’�
’�No injection.’�
’�Okay, agreed. You’re very brave!’�
The doctor took care to put George at ease, privileges of the family.
’�Nothing, no injections! Happy?’� said the doctor after the examination.
’�He’s alright?’� asked Muthalali.
’�Yes, no problem.’�
’�We’re relieved. Yes, but why headache?’�
’�Does Georgekutty ’�ve trouble, any difficulty, you know what, in school?’�
’�No, nothing we know. Why?’�
’�Sometimes children develop headache, stomachache, under stress.’�
’�Anything to worry, doctor?’�
’�Nothing to worry.’�
The recurring illness and doctor’s last remark made his parents suspicious.
’�Georgekutty, you’d severe headache?’� asked his mother.
’�It’s not severe.’�
’�Then why tell the teacher?’�
’�Afraid it’ll increase!’�
’�So you told Malathyteacher?’�
’�It’s not teacher.’�
’�Then?’�
’�Oh, hum, Madhavanmaster!’�
’�Oh! What happened to Malathyteacher?’�
’�She’s on leave.’�
’�That’s last time.’�
’�Yes.’�
’�Before that?’�
’�Before?’�
’�Yes?’�
’�Madhavanmaster.’�
’�Every time?’�
George was ashamed. His parents suspected him scheming and feigning illness. If Madhavanmaster learnt, he might thrash him. He was frightened.
’�Amma, I don’t want to go to school.’�
’�Why? Eeshoye! Don’t want school!’�
’�I don’t like this school.’�
’�Why?’�
’�I don’t like.’�
’�So you want to change school?’�
’�No.’�
’�Then?’�
’�I don’t want to go to school!’�
’�Eesho! No school! How could you ’�’�
’�But, Amma!’�
’�Tell me, why are you sobbing?’� asked she, putting her arms around and pulling him close.
’�I’m afraid.’�
’�Ente Eesho! Afraid? Of what?’�
’�Amma,’� between sobs he told her about Madhavanmaster and his cane. ’�I’m frightened! I only like Malathyteacher.’�
’�Mone, don’t worry. We’ll take care. They’re kind. They just show the cane to discipline bad boys. You know, many boys in class are bad!’�
’�But.’�
’�No. Don’t worry. You’ll see. It’ll be settled tomorrow. Eesho!’�
And it was.
Next day the headmaster summoned George. Frightened, he tiptoed into the room. He was surprised to see Muthalali, Malathyteacher, Madhavanmaster and the headmaster there. He wanted to flee.
’�George,’� asked the headmaster, ’�Why are you frightened?’�
George looked at his father.
’�George’s a good boy; no trouble,’� said Malathyteacher.
George was quiet impressed. His father came to the school and assembled all these teachers. And his favorite teacher said he was good.
’�Then,’� asked the headmaster, ’�Why are you frightened?’�
’�George,’� Malathyteacher asked, ’�You aren’t afraid of me, are you?’�
’�No!’�
’�Are you afraid of me?’� asked Madhavanmaster. ’�I don’t even go to his class!’�
George was relieved to see the smile below the heavy mustache.
’�George,’� the headmaster spoke, ’�Don’t be frightened. Teachers are here to teach you. Not to torment.’�
George looked at them one by one. The teachers smiled their assent.
’�You teachers are great people; we’re grateful,’� Muthalali patted George.
This was yet another lesson in class privileges. He remembered his classmates and the perquisites of the privileged in a depraved society.
By this time, the practice of untouchability and cast based social segregation were on the way out. No one was ostracized because of religion or creed. The rampant socioeconomic disparity had emerged as a dominant force. Communist and socialist ideologies started influencing people.
George’s sleepy village did not see any huge popular upheaval. Elsewhere, especially in areas in Travancore, armed-revolution erupted. News about attacks of police stations and murder of wealthy landowners spread in the village. The poor and deprived received this news with glee. George was frightened.
’�Amma, you know, we’ll get attacked?’�
’�Attacked? Eesho! Who’s attacking us?’�
’�Communists! Killing landowners!’�
’�Somewhere far away! Not here. Don’t worry.’�
’�They’ll come here?’�
’�No. Certainly, not!’�
’�Boys say it’ll come here.’�
’�What’ll come?’�
’�Revolution, that’s what they say.’�
’�Don’t believe them; bluffing! Nothing will happen; we’re safe.’�
’�They’re killing even policemen. They must be very strong, kill police!’�
’�No, no. Just stories, Ente Eeshoye.’�
’�Sure?’�
’�Yes. Look around, see for yourself. See any disturbance?’�
’�Who told you about revolution?’� Muthalali tried to reassure George, that night.
’�No, no one.’�
’�Then how do you know?’�
’�Just general talk.’�
’�Oh, I see.’�
’�Don’t tell teachers, please.’�
’�Oh, yes. Son, you don’t worry. No revolution here. We’re not big landlords, not bad landlords, like some others, out there. Nothing will happen here.’�
George did not argue with his father. But, he was not completely comforted. His father’s name, Muthalali, was not reassuring.
The revolution did not reach George’s village. However, the underprivileged started demanding, and often fighting for, their rights. They looked down upon the wealthy, like the Murippalathu family, as exploiters and oppressors of the downtrodden. It was peaceful. But, George was clearly a casualty. In the class war between the bourgeois and the proletariat, George had few classmates on his side. Being rich was a disadvantage, a handicap.
George frequently heard his classmates say, ’�We’re poor!’� They said it with pride and often used it as an excuse. George was surprised to hear those words even when a game was lost; that justified the loss.
Whenever a teacher punished an economically-weak student, the same feeling boiled up. Because they were by far the majority, the teachers punished the underprivileged more frequently. Thus, the teacher often became a pawn in the class struggle.
To George, this was an unjustified malapropism. His class-war was in the classroom; students without exception were the deprived and beaten; the teachers were the oppressors. He was underprivileged, a victim.
If uplift of the downtrodden was the function of any ideology, George was all for it. The ideologists should understand that George endured oppression and tyranny.

Chapter 15

Once he finished school, Jayarajan went on to the local college to study the two-year Intermediate course. Two years later, after the final examination, he returned to the Tharavad. The future was uncertain. He had decided to study medicine. He liked that profession. During that vacation, Jayarajan send his application to the Regional State Medical College. Then he waited impatiently for the result.
The old house was less lively now. Some of the youngsters finished school and left for college elsewhere. The new generation was more interested in jobs and careers than a lazy existence in the Tharavad. Some nuclear families left to tend their children. That was the new tendency too; nuclear families were more practical and natural.
’�Jayaraja,’� his mother asked, ’�Will you get admission? Medical College?’�
’�Not sure, Amma.’�
’�Why not sure?’�
’�Depends.’�
’�You’ll get good marks, no?’�
’�Yes. But it’s competition. If others get better marks they get admission!’�
’�It’s an excuse, aha? You wouldn’t get good marks?’�
’�No, no. I’ll get good marks. Okay I’ll get into medical college.’�
’�Have you told anyone here about medical admission?’�
’�No, Amma, no.’�
He ran away. He knew what was coming.
On the way Jayarajan met Radha and told her the same thing.
Then the results were out; Jayarajan had good marks. Still he was apprehensive; medical-college admission was very competitive. Finally, he received the buff envelope. Even before opening it, Jayarajan knew what was inside. He was going to be a medical student, starting his long journey to become a doctor.
Jayarajan’s relatives were watching him with amazement and grudging admiration. That evening when they gathered in the front porch, the main topic of gossip was Jayarajan’s admission.
’�Now Jayarajan’s to study hard. Medicine’s no joke.’�
’�Jayarajan would’ve no difficulty,’� Karunakaran Nair, Radha’s father intervened. ’�Don’t we know he’s bright? You’ll be a doctor, no Jayaraja, in four years?’�
’�No uncle, it’ll take full five and a half years; final exams in four and a half, and one-year house surgeoncy. Then we get the license.’�
’�License to kill, to kill legally, ha, ha, after five and half years!’�
Everyone laughed.
’�He’s to pass every exam at first attempt,’� added Sarojini, ’�To complete in five and half years.’�
’�How many exams in all? Every year?’�
Jayarajan explained the intricacies of medical education.
’�Too many examinations!’�
’�No! Not too many. They’ll play with our life. It should be tough!’�
’�We’ll start canvassing patients for Jayarajan! Ha, ha, after five years we’ll line them up for our new doctor,’� Karunakaran Nair joked, ’�But, we’ve to get commission. Ha, ha. Radhamol, start touting; get patients!’�
The laughter was loud.
’�None need canvas for my son,’� snapped Sarojini.
Uneasy silence.
’�During house surgeoncy you’re a doctor,’� someone changed the topic, ’�You practice, wouldn’t you?’�
’�Yes; but under a senior’s supervision.’�
Jayarajan’s parents made elaborate preparations. He was the first doctor from the family. Though many were jealous, no one displayed it. They either were genuinely happy or feigned delight. Every family member gave Jayarajan presents, mostly cash or cloths. Education in the government-run medical college was heavily subsidized; it was affordable. The Karanavar, in a rare magnanimous gesture agreed to bear the expenses from the family coffer.
Radha was still in school. Jayarajan’s good fortune overwhelmed her. In a sense, it was her luck too. Sarojini Amma tried to keep Radha at a distance; but Radha was oblivious.
Jayarajan was increasingly aware of his parents’ hostility towards Radha. He was not sure if they disapprove her or her parents more. He even felt that they did not dislike Radha altogether; they just did not want her as their son’s fiancée.
Sarojini Amma kept advising her son not to get into the clutches of any girl, ’�inside or outside the family.’� Now that Jayarajan was going to be a doctor, she regarded him as the most eligible groom in the society.
On the day of Jayarajan’s departure, he bid farewell to every one, including Radha. That was just perfunctory. The previous evening they had met and bid an intense, passionate adieu. Both of them wept shamelessly and promised to meet as soon as possible. They knew that medical studies were tough. Jayarajan would visit home infrequently.
After Jayarajan’s departure Radha spent her days with her dreams. She had plenty of time to dream. She knew Jayarajan was busy and had little time to ruminate about her. The distance and lack of contact could fade anyone’s love. Then there were girls in his college.
Radha resolved that she would write to Jayarajan regularly. Somehow, she will sneak out to the post office. Jayarajan had no restrictions; no one checked him. But, she could not still receive letters at home. She was under watchful eyes.
Despite the pain of separation, Jayarajan was ecstatic. It was only a matter of time before he was a doctor. However, that elation did not last long.

Chapter 16

Early in life, to evade the ennui of loneliness, George’s mind used to wander, escape into a world of fantasy. It started automatically but with total intensity and passion. During the long church services, visiting elderly relatives, or through drab tuition classes, George would engage in thoughts and recollections. He got away from the tedium of monotony.
George started this habit with pleasant fantasies. His early life nurtured it. Unfriendly classmates, unaccustomed ethos and disagreeable teachers enticed escape into fantasy. Though sitting quietly, he would be agreeably active, if only in his imagination. Therefore, unlike the typical child, he did not become restless, frisky or boisterous, but appeared disciplined. He was a well-behaved and serene child.
Nevertheless, the wandering mind was a handicap. Classroom learning would suffer. Success in life demanded the ability to concentrate when necessary. George did not realize that difference. Escapade into fantasy became an addiction.
Daydreaming during serious business was not uncommon. George made a virtue out of it. His habit had some remarkable features. His identification with the fantasy was absolute. His deceptive transformation into the characters was total. At the same time he projected a façade of attention to what went on around him.
The habit came with a price tag. It troubled his conscience. After a long church session, he felt guilty that he did not concentrate on prayers. He was a whited sepulcher. It could be a sin. A tug-of-war between comfort and responsibility went on.
Life was full of unpleasant obligations. George kept this practice up. He should fulfill his responsibilities, but need not suffer more than necessary. Gradually but deliberately, he refined this habit into perfection. Conscience pricked, but he ignored.
George concentrated on matters totally unrealistic and preposterous, always fictitious and invariably pleasurable. He found it accelerating to transform, if only for short duration and merely in his imagination, into a glorious, triumphant celebrity, a preview, he thought, of things to come in real life.
During childhood, he preferred the pageant of liveried armed forces, glittering epaulettes, coordinated cadence, precise march past and elegant guards of honor. Even as a small boy, he was conscious of the rank and the privileges attached to it. He carefully studied the pictures and read the accounts of the receptions accorded to visiting heads of state and the royalty. He scrutinized the composition of the parade and observed the costumes, the customs and conduct of formal receptions.
His parents occasionally allowed George to a movie, always chaperoned. His attraction was not the main movie, but the news reviews showing splendor and pomp of state functions. Occasionally it included images of Indian leaders’ formal visits abroad. In the hushed theater, George saw the glittering display with mounting excitement and longing. Half way through he would transform from a spectator to a participant ending up as the principal celebrity, the star, in the extravaganza. He was filled with inflated pride; the future would see his own spectacular show. Those were his innocent years. Later on, he just wished that one day, somewhere, sometime, he could live that life. Later as he wised up, he gave up the pretension and hope. He learned just to enjoy the pageantry in imagination while it lasted, with no ambition, no vanity and no aspiration.
As age advanced, like the James Thurber hero, Walter Mitty, George lived through these images. During a monotonous train journey, at a moment’s effort, George got transformed into a brilliant scholar presenting his original work to a distinguished audience. Or, more pleasurable, his adulating audience, including his friends and teachers, were in his alma mater. He would visualize his mannerisms, facile elegance and scintillating demeanor during a presentation. At times, Dr. Thomas will be in Stockholm receiving the medallion with the etched profile of Alfred Nobel, from King Carl XVI Gustaf of Sweden. The variety was inexhaustible. After seeing a football match he would play winning strategy and score brilliant goals leading his team to a scintillating victory. If it was football one day, it would be cricket or tennis the next day.
Nevertheless, the reminiscence was not always pleasant. As George grew up, unpleasant memories occupied his mind. Memories of improprieties he might have committed in the past would come up in mind. The unpleasant recollections punctured his fantasies. He became more and more depressed.

Chapter 17

Jayarajan thought of the medical college as a new start in life. First, he decided to change his name. He discarded ’�Nair’� from ’�Jayarajan Nair.’� The cast name was not mod. Equality without cast and religious distinction was in fashion. Then the name was shortened to a fashionable ’�Jayaraj.’� Because the procedure to officially change the name was cumbersome, he dropped that idea. Instead, he simply introduced himself as ’�Jayaraj.’� That stuck for life.
Jayaraj was euphoric as he reached the hostel. But, very soon, reality struck. The fall from the heady height came in the form of ragging. As soon as he dumped his luggage, he was summoned by senior students.
’�Come here, you ’�’�
Jayaraj did not realize he was summoned.
’�Hai, you bum, we’re calling you!’�
’�What’s your name?’�
’�Jayaraj!’�
’�Say ’�sir!’�’�
’�What?’�
’�Say, ’�sir’� when talking to seniors.’�
Jayaraj did not respond.
’�What’s your name?’�
’�Jayaraj. Sir.’�
’�That’s better.’�
’�Okay, you come down to the hall after 30 minutes.’�
Silence.
’�Answer, say yes’�
’�Yes.’�
’�You bum, say sir!’�
’�Sir!’�
’�What’ll you do after 30 minutes?’�
’�Go to the hall.’�
’�Say ’�sir.’� C’mon, repeat it!’�
’�I’ll come to the hall.’�
’�Ha, this fellow needs straightening up. He doesn’t respect his seniors.’�
’�’� sir.’�
’�We’ll see him in the hall.’�
’�You bum, where’s the hall?’�
’�Don’t know, sir.’�
’�Then how’ll you come?’�
’�Ha, ha. He’s an idiot!’�
Ragging lasted the first ten days. It was not as intense or cruel as it gradually transformed into. The seniors forced the freshmen to do light menial jobs, polishing shoes, washing clothes or cleaning rooms. On the last day, they tossed the freshmen into the dirty pond in the campus. Then all were equal. Many juniors bore it out with light-hearted reticence, but not Jayaraj.
The ragging hit Jayaraj hard. The worst was the military haircut he was forced to have. His short hair became unruly; he thought that made him a comic figure. He was ready to weep. He missed his mother; he thought about Radha.
’�Hello Jayaraj, you seem very upset,’� Ravi, his roommate, asked, ’�Why?’�
’�Yeah, Jayaraj, what happened?’� asked Joseph, Ravi’s friend.
’�These senior bums are harassing us. Aren’t you upset?’�
’�Oh, ragging?’�
’�What else?’�
’�Oh boy, why so upset over that?’� asked Joseph.
’�Isn’t it shameful?’�
’�C’mon!’�
’�I hate it.’�
’�Me too don’t like. But it’s part of life.’�
’�Yes. I’m just waiting for next year. Wouldn’t we enjoy! When we rag new comers!’�
’�I’ll never do that, never!’�
’�I wish they allow us to rag girls. Oh boy!’� added Joseph.
’�Look at this fellow,’� laughed Ravi, ’�So you want to rag girls, ah?’�
’�Yes, that’s fun.’�
’�But then senior girls can rag you now?’�
’�Oh boy!’�
’�Let me tell seniors. They might get girls to rag you.’�
’�Oh boy, but I said next year; this year I’m an obedient fresher.’�
’�How you chaps take it so lightly? Aren’t you ashamed?’�
’�What? Over this silly raging? Oh boy!’�
’�We should all stand united and resist ragging!’�
’�Are you serious? You’re mad.’�
’�Yes, weird idea. Oh boy, if seniors know of it!’�
’�Do you know it’s officially allowed?’�
’�But not anything that cause injury,’� shouted Jayaraj.
’�Oh boy. Who causes injury here?’�
’�C’mon Jayaraj, it’s just fun. If you take it lightly it’s over in a jiffy!’�
’�Yeah Jayaraj, no one bothers me now.’�
’�Me too. Yes, they are friendly, actually.’�
’�But it’s wrong! Think of propriety?’�
’�What?’�
’�It’s savage sadism.’�
’�Oh boy!’�
’�Future doctors behave so cruelly!’�
’�Don’t go philosophic!’�
This experience shook his faith in his future in the college. Lonely in his room, sleepless in his bed, Jayaraj wept. His mother’s image rarely left his mind. He forgot his past anger towards her.
The new life was different from what Jayaraj led so far. The hostel was unsupervised. No one made him study. The girls and boys mingled freely. The relationship was friendly and mature. He had difficulty accepting this.
As Jayaraj overcame the embarrassment of ragging, he was shaken by the next jolt. His second brush with destiny was in the anatomy dissection hall. The vast hall was a gruesome sight. A fresh student was perturbed and often frightened. The initial days were sheer hell for Jayaraj. The sharp, pungent smell of formaldehyde, used to preserve the bodies, hurt the nose and smart the eyes. To dissect out a human body, all wrinkled and dried up, was onerous drudgery. Occasionally, a student or two dropped out because of the anatomy dissection.
Students formed groups of four to dissect and learn. Often, close and personal relationship grew out of these groups. After getting over the initial shock, gossiping, joking and sharing personal problems were common. Often romances budded. Jayaraj and three boys formed a group.
’�I don’t think this much of anatomy’s necessary,’� Jayaraj often repeated.
’�Necessary? Necessary for what? Oh boy, we’re learning it thoroughly, that’s it,’� Joseph added.
’�You like anatomy, don’t you?’�
’�Yes, I like it. It’s interesting; I think it’s useful for future.’�
’�Maybe interesting to you; but to me ’� I asked our seniors,’� said Rakhesh, ’�In clinical studies less than 25 percent’s needed; it’s a waste.’�
’�That’s, my boy, pure education. Education for the sake of education.’�
’�My foot,’� said Jayaraj. ’�You specialize in anatomy. But, for that, you’ll have to complete MBBS. Three years for clinical sciences. What a waste! Just imagine, three years plus house surgency wasted!’�
’�Envy this block!’� said Ravi.
’�Yes. What a break for him! Having a cakewalk doing the most difficult subject,’� added Jayaraj.
’�Me also heard that this much detail’s unnecessary,’� said Ravi. ’�It’s a waste. It’s boring.’�
’�Yes, boring,’� Jayaraj added, ’�Not just boring. My problem’s much more. I can’t remember these retched names. I dread the exam.’�
There was silence. A tutor passed through and the four immersed in dissection.
’�Look, oh boy, the radial artery! And this, here’s radial nerve.’� Joseph lifted the nerve with a forceps. Others looked trying to memorize the structures.
’�Okay, I’m not sure if I’ll remember ’�em tomorrow,’� Jayaraj said, ’�’� honest.’�
’�Somehow we’ve to remember enough to pass. For future, applied anatomy’s important.’�
’�I can’t remember for a day,’� said Jayaraj. ’�How do I remember for exam?’�
’�Oh boy, anyone entering medical college can clear anatomy,’� declared Joseph.
Jayaraj looked at him with jealousy and resentment. He sighed and started looking at the specimen. ’�Once I pass I wouldn’t remember a thing. That’s a promise! I don’t know what’ll happen when I reach clinicals.’�
’�In clinical subjects, applied anatomy’s important, not this pure stuff,’� Ravi said. ’�They teach you that.’�
Another tutor passed by the table. Jayaraj impulsively approached him. ’�Sir, I’ve a doubt. Do we’ve to know all these details when we start medicine and surgery?’�
That was impertinence, thought the tutor. ’�Do you think we’re doing it for fun?’� His voice rose. ’�You think we’re wasting our time? If it’s not necessary, why do you think we’re doing it? Are we fools? Don’t for a moment imagine that you can get through first MB with this attitude!’�
The vehemence in his response startled Jayaraj. He was frightened. The dissection room was bad enough. But, his teachers’ rancor would be punishing. ’�Sir, that’s not what I’m asking. I’m sorry.’�
’�You think I’m hard of hearing? I heard you the first time.’�
’�I’m sorry. I was just asking ’�’�
’�Now try to learn anatomy. And stop fooling around.’�
’�Why did you do that?’� asked Ravi. ’�We’ve asked our seniors. Why did you ask that tutor?’�
’�I thought I could clear doubts!’�
’�You could’ve asked junior tutors, young ones.’�
’�Yes; they just passed out. Wouldn’t mind.’�
’�I thought,’� defended Jayaraj, ’�Old people are more kind!’�
’�That old man’s frustrated.’�
’�He’s not all that old!’�
’�Middle aged?’�
’�Okay.’�
’�He’s struck as tutor for years; and in anatomy!’�
’�Yes, he’s frustrated! You shouldn’t ’�ve asked him.’�
’�I’m so sorry. I didn’t mean it.’�
’�Oh boy, this is not our Intermediate College,’� Joseph added. ’�We’ve internal tests. The final exam has practicals, viva, dissection. There’ll be internal examiners.’�
’�Oh, God, will they fail me?’�
’�If you’re in their bad books they’ll fail you,’� added Ravi. ’�It’s well known. You better be good to ’�em.’�
’�Yes, every year a few flunk because of examiners’ grudge,’� Rakhesh added, ’�Even when they knew subject. So, be careful!’�
Jayaraj was sad, miserable and frightened. How naive he was! Bitterly he reflected how much difference friendly, open, unpretentious, unbiased and helpful teachers would make.
Week after that, the anatomy professor walked into the hall event. The atmosphere changed abruptly. Everyone, including tutors, turned serious. The professor walked by many tables; he asked a question there and explained a point here. He showed some groups interesting parts in their dissection.
Finally, the professor reached Jayaraj’s table. He asked each one’s name. It was the beginning of the term. He did not know junior-batch students well.
’�Jayaraj, sir.’�
The professor stared at him. He showed no emotions.
’�Anatomy and physiology are important subjects. They form the base of your clinical skills. That’s why full one and half years are set apart for them. Only after you master them and pass the examination you’ll proceed to clinical studies. If one doesn’t like anatomy one should stop medical studies. Without clearing - and examination will be tough - no one will go to the next stage.’�
The professor was firm but not angry. Obviously the tutor had informed him. His response was unequivocal.
Jayaraj was ready to weep. Once again, his mother’s face floated in his mind with poignant self-pity. Then he realized that even she would have scolded him for his foolishness.
Jayaraj wondered if his partners considered him a liability. After all, he was part of the group and to be seen with him could be a disadvantage. He was not usually sensitive about matters affecting others. But working together, on the same cadaver, on the same table, made some difference. He watched his partners for any resentment. He started hiding into a shell.
Jayaraj’s glorious dream of medical studies was not coming through well. From day one, his dreams were shattered. He thought about Radha. He felt lonely in the crowded hall. His partners tried their best to cheer him up and help him out. However, they had limitations.
The saving grace was the study of physiology.


Chapter 18

It happened in his parish church, on a Sunday morning. The young George accompanied his parents to the service. As an obeisant devotee, George stood in the front pew with folded arms. The Sunday congregation filled the church to the brim. Inside, it was hushed silence but for the priest’s baritone. Suddenly, a toddler’s shrill bleat filled the church. He proclaimed that he wanted to pass urine. Since the child was not stilted a bit, or was not particularly self conscious, he made no effort to keep his voice low, or the language refined. All the eyes turned to the child’s direction, reflexively; no reprimand, not even disapproval, was intended. The child was too young for refined social etiquette and decorum. However, everyone took note.
It must have been an embarrassing moment for the child’s parents. However, George was not watching the boy or the flustered parent. He could not concentrate on the prayers either. He was fascinated by what he saw and heard. He could not help musing, not without a touch of veneration, how free the child’s spirit was! He instantly recognized the essence of the purity and innocence of babies, a concept immortalized by Jesus Christ. How wonderful to be that carefree! At the same time, George understood that it was the innocence of ignorance. If the child was capable of discernment and discretion, he was unlikely to have said that. If he did, he would be embarrassed. While young George envied the boy, he was aware of the limitations of that innocence too.
This image somehow became a standard for George to measure up his behavior. Subconsciously he compared his actions against this. Was he behaving like the boy in the church? Would his deed attract attention and result in sarcastic smiles? Did his innocence of ignorance prevent proper perception of his actions? George had to be very sure because he was ever frightened that he may not be aware of the full implications of his actions. For, unlike the child, George would surely experience the gaucherie and the embarrassment later. He wanted to avoid memories haunting him the rest of his life.
George remembered his days as a fresher in the class. He was like the baby in the church, ignorant of the norms, especially ignorant of his ignorance. Later, with proper understanding, he was embarrassed. Slowly unpleasant memories and past gaffe competed with enjoyable fantasies.
Paradoxically, a long memory, usually an asset, created problems for George. His xeroxic memory made him a topper in the class. But, that memory reminded him disturbibg, unpleasant or awkward past events. They desolated his daydreams. The intensity of the shame was utterly disproportionate to the frivolousness of the event.
George was an emotional animal and an introvert, traits that ensured a melancholy disposition. Sitting on his school bench hunched on to the desk, eyes intently on the teacher, his mind would wander. The fantasy started with pleasant images but later degraded into embarrassing and awkward recollection. Later, as an adult, innumerable images of the unpleasant sort, collected over the years, constantly conspired in his mind to toss up a sense of humiliation, shame and disgrace.
George did not look so much for adulation or applause. He sought approval and acceptance, if at all he was noticed. He was perfectly happy to go unnoticed. His perception of the public response modulated his action. To affect him, the public did not have to be all that overt, and the response, not very caustic. Very often, they were utterly hushed and stealthy.
George, in later years, wished that he could avoid the unpleasant reveries. He relentlessly tried to check his mind from wandering into annoying memories. It was not easy. As he just about gained some confidence, he would recollect an embarrassing past event and slip into gloom.

Chapter 19

Jayaraj liked physiology and loved the teachers. They in turn reached out to him.
’�Hey, look at that dame!’� exclaimed Ravi.
They were in the physiology laboratory.
’�Shut up. She’s a tutor,’� responded Jayaraj.
’�I know, but so what?’�
’�Oh, boy, is she good looking!’� exclaimed Joseph.
’�She’s good.’�
’�You’ll get into trouble; keep quiet.’�
’�Yes, better keep off,’� Rakesh too was worried.
’�Hey, wouldn’t mind getting ragged by her, would you?’�
’�Oh, boy, that’ll be great.’�
’�What’s this? Tutors might see. I’m already in trouble in anatomy. Now don’t make more trouble.’�
’�Don’t worry. We’ll handle her!’�
’�Keep quiet.’�
’�Oh boy. She’s cute! She’s so young.’�
’�She just completed MBBS, a few months ago.’�
’�Oh really?’�
’�Yes, topper! Varsity rank.’�
’�Then why in physiology?’�
’�It’s temporary. After MB, they join as tutors. Nothing else to do. She’ll get admission for PG, she’ll leave.’�
’�What’s her name?’�
’�Rosily.’�
’�How do you know all details?’�
’�I know!’�
’�You’re in line?’�
’�Oh boy she’s smart, beautiful.’�
’�You guys,’� Jayaraj raised his voice, ’�I’m still worried about anatomy. For you it’s fun.’�
Jayaraj moved away and turned to the experiment. The frog, half dead, pressed out on a board, repulsed him. Despite, this was far better than the anatomy dissection. He felt pity for the frog. How much of suffering went on in this world. Learning came with a price; often species other than Homo sapiens paid the price. Jayaraj was not sentimental about animal rights or even human rights. The new idealism was unusual. He was under stress with no one to console and comfort him. With raging self-pity, he identified himself with the hapless frog. He was lost in that pensive mood when Rosily reached his table.
’�What’re you doing? Dreaming about home?’� asked she in a stern but not unfriendly tone. ’�Get on with the experiment!’�
Jayaraj woke up from the nightmare.
’�No. I was just thinking ’�’�
She looked at the dissection board.
’�You haven’t even started! Why, you don’t know? We explained the steps; ask if you don’t understand.’�
’�I’m planning dissection.’�
Jayaraj was conscious of the pleasant fragrance, the delicate aroma of femininity. He stared at her face. She bent down and looked at the frog. Did her hand brush against his? She then took a scalpel, indicated where to cut up. He recalled the day he was formally initiated into the learning process, when he was just older than a toddler. On that auspicious day, the Guru held his hand and guided his fingers, writing on the sand spread out on the floor. Now would Rosily hold his hand and guide him?
’�Do you understand now?’�
He nodded.
’�Good!’� She walked away.
’�Hi, Jayaraj you’re dazed!’�
’�Oh boy, fellow’s mesmerized; he’s in a dream.’�
’�Hey, wake up!’�
’�She,’� said Jayaraj, ’�crisp as sugar cane.’�
’�Oh, boy. He’s already composing poems!’�
Jayaraj grinned. His mind was calm. He forgot the humiliation of ragging. He forgot the agony in the anatomy dissection. Beaming, he said, ’�Let me also dream.’�
’�Of course, of course, so you dream. We wouldn’t disturb.’�
Jayaraj reached every physiology practical in an exuberant mood.
’�Hi, Jayaraj how come you’re a different person here?’� Ravi asked half in jest.
’�Don’t you know?’� intervened Rakesh.
’�No! What?’�
’�Reason starts with R!’�
’�A rose by any name ’� oh, boy.’�
’�How’s your dream Jayaraj?’�
’�You bums! You’ve nothing else to do!’�
’�Really what’s the secret? You’ve double personality.’�
’�I like physiology! I understand it well, I’m fascinated.’�
’�By subject or by teacher?’�
’�Oh boy.’�
’�Shut up. It’s a living subject.’�
’�Who?’�
’�Ha, ha. She’s living.’�
’�Shut up! Physiology’s vibrant! Theories of body functions come alive!’�
’�Okay, but, still ’�’�
Jayaraj faced ridicule every day. He enjoyed that too.
’�Jayaraj, she’s coming.’�
’�Keep quiet. I’m dissecting.’�
’�Dissecting what?’�
’�Oh boy! He’ll soon ’�’�
’�She’s stopping and talking to everyone. I thought she’s only Jayaraj’s.’�
’�No. Jayaraj is only one.’�
’�Don’t worry Jayaraj, she’s easy.’�
Time fled. Once he entered anatomy building, Jayaraj was anxious, moody and dejected. Class examinations went on at regular intervals. He was tongue-tied in front of the anatomy teachers. Gradually some of his anatomy teachers understood his problem. They tried to help him out.
’�C’mon,’� Ravi told Jayaraj, ’�You must believe anatomy’s easy!’�
’�So I believe.’�
’�It’s easy, not bluffing!’�
’�Belief doesn’t help me.’�
’�You’re so good in physiology.’�
’�Oh boy, we should get a Rosily in anatomy!’�
’�Shut up,’� retorted Ravi, ’�This is serious!’�
’�Sorry. Just joking. Anatomy’s not all that difficult.’�
’�Maybe for you guys.’�
’�No! See it’s only reading and memorizing.’�
’�There’s nothing to understand!’�
’�Yes, oh boy, you need no intelligence.’�
’�Yes, really it’s a moron’s subject. Look at Ravi!’�
They laughed.
’�Yes Jayaraj, you’re good; that’s why you’re doing well in physiology.’�
’�I’m trying.’�
Jayaraj did try. He read and reread the textbook. With his friends he went over the specimens again and again. Just when he was getting his confidence up, he would encounter an unfriendly teacher at a periodic test. A bad performance there would push his faith way down. With jealousy and admiration, he watched the ease with which his colleagues handled them.
In the physiology laboratories, Jayaraj regularly sought Rosily’s help. Doubts were rarely real. He liked to talk to her and just be near her. He did not realize that she reacted with everyone with the same poise and friendliness. He fantasized that he was special to her.
Those days Jayaraj hardly thought about Radha. That he could not write to her helped. However, he received her letters. With a pang of guilt that lasted for but a few brief moments, he glanced through and tossed them aside. The thoughts about Rosily cleansed that guilt. However, during vacations he had to put up a façade. Luckily, during medical education vacations were short and rare.

Chapter 20

’�You know, I’ve a new name,’� Jayaraj confided to Radha. He was home during a short vacation.
’�New name?’�
’�Yes, Jayaraj.’�
’�Jayaraj, just Jayaraj?’�
’�Yes.’�
’�Jayaraj! Not much change, but new. I like it.’�
’�Don’t tell anyone.’�
’�You’re ashamed? Why? It’s a good name.’�
’�I’m not ashamed!’�
’�Then?’�
’�Parents gave that name. They wouldn’t like it changed.’�
’�Oh, then?’�
’�Don’t tell anyone.’�
’�It’s a secret?’� She giggled.
’�It’s not exactly a secret!’�
’�No?’�
’�No. I’m known as Jayaraj in college.’�
Tenderly she called, ’�Jayaraj!’�
Suddenly, Rosily’s image flooded his mind. A profound sense of betrayal hit Jayaraj. But that lasted only moments. Tenderly he took Radha’s hand. He did not know what to say. Finally, what he said was very simple and practical. ’�Promise, you wouldn’t tell anyone!’�
Radha was silent for some time. She luxuriated in his grip.
’�I promise,’� she did not say what she promised.
Jayaraj remained contended with the belief that he was special to Rosily. However, occasionally, he had doubts. He longed for a straightforward confirmation. But, he was frightened. Rosily was not Radha; college was not his Tharavad. He kept it a secret for which, later, he would be grateful to his family deities. Sardonically, he thought that he was incommunicado with both of his loves!
’�Jayaraj,’� asked Rosily one day, ’�Where’s your house?’�
That set his mind on fire.
’�Parur.’�
’�Your parents?’�
’�They’re in the Tharavad.’�
’�You miss them?’�
’�Yes. Somewhat.’�
Having crossed over recently from student life to teaching, Rosily behaved more like a carefree undergraduate than a serious teacher. At times, she joked with him. Coming from a conservative family in archaic society, Jayaraj thought a gregarious girl talking to and mingling with a boy meant love. He would soon find out that such behavior was the norm for successful modern women.
Finally, the examinations arrived. Physiology was no trouble. Even in the crucial anatomy practical examinations his chances would be fair, if only his teachers were not examiners. That was a paradox. Usually students welcomed their teachers as examiners; but, not Jayaraj.
During physiology viva, his professor did not ask Jayaraj questions. The external was a fair woman. She started with simple questions. Gradually she went on to increasingly complex ones.
’�Excellent! Good performance! We don’t ’�ve to say! You know it.’�
Jayaraj’s professor beamed, satisfaction and pride written on his face.
’�I’ve not seen any student with so through an understanding of the Best and Taylor,’� the external examiner commented, ’�You study that book, don’t you?’�
’�Yes ma’am.’�
Jayaraj could help but reflect that he was always lucky with women!
’�Excellent book. But I studied Samson Right. Much smaller, but I think more difficult.’�
’�Ma’am.’�
’�Congratulations! Now that exams are over, don’t stop studying physiology. I’ll be watching your progress!’�
’�Yes ma’am, thank you.’�
The next day he walked into the anatomy hall. Two vast tables were set up with several dissected specimens. Behind one table was an external examiner. By the other was his professor. Standing there, holding a long thin metal rod, he looked more like hell’s gatekeeper than a benevolent teacher. The rod was to point out the structures on different specimens.
Pointing a nerve, the professor asked, ’�What’s this?’�
Jayaraj thought for a second and uttered a name.
The professor stared at Jayaraj. ’�I’m not asking your opinion. Just identify, it already has a name!’�
Jayaraj was mortified. The exam was over for him then and there. Like a zombie, he mechanically went through the rest of the day. Later he could not recall any detail. Therefore, he had a faint hope he would scrape through.
The day the examinations finished, Jayaraj felt a vacuum. The tension and pressure had gone. But all that adrenaline in his blood now unleashed its raw power. Restless and sleepless he tossed around on his bed.
Then he remembered Rosily. He would be leaving her now. In any case, he would not see her in the physiology labs. The next day he would go home. There he would wait for the results. What would happen to the relationship? He prepared to go home.
’�Hello ’�’�
Jayaraj was going to the bus station on his way home. He would never fail to recognize that husky voice. He spun around and looked straight at Rosily. He smiled and grappled with words to say something sensible. However, nothing came out. With dropped jaw, he just stared.
’�Finished your exams, ah?’�
’�Yes, I’m going home.’�
’�I see. By the way congrats! You’ve done extremely well in physiology!’�
’�Thank you. Also for all the help.’�
’�You see, I’m also leaving physiology.’�
’�Oh, why?’�
’�I’ve got admission for MD, medicine. I’ll start next month.’�
It was Jayaraj’s turn to congratulate.
’�You see, when you’re in hospital for medicine posting, I’ll be there. So, I’ll see you. Who knows, your first posting might be in medicine!’�
Jayaraj’s heart was racing. Now more than ever he wanted to pass.
’�Probably I would see you next month.’�
Jayaraj was in frenzy. Here comes, he thought, the sentimental part! He did not interrupt.
’�Look, I forgot! Meet Dr. Rajiv.’�
Jayaraj noticed the handsome young man standing near her. Jayaraj was so immersed with Rosily, he had noticed no one else. Rajiv extended his hand, saying, ’�Hello!’�
Jayaraj hesitantly shook it.
’�He’s just completed his MD. He’s my fiancé!’�

Chapter 21

The long summer vacations brought reprieve for George. True, at home he was lonely. Still it was better than the captured loneliness in his classroom. He spent time playing his lonely games. Occasionally his cousins came. They appeared gentle now. He observed their manners and behavior. He tried to learn social etiquette. They were more agreeable than his classmates. Natural, no class war there.
The highpoint of the vacations was his grandfather’s visit. George Thomas, senior visited them during summer. He dotted on George and brought presents, carefully selecting something unusual or unique. George looked forward to these presents.
One summer, during George’s early school years, Senior presented George with an umbrella.
’�Here, see what I’ve got for you!’�
’�Wow! Beautiful.’�
’�Like it?’�
’�Very much! Amma look, ’�ve you ever seen this?’�
’�What?’�
’�See this umbrella! Beautiful! Not black, Amma! How many colors, one, two, six! Six different colors! Have you seen before?’�
’�No! Eesho, it’s cute!’�
’�Yes Amma!’�
’�Did you hug and kiss Grandpa?’�
’�Yes.’�
’�Good.’�
’�Grandpa, how’d you get it?’�
’�I’ve a friend in Malaya. He brought it.’�
’�Oh! Foreign!’�
’�Eeshoye!’�
’�Watch me going to school! It’ll rain wouldn’t it?’�
The school reopened in pouring monsoon rains. Young George was apprehensive and unhappy, like a soldier going back to battlefront after leave. Worries about the class and the new teacher tormented that young mind. On that particular day however he felt a wee bit of excitement. The reason was that umbrella.
George proudly walked in the rain with that multicolored umbrella. As expected, it attracted abundant attention. But totally unexpected were the booing and ridicule, the sarcastic laughter and nasty comments on the way. First, he was bewildered, unable to understand the reaction; then he tried to believe it was jealousy. By the time he reached the school, he was ready to weep. He did weep when the school bullies’ turn was over.
Years later, whenever he recalled that incident, George felt intense self pity. He could, and frequently did, look upon his past in absolute detachment, as if watching another person in fluid motion. He could visualize the lonely, unhappy child walking down the muddy, slippery street in pouring rain. Proud first, but then bewildered, and later bitter and sad, the desolate boy, at last, sat alone in his class. What should have been a triumphant march, ended in shame, disappointment and sorrow. That was a pattern he would recognize again and again as he grew up slowly and painfully. George felt pity and compassion for that little boy. The experience, his first lesson in self-restraint, was so poignant that to this day the memory made him weep.
This was one of George’s early trysts with disagreeable, hostile attention; it had something to do with the shaping his temperament.
If George was sitting in a crowd, in a meeting, and wanted to leave early, his mind debated, what others might think of it. Was it improper? The usual result was that he sat through the proceedings and left with everyone else at the end. But, all the time, he was distraught that he did not leave when he wanted. If anyone got up and left, then George timidly followed. He still would not be comfortable; but he could just do it. His self-consciousness, blushing shyness, were formidable. Was he being the boy in the church? Was he still the child with the multicolored umbrella?
In later years, depending on the circumstances, people interpreted this shyness variously as arrogance, conceit, ego, pride, indifference or hostility. George, if asked to ’�lead, follow or get out of the way,’� would gladly choose the third option.
That evening George asked his mother, ’�Amma, why did they ridicule me?’�
’�Eesho, look,’� she addressed her husband, ’�Listen ’�’�
’�I heard.’�
’�Why did they?’�
’�Maybe they’re jalous.’�
’�Yes, they’ll never ’�ve it.’�
’�But why’s this fellow lamenting?’�
’�He’s hurt.’�
’�Hurt! How?’�
’�No, he’s sad.’�
’�Oh!’�
’�Poor boy.’�
’�Boys should be brave.’�
’�True. Georgekutty, look at your father. He does whatever he wants. Doesn’t care what others say.’�
’�yes, Amma. But I can’t.’�
’�If you believe you can’t, you wouldn’t do anything. Think you can,’� said Muthalali.
’�Learn to your father.’�
’�You carried that umbrella. People laughed, okay, so what? Boys rediculed, so what? I wouldn’t ’�ve cared.’�
’�Eesho! Do the right thing and ’�’�
’�Yes, you do right. Don’t worry about people. Follow me?’�
’�Yes.’�
’�If you don’t bother, they’ll get tired.’�
’�They’ll leave you alone!’�


Chapter 22

That vacation was the worst in Jayaraj’s life. His life was changing so rapidly, so unpredictably, he lost his balance. Occasionally, for a brief moment, he would be elated. After the vacation, he might enter the hospital. Then he remembered anatomy. And, there would be no Rosily. What a twist that was!
Radha was a burden. He could not abandon her. Yet, she hardly had any place in his heart. In a way, loosing Rosily was a blessing. Otherwise, what would have happened to Radha? But, he simply wanted Rosily. It was an emotional compulsion and a physical passion.
Jayaraj wished that the fiancé did not exist. How fortunate that would have been! If he would scrape through the exams! If he and Rosily were posted in the same ward! Then, it would be the physiology lab all over again. But, too many ifs!
The elders in the family were excited.
’�Jayarajan will soon be in white coat!’� Radha’s father said.
’�Yes, in hospital.’�
’�Now we’ll get proper treatment there.’�
’�Yes, we’ll have our boy.’�
’�But look, he’s very serious now a days.’�
’�Oh! Because he’ll be doctor soon. Big man!’�
’�No, he’s gloomy.’�
’�Poor fellow, worried about results.’�
’�Worried? Jayarajan?’�
’�Yes, he shouldn’t worry!’�
’�True, why worry? He’s sure to pass.’�
’�He’s brilliant. But medical college’s tough!’�
’�See, Radha. Failed! But no worry!’�
Everyone laughed.
’�She expected that.’�
Laughter again.
Radha was worried about Jayaraj. He was serious and preoccupied.
’�Why are you sad?’�
’�Sad? Who? Me?’�
’�You’ll never admit, I know. But everyone knows you’re worried!’�
’�Ha! Everyone but me!’�
’�Whatever you say. You’re adamant.’�
’�Now, what’re you going to do?’�
’�I’m studying. I’ll continue.’�
’�But you failed!’�
’�Yes, I’ll study in same class.’�
’�Very simple.’�
’�What else?’�
’�You could’ve studied well.’�
’�C’mon. I’ve to wait - how many years, one and a half years over ’� now, three more years before we marry. I’ve to spend time.’�
’�You’re just waiting for that!’�
’�What else?’�
’�You study and pass exam.’�
’�Not interested.’�
’�But if I fail?’�
’�C’mon. You’ll never fail.’�
Then the results were out. The family was stunned; Radha, in tears, refused to believe. Jayaraj had failed in anatomy. Still Radha found some reprieve in the miserable situation. She found consolation that Jayaraj’s indifference was due to his apprehension about the result. What a relief; the reason was not she! In a strange way, it pacified her, as if she suddenly found out that Jayaraj too was a mortal.
Later, when the significance of that failure sank in, Radha was dejected. She did not even feel the need to console Jayaraj.
The whole family went through the shock. No one tried to comfort Jayaraj. Jayaraj was hurt that not even Radha sympathized or supported him.
Yet, Jayaraj could not blame her. He had not been faithful. For a moment, he panicked. Did she have any inclination of the affair? But, then, what affair? A smirk appeared on his face. Affair! It was a fantasy played out by his mind.
Jayaraj derived perverted comfort from Radha’s failure to console him. That vindicated his infatuation with Rosily! The simplistic defense in situations so complex was typical of Jayaraj. Then he tried to justify the affair as a ploy to kindle his interest in physiology.
’�My poor boy, he was bright,’� Sarojini shouted, ’�But, people, jealous people, witchcraft! What not! I know, several sorcerer and sorceress here do that!’�
’�Amma, Stop it!’�
’�Now you shut up!’�
’�People are listening.’�
’�So what? Let ’�em hear! I’m not lying!’�
’�Amma!’�
’�I know! You didn’t study. What were you doing? Go after some girl? Bhagavane!’�
’�That’s not ’�’�
’�Shut up! I’d warned you several times not to do that. Here also, someone here also! You’re just spoiled!’�
’�Amma, stop!’�
’�Who’re you to ask me to stop? Even your father don’t!’�
Jayaraj fled from there.
’�Jayetta,’� Radha told him later, ’�I know you’re upset!’�
’�Aren’t you?’�
’�Yes, yes, I couldn’t even talk to you!’�
’�Oh, I’m an untouchable!’�
’�Jayetta, why say such things?’�
’�No one cares about me.’�
’�I do, promise.’�
’�Okay, okay.’�
’�So unexpected! We’re all stunned.’�
’�Leave me alone.’�
’�You’re not same. You’ve changed!’�
’�How?’�
’�I want my old Jayettan.’�
Jayaraj no longer wanted to stay at home. He found expressions of accusation, contempt and, sometimes, glee. But, neither did he want to go back to the college. He would have gone like a triumphant worrier if he had passed. By the time the vacation ended Jayaraj regained his equanimity. The memories faded. Depressed and forlorn Jayaraj left for the college.


Chapter 23

George felt lonely. He was an outsider. Some of his classmates could foster deep friendships. Many of them formed small close-knit groups. They studied and played together. They shared whatever they had. George envied them. He could not develop such a friendship.
Meanwhile a new character, a lunatic living in the village, entered George’s life. Before starting school, George did not know about him. In the school, inevitably, he heard about Koran, the lunatic, and bit by bit learned the whole epic.
That middle-aged man was sort of a celebrity, a colorful local character, a hero for the children. No one knew where he came from or where his family was. He wore dirty cloths and talked incessantly to no one in particular. He slept in the temple compound and ate whatever he got from teashops or the temple kitchen. Koran was quite benign; his prangs were harmless. He was remarkably kind and helpful. Stories about his magnanimity were legion.
The anecdotes captivated George. Soon Koran became his hero. George, craving for companionship, set Koran up in his mind as a close friend in absentia.
George wanted to visit Koran. He was afraid to ask his parents. He felt his hero might not meet his parents’ approval. George was sensitive. He did not like to face refusal. But Koran was a strong presence and he had to talk about him. He chose to tell his mother first.
’�You know Amma, you know Koran?’�
’�Who?’�
’�Koran! Lives in temple!’�
’�Oh, the lunatic? How’ll I know him?’�
’�But, you’ve heard?’�
’�Yes!’�
’�You know him!’�
’�I’ve heard about him.’�
’�H’s ’� his name’s Koran.’�
’�Yes, Koran the lunatic.’�
’�Everyone calls him that! But, he’s a good man, actually!’�
’�Oh! Eeshoye! How do you know?’�
’�He helps others.’�
’�How?’�
’�He gives food to poor; he helps porters carry weight, pulls cart for them.’�
’�I don’t know; but he’s maniac.’�
’�No, Amma. He’s not! He’s a good man, honestly.’�
’�Okay. But, careful! Don’t go near him. Understand?’�
This was not unexpected but was disappointing. Still George did not stop admiring Koran, a misunderstood hero.
Frequently George heard new anecdotes. The boys recounted Koran’s escapades with zest, how he forcibly took sweets from shops and distributed among children. Later, he did manual labor, earned money and repaid the cost, even more than the real cost. The shopkeepers, partly out of fear and partly because he repaid later, never really objected. He carried the sick to the local hospital, unprompted and un-rewarded.
To his surprise, George found his father more receptive.
’�You know, Appa, Koran today gave sweets to some boys in my class.’�
’�I see. You got some?’�
’�No, no. I didn’t see him.’�
’�I see. How’d he get the sweets?’�
’�Took it from Shenoy’s Shop opposite school.’�
’�I see.’�
’�He didn’t pay for it; he’ll, later.’�
’�How?’�
’�He’ll work, earn and pay.’�
’�I see.’�
’�It’s good! Isn’t it, Appa?’�
’�What’s good?’�
’�Giving sweets to boys.’�
’�Yes.’�
’�He’s so nice.’�
’�I see.’�
’�I haven’t seen him yet.’�
’�Hum.’�
George was afraid of the older bullies in his class. They presided over the gossip groups, spreading village rumor and narrating dirty jokes. They were heroes of the class. George never went near them, not even to hear the jokes. But, other boys heard and recounted; eventually George heard. Occasionally, he did not understand the full denotation of these stories. Often they were obscene. One day again, George heard a story he did not understand; it roused his curiosity.
’�Have you heard this story?’� shouted a boy, ’�Actually a riddle; sure you wouldn’t answer!’�
It was the lunch interval and boys gathered around him. George stood away, but within earshot. The story from mythology involved two married women who were cut into two but later rejoined and brought back to life. George could barley hear the narration; he caught some words here and there. He did not understand.
The boy giggled and whispered to his friend standing near by. He repeated this to some others. They all laughed. George did not learn the answer. He remained curious. There must be some catch.
That night George told the story, as much as he knew, to his father and asked him the answer.
’�What! You’re talking rubbish! Good boys don’t tell such vulgar things. Who told you this?’�
’�Just heard ’�’�
’�Where? Where’d you hear? Who told you this?’�
George was shocked.
’�Did you go see Koran?’�
’�No, no!’�
’�Then?’�
Silence again.
’�In the school, ha?’�
George was at the verge of tears. If his father went to the school and tell the teacher, he could be in trouble. The teacher might punish some boys. They in turn might revenge against George. He was frightened.
’�I should tell headmaster. Should be stopped.’�
George started sobbing and as his moan became audible, it softened Muthalali. ’�Now what?’�
’�No. I didn’t know it’s wrong! Promise, I didn’t. Don’t go to school and ask.’�
’�Alright. You’re picking up dirty habits. I wanted to send you to a good school. Don’t repeat this. Don’t mingle with those bad boys.’�
George sulked. He did not understand. Why did the boys giggle? And, his father got angry. That must be some dirty story.
When he grew up, George thought his father’s reaction was unreasonable. If George knew the story in full, he would not have told his father. The incident later ignited sense of shame and guilt.
George remained moody for a few days. Then he regained his composure; Koran again occupied his attention. He could talk to his father about him. Muthalali heard him with benevolent patience. He did not shatter his son’s idol; it would be cruel.

Chapter 24

Jayaraj had little to do the next six months. He concentrated on anatomy. He thought he had dyslexia, selective disability to learn anatomy! At times, he was genuinely concerned. He was frightened if he might be forced to discontinue medical studies. But, his friends repeatedly reassured him and tried to boost his morale.
In the campus, he learned about the behind-the-scene drama of the examination. The anatomy professor was not against George. He knew about Jayaraj’s outstanding performance in physiology. He tried to help him. However, the external examiner was adamant; the animosity between the two professors stood on the way. His professor did not probably help the other’s candidate in a previous examination. Helping candidates was a two-way street, a debt that should be repaid with interest. Jayaraj was an unfortunate pawn in the power game. Of course, it was his problem; he needed help. The little games the powerful played, full of prejudices, ego and vendetta!
Now the anatomy professor showed special concern. One day he stopped Jayaraj in the corridor.
’�You’re good in physiology, I’m told.’�
’�Sir.’�
’�What happened in anatomy?’�
’�I don’t know sir. I can’t remember, can’t retain details.’�
’�Strange! It’s not that difficult.’�
’�Somehow anatomy frightens me!’�
’�Ha, there’s nothing frightening! You’ll probably end up in general medicine. What do you think?’�
’�Yes sir. But, I haven’t thought about it!’�
’�A surgeon needs to know anatomy thoroughly. Without that none can be a good surgeon.’�
’�Yes sir.’�
’�Don’t worry. It’s not that important for other specialties. You’ll learn applied-anatomy as you go through, easier for folks like you.’�
’�Yes sir.’�
’�You should’ve more confidence. Try to face examinations with poise.’�
’�Yes sir! I’m frightened. I’m nervous.’�
’�Well my boy, you study as best as you can. If you can be first in physiology you wouldn’t be so far behind in anatomy. Sure, you’re going to do well!’�
Jayaraj felt he was reborn. His eyes had swelled up. The professor’s friendly talk touched him. He wanted to help Jayaraj. If only the professor gave him this pep talk before the examination! George would have even passed! For the first time Jayaraj dared to hope. Yet the lost opportunity depressed him. What a break that would have been, clearing the first MB with a rank in physiology!
Jayaraj finished his examination, went home and waited for the result. This time he walked into the vast compound with some confidence.

Chapter 25

George was resigned to the local ethos in due course. Yet, he never accepted the norms. He felt insecure and spent time brooding. He was quiet and lonely. To escape from unpleasant environment he withdrew into a shell, increasingly living in his dream world.
One day, as he entered the school, George heard excited shouting and laughter. He asked the reason, but no one cared to tell him. Therefore, he hung around and tried to pick up the conversation. What he heard horrified him. That morning his hero, Koran, was beaten up. George felt miserable. As a wounded animal running around, he moved from group to group, desperately believing that the specifics would exonerate his hero. Slowly, bit by bytes, the jigsaw fell in place.
That morning Koran was sitting under the banyan tree by the temple. A village lass, carrying a pot of water from the temple pond, came his way. Boys were agog about her beauty. Koran usually showed no interest in women and therefore was considered a safe, perfect, gentleman. The girl smiled at him and asked, ’�Well Koran what’re you doing here?’�
’�Not doing anything. Can’t you see? But, I’m going to do something!’�
He moved swiftly, took the water-pot from her and kept it on the ground safely. He then embraced her tightly and kissed her on her lips. Stunned, the girl just stood there for a few seconds and then screamed wildly. A small crowd gathered immediately. They proceeded to law-keeping responsibilities and beat up Koran thoroughly. Soon the woman’s brothers joined the group giving additional impetus to the thrashing. Eventually, they threw him down with a warning that if he repeated this, he will be murdered.
George did not understand the situation. But felt pity for Koran. Why were the boys laughing so much; what was funny? Innocently he asked, ’�But, why’s he beaten up?’�
There was laughter.
’�Hey George! What else? Give him a medal?’�
More giggles.
’�He just kissed, didn’t he? Why’s he beaten up?’�
They went wild. Even the girls, sitting at a distance following the conversation, could not contain the laughter. Bashfully they covered their face and demurely stole a glance at George.
George realized that he had not exactly matured; he had committed some gaffe. George mourned his friend’s fall. He could not bear the thought that Koran did something that deserved punishment.
But, the boys were enjoying it like a comedy show, impersonal, uninvolved and unconcerned. These boys had praised him as a hero. They had talked about his charities with admiration. They enjoyed his generosity. Koran was poor and he loved the poor. That was the ultimate tribute they could pay.
George had to get the facts clear. He could not go to his mother. He had a feeling that his father too did not really approve Koran. But Muthalali did not disapprove his admiration of Koran. Nor did he use the derogatory, ’�lunatic,’� with his name. He probably did not consider Koran an evil, depraved person. Muthalali told him about inequalities of life, disparity of privileges by birth. The lunatic was born with a burden on his shoulder, a terrible burden. He grew up oppressed by fate.
Now, with some confidence and optimism, George told his father what had happened to Koran.
’�Unfortunate. Very unfortunate.’�
’�Yes, poor man, isn’t he?’�
’�No, the incident, it shouldn’t ’�ve happened’�.
’�Oh. But, Koran just ’�’�
’�What Koran did was wrong. But, it’s sad he was born that way; that’s not his fault. He got beaten up for something he did; he did it because he’s born that way; that’s not his mistake.’�
George was impressed with his father’s logic. Even for a moment, he did not consider that his father’s reasoning was in reality, escapism. His father was passing the blame to God. But, no one had a rational explanation. It was impossible to fix the responsibility for a schizophrenic’s behavior.
From his tone George knew his father wanted to stop the topic. He was disappointed. He expected some sympathy for his fallen hero. In fact, he craved for sympathy and compassion for himself. An icon lay shattered in his mind. Could anyone prop it up? Later, when he could grasp the full implications of Koran and his behavior, he understood the beating up. He understood even the inevitable fall of his hero. But, he could still feel, and still suffer from, the sense of loss and hurt.

Chapter 26

Once he reached his Tharavad, Jayaraj realized how much others’ moods affected his spirit. He was cheerful and optimistic when he came. Everyone was either indifferent or hostile. The depressing atmosphere left him plaintive.
Jayaraj found his parents’ hostility intolerable and inexplicable.
’�He doesn’t study properly,’� Sarojini Amma rambled, ’�Doesn’t obey elders! Doesn’t listen to his parents! Look at the wage we earn for rearing a son.’�
Jayaraj tried to avoid her altogether. This angered her further. He sensed the widening gap between them. He was not a close-knit-family man. The residential school had taken its toll. But, his mother’s behavior did not meet even his expectations.
’�Jayettan, you’re unhappy,’� Radha sympathized.
’�No, no! Why, oh, yes.’�
’�Exams bad?’�
’�No. I did well. But why are you concerned?’�
’�What?’�
’�Last time I failed you’re not bothered!’�
’�I was so upset, dejected. Do you think I don’t care?’�
’�How do I know?’�
’�Please, I care, I love you.’�
’�Maybe.’�
’�Not maybe. I do.’�
’�Okay, okay.’�
’�You’re unhappy because of that?’�
’�No.’�
’�Then?’�
’�It’s this Tharavad. Terrible atmosphere!’�
’�Actually, it’s hell here. Now, do you realize I’m here all the time? You come for a few days.’�
’�I understand. I’m sorry.’�
’�No, no. But you must believe that I care for you.’�
’�I know that.’�
’�Surely?’�
’�Yes.’�
’�You’re not angry with me?’�
’�No.’�
’�Then? Why sad?’�
’�See my parents. They hate me!’�
’�Oh, no!’�
’�Yes I know. It’s one thing punishing me. But to disown!’�
’�They’re just upset.’�
’�Why?’�
’�See, your failure. We’re all distressed.’�
’�Ah! That failure made such difference? What’s that relationship worth, then?’�
’�I’m not angry. I was upset just for a while. I love you.’�
’�Okay. But my parents?’�
’�Actually, they’re angry with me too.’�
’�Why?’�
’�I don’t think they like me!’�
’�Why do you think so?’�
’�I know it! I’ve seen, heard ’�’�
’�What?’�
’�That’s okay Jayettan. I’ve you, don’t I?’�
’�Yes.’�
’�I’m satisfied.’�
’�Olden days! Amma pampered me so much!’�
’�You’re sore?’�
’�I don’t know if she loved me at all!’�
’�Actually, I know she doesn’t love me!’�
Jayaraj tried to reason with his father. ’�Acha, you, please listen ’�’�
Kesavan Nair just stared.
’�I didn’t neglect studies. Failed not because I was lazy. I’d trouble, difficulty with anatomy.’�
’�You alone had difficulty? So many others passed, no trouble! How?’�
’�It’s hard to explain.’�
’�Ah, don’t explain!’�
’�But, I’d trouble learning anatomy. I thought professor was angry.’�
’�Ah! You must’ve done something wrong. What’d you do?’�
’�What?’�
’�Why was professor angry? You must’ve done something!’�
’�Why do you think so? Look at my physiology marks. I scored high, didn’t I? I didn’t do anything wrong.’�
’�Then why’s he angry? Don’t like your face?’�
’�Yah, he didn’t like my face! Am I responsible for my face?’�
That jolted Nair. He was silent. That gave Jayaraj time to regain his composure. This was leading to an acrimonious row. In the past his mother would come in to pacify.
Jayaraj did not want to continue the altercation. He walked away.
But Nair shouted, ’�Oh, he’s too big to talk. He’s Dr. Jayaraj!’�
Jayaraj stopped dead on the track, and not because of the mocking, ’�doctor.’� For the first time his father called him ’�Jayaraj.’�
’�You changed your name we gave. Not fashionable for Doctorsar.’�
Jayaraj fled. As long as he provided gist to their narcissistic pleasures, he was their dear son. The moment he ceased to be their fulfillment he was persona non-grata.
He confronted Radha. ’�You told anyone here that I, er, you see, changed my name?’�
’�Of course not! Why should I?’� protested Radha.
’�Then how ’�’�
’�Your parents know, no? Actually your father learned it in your college. Went to see you. That’s how he knew that! But not many know here.’�
’�Oh, I see!’�
How simple!
Jayaraj wanted to leave his house immediately. This time going to the college was not unpleasant. However, the college was still closed. He kept away from everyone as much as possible. And, he went when the classes were about to restart.

Chapter 27

’�So, you’re the repeaters’ batch,’� Dr. Peter Roy, chief of medicine unit 4, welcomed the students starting clinical training in medicine. Jayaraj felt anger, frustration, disappointment and shame.
What a way to start! First day in the hospital, the day the students started using their stethoscope. ’�Repeaters,’� underlined their failure at the First-MBBS examination, something this class would hear throughout their college days.
Traditionally the chief of medicine welcomed the freshers. But, for the ’�repeaters’ batch’� he was too busy. Roy, the most unfriendly and misanthropic teacher in the hospital, was deputed instead. He was a morose and cynical eccentric.
Clinical training was a daily affair. The students rotated through medicine, surgery and obstetrics and gynecology with smaller subgroups joining different units in each subject. Jayaraj started in medicine chief’s Unit 1.
Ward 10 was special. It was the professor’s ward. Dr. Raj Mohan, professor and head of the department of medicine was a colorful personality, a showman. Students affectionately called him the Proff. Short in stature, he successfully used it to his advantage. He commanded attention in any crowd. Of all the men, long or short, Jayaraj had ever met, he found the Proff the most magnetic and mesmeric. He fervently wished that the professor had initiated his clinical training. But, failure had its drawbacks.
Yet, none of these disappointments dampened Jayaraj’s enthusiasm. During the initial days, teachers taught the techniques of examination. With increasing fascination and awe Jayaraj concentrated. He watched his teacher’s every movement, heard and retained every word. He had never witnessed anything that captivated his interest and attention so totally. He had forgotten the environment. And he had forgotten Rosily standing nearby.
When the students arrived, Rosily received them. She knew them from her physiology days. She initiated them to the ward, told them the norms to be followed. Jayaraj remained aloof; she did not seem to notice though.
Postgraduate students had multifarious role. They were students. At the same time they taught the undergraduates. They were also important members of the treating team. Unlike undergraduates, they were full-fledged doctors, licensed to practice. An overworked lot, they were the backbone of patient management.
Rosily was in the euphoric phase of graduate training. It was too early for the pressure of work and final examination to bog down the enthusiasm. Pressure, tremendous pressure, would come, but later. Now the new teaching and patient-care responsibilities were pleasant. With them came a sense of importance and éclat. Rosily felt all these and something more. For, she was engaged and was in love. She needed time to spend with her fiancé. Yet she did not demand respite from work. She wanted more than 24 hours in a day!
Rajeev had gone through this grind recently and tried to dissuade Rosily from postgraduate studies. They could have settled down. But, she did not want to miss the opportunity. Sacrifices were a way of life in the career she chose.
Jayaraj picked up his clinical skills fast. His grasp of fundamentals was thorough. He read and reread books.
One day, after the clinic, Rosily asked Jayaraj, ’�So, how’s medicine?’�
’�Great, I like it; clinical subjects are interesting.’�
’�You’ve aptitude, good.’�
’�They’re alive and vibrant.’� He did not say what he thought, ’�Like you!’�
’�Yes, they’re interesting. But, you must study pharmacology and pathology too. Don’t forget ’�’�
He understood she meant anatomy.
’�’� They’re as important as clinical subjects.’�
’�Yes, I know. They’re interesting, when combined with clinical subjects.’�
’�Just wait; once you’re deep into clinicals you’ll see how interesting they become. Even anatomy will come to life.’�
’�I’ll wait for the day!’�
Rosily smiled.
’�So you’re well settled in medicine. Concentrate on physical examination. I mean eliciting signs, techniques of examination. Practice, not just reading, you see!’�
’�I attend clinics. Follow very carefully.’�
’�That’s okay. But, not enough.’�
’�Oh! Then?’�
’�Everyone does that. But, do more.’�
’�What else?’�
’�Go to ward in the evenings. See complex cases. Examine thoroughly, perfect techniques.’�
’�Oh, I didn’t ’�’�
’�Yes. You can discus, clear doubts with seniors, PGs. More leisurely, informal. When I’m here - I’m here most days ’� we can discuss, or even argue!’�
’�I like that very much!’�
’�To argue?’�
’�Oh, to discus. Thank you.’�
If only her fiancé did not exist! His mind weaved fantasies. She wanted to have him with her. No, not true, it was only her professional interest. Then he remembered Radha.
Jayaraj visited the hospital every evening. Studious students often did that. However, few did it regularly. To Jayaraj it became a passion. Hospitals were strange places. Women and men worked to alleviate suffering; they worked together to revive the dying; they shared the grief over the dead, celebrated the rebirth when they resuscitated. Emotional attachments developed frequently and easily. Romance among students, nurses and doctors was quite common. Indeed, that motivated some for evening visits. Therefore, Jayaraj’s regular visits roused suspicion. Inevitably, Jayaraj and Rosily became the butts of gossip. This time it was not just his close friends, but many more students started teasing Jayaraj.
’�Hey Jayaraj, going for evening visit?’� shouted someone.
Jayaraj passed a group of students in front of the hostel.
’�To the ward; there’s an interesting case. Coming?’� Jayaraj answered.
’�Very interesting? In Ward 10, no?’�
’�But it’s interesting only to you!’� shouted someone else.
’�Not it, it’s a she!’�
’�Really?’�
’�Don’t you know?’�
’�Jayaraj, you’re lucky.’�
’�Tell us the secret, yaa!’�
’�’� off you fellows!’�
Jayaraj was afraid of the rumors; he knew it was dangerous. Nevertheless he relished the gossip. Gradually the banter increased.
One day his fried Ravi asked Jayaraj, ’�What’s going on now?’�
’�What?’�
’�I’m serious. Tell me.’�
’�What’re you talking about?’�
’�C’mon. What’s between you and Rosilyma’am?’�
’�Oh boy. You’re Lucky, Jayaraj,’� Joseph intervened, ’�Are you talented! How do you manage?’�
’�Now shut up. This is serious!’�
’�Oh, sorry. Just joking.’�
’�Now, Jayaraj tell me.’�
’�Nothing! Honest! I promise.’�
’�Then, why all this rumor?’�
’�I don’t know.’�
’�Look, she’s senior to you, us, by several years. She’s engaged.’�
’�I know. I’ve met her fiancé.’�
’�Oh, still you ’� why?’�
’�I’m only going to see and discus cases. There’s nothing else. Promise.’�
’�You shouldn’t allow this to go on!’�
’�What can I do?’�
’�Stop seeing her.’�
’�I like to see cases and discus. Why should I stop?’�
’�You go to other wards and see.’�
’�She discusses cases with me.’�
’�It’s dangerous. Don’t be foolish!’�
’�Let’s see.’�
’�Nothing to see. You better stop!’�
Jayaraj did not stop. And the loose talk increased.
Ravi’s warning jolted Jayaraj. He felt uneasy in Rosily’s presence. Gradually she appeared perturbed. That made Jayaraj more nervous. Meanwhile this trumped-up but trumpeted relationship grew into a major rumor among students.
A few weeks later, Rosily suddenly left ward 10, moved to ward 13. That surprised everyone. Midterm shift of postgraduate students was unusual. Jayaraj was disappointed. She had made his study of medicine a pleasure.
’�Hey, what happened? She cross with you?’� Students did not waste any chance to tease Jayaraj.
’�You two fell apart, ah?’�
’�Shut up,’� retorted Jayaraj. ’�Don’t talk rubbish.’�
’�Why did she leave, yaa?’�
’�Did you try something funny?’�
Loud laughter and catcalls greeted this.
Jayaraj blushed. ’�You guys have dirty mind!’�
’�Look, he doesn’t deny!’�
’�Did she slap you?’�
’�Yaa, with her slippers! There’re marks on his face?’�
Again, laughter.
’�Slap’s okay. But she’s left, romance over.’�
’�Her fiancé’s tough.’�
’�She’s a fiancé?’�
’�Of course, yaa! You don’t know?’�
’�Jayaraj, better leave her alone!’�
’�Nothing better to do? You guys are the limit!’� shouted Jayaraj.
’�Are you going to ward 13!’�
’�She’s there?’�
’�Of course!’�
’�Unlucky number.’�
’�Be careful! Slippers!’�
Jayaraj thought. Why not go to Ward 13? Students often went to different wards to see interesting cases.
Rosily was disturbed and annoyed to see Jayaraj in ward 13. She avoided him. But he had to find out the reason for this sudden change.
Jayaraj did not want to, but had to see patients, to stay there. With his attention elsewhere, he went through the motion of examination. He waited for Rosily to be alone. He did not wait long. As he saw her entering the procedure-area, he followed.
Jayaraj was too disturbed to notice Rosily’s annoyance.
’�You’re transferred? To this ward?’� stammered Jayaraj.
’�Yes. Why are you here?’�
’�I ’� to see patients!’�
’�This is not your ward!’�
’�No, but just ’�’�
’�Oh, then see patients!’�
’�You were in 10. I thought you’re there for whole term. Why this shift?’�
’�Do I’ve to give a reason?’�
’�No ma’am. I’m sorry. I was just asking.’�
’�So you ask!’�
’�We’re discussing cases regularly. Suddenly you left. Didn’t even tell me.’�
’�I’ve to have your permission?’�
’�No ma’am, no. I’m sorry. I just wanted to know ’� ask you, I did anything wrong? something that hurt you.’�
Rosily stared at Jayaraj. Then she emerged from the shell. A flicker of her old smile appeared just for a brief moment. They were silent.
’�You know about the rumors going around here, about ME, the two of us?’�
’�I’m ’� I didn’t ’�’�
’�No, no. But they’re not good. Dangerous, especially for a girl. I should’ve realized that. I don’t blame you entirely.’�
Jayaraj noticed that she said not entirely. He kept quiet.
’�But, there it’s. Thought it’ll fade off, but it didn’t.’�
’�I didn’t even know.’�
’�You didn’t know? Don’t tell me!’�
’�No ma’am, I didn’t know that you’ve heard!’�
’�Oh, I see.’�
’�Yes, but what could I do?’�
’�It reached my family, Rajeev - you see, he’s my fiancé - he heard it too. Not very pleasant.’�
Not very pleasant! What an understatement it was! So, Jayaraj thought, women did not always exaggerate.
’�He’s understanding, Rajiv!’� Rosily continued.
’�Yes?’�
’�Yes. But you did nothing to help.’�
’�What? What could I ’�’�
’�Not blaming you.’�
Jayaraj was afraid if she suspected that he encouraged the rumors.
’�I’d to get out of that situation. Don’t come anywhere near. Leave me alone!’�
It was a plea and a command. Pensive, but wiser, Jayaraj left Ward 13.

Chapter 28

1 November 1956. The state of Kerala was born. Travancore-Cochin and Malabar joined together, transforming a dream into reality. George, however, saw no reason to celebrate. The only advantage was a holiday.
Jayaraj was in the medical College, busy becoming a doctor. Those at the Tharavad hardly welcomed the Kerala State. They were sorry that the name ’�Travancore’� disappeared forever.
Early next year, in the election to the state assembly, the Communist Party came to power. This was hailed as the first-ever democratically elected communist government anywhere in the world. Communist tradition was to capture power through revolution. Contesting elections was a new experience for the movement. However, George, an avid reader, knew that the tiny Mediterranean country, San Marino, actually had an elected communist government as early as 1947. However, no one heeded; boys in his class, overwhelmed at their class victory, continued to celebrate the first elected communist government. George, accustomed to indifference and neglect, was neither surprised now disappointed.
Opposition to the government started soon after its formation. The privileged class, used to the benefits of authority, found it hard to accept the proletariat wielding power. The new rulers, oppressed so far, did not help matters by the overenthusiastic control of civil administration and police enforcement. Both groups followed their own agenda and a collision became inevitable. Within a year, a strong movement against the government started with the politicians, vested interests and communal forces joining hands. Students soon became active participants in the battle. In an action, both undemocratic and unfair, the Central Government took over the state administration. The first communist government in Kerala came down after being in power in just over two years.

Chapter 29

’�Why are you late?’� asked Dr. Radhamani Menon.
’�I just went to Ward 10 to see an interesting case, ma’am.’� Said Jayaraj. He, with two classmates, was waiting for permission to enter her class.
Teacher’s face darkened. ’�Oh! Then go back and see more patients!’�
’�Ma’am, I’m sorry.’�
’�Don’t disturb!’�
Well qualified, knowledgeable and pleasant, Radhamanima’am, an assistant professor of gynecology was popular; she was proud of it. Compassionate and kind, her indulgence to student-delinquency was well known. She admitted students late, provided she thought the excuse was reasonable.
Jayaraj’s friends gave plausible but false excuses and were admitted. Jayaraj realized truth was not appropriate for all situations. The rejection was bad enough; more disturbing was the hurt look on Radhamanma’am’s face.
Jayaraj realized that he had committed another faux pass. What a walk-straight-talk-straight sort of fellow he was! After his medicine posting, he was in gynecology. He did not like the subject. But, he tried hard. He had no intention to repeat his performance in anatomy. Now he wondered if the pattern was recurring. He resolved to mend his rapport with Radhamanima’am.
Jayaraj went to the next clinic quite early. He volunteered to discuss a case, hopping to please her. He probably did. Her face was impassive though. But Jayaraj could not find the patient; the bed was vacant. He panicked. Knowing that wandering in the female ward was bad manners, he went to the duty room. Radhamanima’am was there.
’�Can’t find patient. She’s not in bed.’�
’�Do you expect me to hold patient down in the bed for you?’�
’�Sorry ma’am.’�
’�Go and wait; she can’t disappear!’�
Jayaraj thought that certain subjects were not for him. Again, he resolved not to allow the incident to bog him down.
Later when he found the patient, he prepared the case well and used all his skills at the presentation.
Initially Radhamaniteacher was impassive. But his presentation roused her interest. She finally complimented him. He had won the day.
Days went by. Jayaraj started his third and final tenure in Ward 10. By that time, he was a rising star. His classmates often came to him to clear their doubts. His teachers, even the professor acknowledged his depth of knowledge and patient-examination skills.
One day, while waiting for the clinics, Jayaraj was summoned to the professor’s office.
Jayaraj was curious but not perturbed.
’�I’ve urgent work. What’re you doing now?’� Ram Mohan asked.
’�Waiting for medicine clinics, sir. Ward 10, Dr. John.’�
’�Okay. They wouldn’t discuss anything you don’t know! We’re short of staff. I’m supposed to teach first termers.’�
Jayaraj waited.
’�I’ve to leave! Now, you go and engage them.’�
Jayaraj was startled first, and then, amazed. A little later, he was proud and satisfied. This was a moment of crowning glory. Unique, once-in-a-life-time opportunity! He was mesmerized.
’�Don’t worry. Tell then basics. Stress on examination. You select any patient for discussion in ten; or, do you want from another ward?’�
’�No sir! Ten’s fine.’�
’�Okay. Get going. I’ve urgent work.’�
More than the recognition, the way the professor treated him, as if he was a colleague, elevated Jayaraj’s spirits to cloud nine. This would happen in Ward 10, where some of his classmates assembled. His glorious performance would be right in front of an audience.
Jayaraj knew that the professor did this occasionally, not always due to staff shortage, but to reward an outstanding performance and to test the talent. It was the ultimate compliment paid to an undergraduate. The rarity made it a coveted honor awarded by a distinguished teacher.
Jayaraj was in a trance the rest of the day. The clinical discussion went on well. His first thought was that the ’�repeater boy’� had made it to the top, a rug-to-riches fairytale. He was proud and arrogantly conceited. He longed to share this glorious moment with someone who would understand and appreciate it, someone like Rosily. But, she was someone else’s girl.
Radha, his girl, was not intellectually apt to appreciate his achievements or share his dreams. He realized that whenever he was seeking companionship, a hand to hold and a shoulder to rest head on, he was not looking for Radha. He wanted to believe that he loved her. But he did not know what type of love it was. It could be physical attraction. He suspected that his emotional commitment to Radha was waning. He was afraid that it might break off totally. Then he remembered her plight, a captive in the old sprawling house. With no one to turn to, disowned by his parents, she was a forlorn girl. She haunted his conscience. But, that was not love. He doubted if he could bring in Radha into his present verve.
As time went by Jayaraj’s confidence increased. His personality and aspirations changed. The boy who wanted to amass wealth and enjoy worldly pleasures had changed. He found the joy in his life. He was in love with the subject he was studying, the profession he would practice. The taste of success made him a new, mature man. He now wanted to emulate Ram Mohan, a great teacher, a skilled diagnostician and a brilliant clinical scientist. He wanted to be a leader of women and men.
Jayaraj thought about his parents. He no longer remembered the day his mother gave away her gold for his education. He was temperamentally incompatible with his father. However, his mother was close to him, once. He had shared his moments of triumph and thrill with her. But, she had moved away, far, far away. He was distained to be lonely.

Chapter 30

George completed school and was ready for college when he was 15 years old. His choice was the Maharaja’s College in the nearby town. Daily commute was impossible; George stayed in the hostel. Though sad to see him go away and concerned about his safety and comforts, his parents accepted the inevitable. No matter what, studies must be continued.
The college was the best in that area, with a long tradition of excellence. Faculty was outstanding. The Malayalam faculty consistently contributed to the literature.
Transition from school to college was an exciting experience. Suddenly his cloistered and chaperoned life changed to a free, unsupervised and unrestricted one. The easy informality of the campus was in stark contrast to the puritanical-behavior code and uncompromising boy-girl segregation of the village. A bewildered George observed, with wide-eyed innocence, the boys and girls talking with each other easily and naturally. Tongue-tied and socially awkward, he could not face girls, let alone talk graciously. He tried to avoid them.
Yet deep within, he nurtured a desire, a dream. One day he too will acquire enough poise to talk freely with girls. For the first time he regretted that his parents did not sent him to a liberal boarding school.
Soon rapport developed among students; friendships evolved. Masks and guards came down and true character surfaced. In the school, George had joined an ongoing class; here everyone was new. Class segregation based on economic status was less. George did not feel isolated. Yet George was uneasy. Initially he thought it was his usual, dismal fright of new people.
Students reached the campus early, before classes started. They loitered in the corridors and in the classrooms. The smart boys, and even some girls, indulged in playing practical jokes, targeting the weaker and the silent. Before long the class understood George, his timidity and trepidation. To tease and torture the weak were favorite pastime of many. George was an easy prey.
The class nicknamed George, ’�priest.’� As he entered the class, catcalls, ’�amen’� and church hymns filled the room. When under pressure, George nostalgically thought of his parents; that made him sad, occasionally visibly. This amused and stimulated his tormenters. George bore silently, but seethed in his mind.
George remembered his mother. He missed her. She was sensitive to his moods, consoled him when necessary. Even his father would have tried to comfort him. Later, even when he blamed his parents for his psychological makeup, he did not forget their kindness and love.
The hostel was not a comfortable place, with three boys crammed into each room. Filthy toilets and grisly bathrooms did not make life agreeable. The food was plain and unsavory. Muthalali periodically visited his son. He was sorry at his son’s suffering. But that was part of the preparation to face life with confidence.
’�Georgekutty,’� asked Muthalali, ’�How do you like it here?’�
’�Nice. I like it.’�
’�How’re your studies?’�
’�No difficulties.’�
’�Are you home sick?’�
’�No.’�
’�You’re happy?’�
’�Yes.’�
’�Do you want to come home?’�
’�Now?’�
’�No, to live there. Come to college daily by boat.’�
’�Three hours in boat, morning and evening! No.’�
’�You can study in boat. No disturbance.’�
’�No, not good. I’ll continue here.’�
The class had a girl, good-looking, quiet, composed, serious and studious. Because she was tranquil and aloof, the class nicknamed her ’�nun.’� They tried to torment her. But, she did not seem to care. Unlike George, she was confident. And the class lost interst.
But, this led to an unwelcome development for George. The boys arbitrarily decided that the nun and the priest were in love! They found one more gist to tease him with. If she knew this, she showed no indication. To George this was blasphemy. He worried if his parents would hear about it. They would not care if this was real or just fabricated. How could there be smoke without fire?
This was his old school all over again. George was looking forwards to a great college life. Now it was not going right. Again, self-pity engulfed him. But, this time it did not last long.


Chapter 31

Unexpectedly one day Radha’s father showed up in Jayaraj’s hostel.
’�Came to admit Radha to college here,’� Karunakaran Nair said. ’�She got admission in the Convent College.’�
’�Convent? Here?’�
’�Yes.’�
’�Oh.’�
Jayaraj looked for Radha.
’�No, she’s not here. She’s in hostel.’�
’�Oh, I see.’�
’�Yes.’�
’�But, she could’ve come.’�
’�Warden’s very strict. In room by six. Leave hostel only by permission. Good too. We’ve peace of mind. Discipline’s good.’�
’�Oh, I see!’�
’�Now you’re her local guardian. Wrote your name there. You can visit her, but visiting hours only, four to six, evening.’�
Jayaraj remained silent.
’�Take care of her. First time she’s outside home. Very homesick.’�
’�Yes, I’ll visit her. She can contact me if necessary.’�
’�Tell her yourself. I wouldn’t see her again today.’�
’�I shall take care. Don’t worry.’�
Jayaraj was pleased. Good arrangement. He could visit Radha whenever he wanted. Right of entry to the girl’s hostel was a rare privilege; his friends will be jealous. At the same time, Radha cannot visit him. No disturbance. An unsophisticated girl visiting him in the hostel could be embarrassing.
’�Now my mind’s at peace. We knew, we could count on you. Her mother will be happy.’�
Jayaraj tried to figure out their motive. Radha was not good at studies. Career was unthinkable. They might have sent her to be near him, to foster their relationship. If they sold Sarojini Amma’s gold to finance, it was a good investment! Jayaraj wondered what his parents thought.
He smiled.
Jayaraj did not have to wait long. A letter from his mother arrived the same week. It was full of derogatory and abusive epithets of Radha’s parents. She decreed that Jayaraj should not visit Radha. Or else! It ended with a stern warning.
Jayaraj was not pleased at his mother’s meddling. He was in no mood to oblige; but he would not tell her. He will see Radha, if only to rebel.
Next evening Jayaraj, in his best attire, reached Radha’s hostel. He was upbeat.
Radha came to the visitor’s room.
’�So,’� started Jayaraj, ’�What a surprise! You came here!’�
’�Yes. Happened so fast!’�
’�How?’�
’�Achan and amma were talking about this for some time. But, everything happened so fast.’�
’�How did they manage? Admission? Money?’�
’�I don’t know. They arranged everything.’�
’�You don’t know at all?’�
’�No.’�
’�Good you’re here!’�
’�Yes, Jayettan, I’m so happy!’�
’�Yes, yes. So unexpected.’�
’�I was praying for this.’�
’�I’m glad it worked!’�
’�I want to be near you.’�
’�I know, I too.’�
They talked for an hour.
’�When’ll you come back?’�
’�Soon. But I’ve to study! Anyway you’re here now.’�
Jayaraj saw Radha several times the first month. After the initial excitement, homesickness, apprehension and loneliness Radha settled down. And she became more demanding.
’�Why didn’t you come all these days? I was waiting!’�
’�Just over one week! Needed something? Could’ve asked me.’�
’�How? Shout from here?’�
’�Post a card. Would’ve reached me next day.’�
’�Oh, postcard, ah! So I’ve to write to see you?’�
’�Did you need anything?’�
’�Just you, Jayettan. Needed only you.’�
’�Okay. Come now, I’ll come more frequently.’�
’�Please!’�
’�Yes. But, my final exams. I’ve to pass, don’t I?’�
’�Oh, yes. Oh yes. See me when you can.’�
’�I want to see you, you know!’�
’�After exam what’ll happen to us?’�
’�I’ll be here as house surgeon, one more year.’�
’�One more year after exam?’�
’�Yes. That’s student life, without examination. After that, I’ll be independent. So, same life for another one and a half years.’�
’�But, what happens then?’�
’�Plenty of time to decide, don’t you worry.’�

Chapter 32

George found his salvation in college politics. His knowledge and understanding of public affairs, acquired through reading, helped. He had sound political awareness and social conscience.
But, George’s most remarkable experience was the pure joy of attending classes. Teachers mesmerized him. The Malayalam and English lectures were captivating voyages through the panorama of scholarship. They fascinated him. Knowledge for the sake of knowledge was not a popular concept. But, George understood the essence of true scholarship, acquiring knowledge with no strings attached.
The large, crowded language classes provided no opportunity for individual student-teacher interaction. That was a disappointment. George idolized some of the teachers. A personal amity with them could mean a great deal.
Malayalam classes were his favorite; he never skipped one.
’�Some biographers meticulously record every detail of their subject,’� A Malayalam lecture was in progress. ’�Boswell’s celebrated biography of Samuel Johnson is an example. Boswell hero worshiped his subject, was constantly with him and recorded all the details. But, some biographies analyze, often ruthlessly criticize and dissect out the person; yet others are complimentary, appreciative. Some biographies are tomes, thousands of pages, compiled in many printed volumes. We have examples in our country, take Gandhiji’s biography ’� by ’� hum ’� by, I forget the author. Does anyone know who wrote ’�Mahatma,’� the multi volume biography?’�
George was excited; he could answer. But, he was weary of standing up and say, attracting attention. He almost gave up; but then suddenly the urge to attract his idol’s attention was too much. He stood up, and with his heart racing madly, blurted, ’�Pyarelal, sir?’�
’�No, I’m talking about the eight-volume biography; not the one written by Pyarelal.’�
’�Oh! That’s Tendulkar, sir! ’�Mahatma’� by Dinanath Gopal Tendulkar!’�
’�Yes, that’s it! Hum, have you read it?’�
’�Not completely, sir. Some parts, mostly photographs.’�
’�Wonderful! And good photographs too. You must keep up the habit of reading.’�
Suddenly George was conscious of the crowded class. He was standing and talking to his teacher, one to one. Was this happening to him? Slowly he sat down. George was in a reverie rest of the class.
After the class, some one shouted, ’�Our priest’s trying to shine!’�
’�Who’s he trying to impress?’�
’�Nun.’�
But, for once, George did not care. For a brief but shiny moment, he was alone with his teacher, talking personally. What more could he ask for?
With envy, George had watched the postgraduate classes, half a dozen students and teacher forming a small intimate group. He longed to belong there. How much would he love that! But, he was sure his parents would not allow.
Elections to the college union came up. It was a politically charged affair, fiercely fought between two student parties, the Students Federation of India (SFI), the student wing of the Communist Party and the Democratic Front (DF) supported by the non-communist parties.
The senior students frequently met and talked to the freshers, to win their votes. Meetings were organized. George got interested. He attended the group meetings, heard the speeches. But, he was in a dilemma about the party to support. The SFI appeared progressive, liberal and radical, the smart choice. The DF on the other hand looked traditional, conservative and reactionary, not fashionable.
The prevailing intellectual thinking in the campus supported left-wing ideology. He resented stylistic consideration for supporting any ideology. But, now he was in another world created by his favorite teachers, mostly leftist thinkers. Therefore, George initially preferred the SFI. But, the communist label was a problem. He could not reconcile to that movement. Traditionally his family was fiercely against it. He chose the DF. His involvement was not substantial. He was happy to tag along with group of students going around canvassing votes. To his surprise, he found that the DF was quite popular. It was a turning point. There was no reason for him to suffer in the class. He should not surrender.
George found a small number of his classmates deeply involved with politics. They consistently occupied the backbenches, ignoring prangs and banters. Confident, intense, sharp and loud, politics was their religion. They had support of the powerful politicians outside. Colleges were the recruiting fields of high profile future leaders. George used the opportunity to mix with some of these boys in his class belonging to the DF.
Slowly George moved to the backbench. He contributed to their serious conversation, be it politics, philosophy or literature. Their friendship grew. George found them well-informed. They were skilled debaters. Once his party leaders learned of his interest and erudition, they considered him as a candidate for the College-Union election. He was elated; at the same time, he was frightened. Stage fright! He sweated and trembled at the thought of public speaking. Tagging behind a group was one thing. Standing on the podium was another. But he started savoring the campus life.
’�I hear college politics is very wild. Is it right?’� Muthalali asked when he visited George.
’�Very active, very interesting.’�
’�Interesting! Violence’s interesting?’�
’�No! There’s no violence.’�
’�That’s not I hear!’�
’�But Appa. There’s ’�’�
’�You came to study, no? Don’t get involved. Do your duty.’�
’�Yes, Appa.’�
He killed the idea of election then and there.
But, his politics had an important byproduct. He could contain the teasing. He ignored his classmates, everyone except the nun.
’�Georgekutty,’� Muthalali asked, when he met George later, ’�How’re studies?’�
’�Very well, Appa!’�
’�Good. Are you weak in any subject?’�
’�I don’t think so.’�
’�Need private tuition?’�
’�No, not now. Later I’ll tell you.’�
’�Don’t worry about money.’�
That was reassuring to hear.
The nun remained a curiosity for George. With his newfound confidence, George thought he could talk to her. He was unsure why; maybe to prove his social prowess; maybe some other interest. Immidiately he remembered his parents. His confidence faltered. Nevertheless it remained an obsession. Even when debating political ideology, George envisaged the ’�talk.’�
Finally, one day George acted. Carefully choosing the time and place, he waited near the college gate. He was sweating, his face pale. He felt the fast and vigorous throbs within his breast.
Then he saw her coming. His heart missed a beat. But, he had crossed the point of no return.
’�Going home?’� he blurted out.
She just nodded, as if mocking, where else. Was there a derisive look on her face? The beginning was over. What next?
’�You’ll come tomorrow?’�
’�Yes, of course.’� Again, that amused look.
She waited. But, he had nothing to say. His mind was blank. He was disappointed she asked him nothing. Desperately he searched for another question.
’�You’re going home?’�
She laughed. ’�Yes!’�
And she walked away.
That crushed George. He cursed himself for starting this. Whatever be his strengths, talking to a girl was not one.
But, to his utter delight, next day he saw her looking at him and smiling. It was a rather shy smile.
George again wanted to talk to her. He doubted if he could do any better. But now he was not testing his communication skills. Nor was it to entice her by his magnetic appeal. It was the fulfillment of a desire to be near her, to understand her. But he doubted if he was ready for the follow up. Then he remembered his parents. He did not pursue.
George was uneasy when he met his father next time. His ’�talk’� was fresh in his mind. His fear was baseless; his father could never have learned that. But, disobedience was a sin; he was uneasy.
’�How’re studies?’�
’�Good.’�
’�We’re happy, your mother especially, about your progress.’�
’�Oh!’�
’�You happy here?’�
’�Yes, yes.’�
’�What’re your favorite subjects?’�
’�Aha, I ’� Biology! Botany and Zoology.’�
’�Good, you’ll go for medicine!’�
’�Appa!’�
’�What?’�
’�Nothing.’�
He was marked up as a future doctor. George so far was not averse to taking up medicine as his career. It was a noble calling. But he no longer wanted that. The college education changed his outlook.
George could not forget the nun. It was not love, certainly not passionate infatuation. It could be a fancy, just a fantasy of a suppressed adolescent mind. It was the tenderness he felt towards the first girl he looked straight at face.
Later, George often wondered what his life would have been if he were more gregarious and outgoing; and if his parents did not enslave his mind. Too many ifs! Who knew, he might have ended up living with the nun. That was interesting to contemplate. This was just about the only humiliating memory that amused him. Because the incident was so far out of his character, he saw it as something that happened to someone else.

Chapter 33

’�What’re your plans for the future?’� an external examiner asked Jayaraj. It was the viva voce in medicine.
’�Sir, I don’t know!’�
’�He’ll be my house-surgeon, and then my post-graduate student,’� declared Raj Mohan, ’�Wouldn’t you?’�
Jayaraj smiled diffidently.
’�If you want a change, come to me,’� external examiner, said, part-joke-part-compliment, ’�We’ve vacancies too.’�
’�I thought you’re my friend!’� said Raj Mohan.
The examination was over.
Jayaraj had nothing to do. He did not want to go home and face his parents. The harrowing past was still vivid. Radha in his life was still a secret. He did not want to lie, yet was afraid to tell the truth. Jayaraj remained in the hostel, read avidly and kept visiting Radha.
Jayaraj was about to become a doctor. He briefly imagined that he could get a wife better than an unsophisticated village girl like Radha! There he stopped. He was ashamed. He now accepted her totally. In recent years, Jayaraj had taken few things, other than studies, seriously. But, now he understood what he was getting into.
Radha had no doubts, anytime, about their future together. Her commitment and fidelity were unmistakable. This was no teenage fantasy. This was all about life. This was basic existence and survival.
Suddenly a thought struck Jayaraj. Did Radha ever have an affair, even a transient fascination, with anyone? Radha’s parents might have shifted her to break the romance. The thought started innocently but grew into an obsession. Jayaraj was restless. He had to find out. Them, suddenly he had the answer. If even a faint whiff of doubt existed, it would have attracted his parent’s attention. Then he would have known. No reason to mistrust.
Again Jayaraj had doubts. Radha could be looking for material benefits, trying to marry a doctor. He was so materialistic. She committed much before he started medical studies. He should believe that she simply loved him. Worldly gains alone did not guide human behavior. Jayaraj had difficulty accepting that.
When Jayaraj saw Radha, he probed.
’�How’s life now?’�
’�Good, very good!’�
’�Like it here?’�
’�Yes, what more can I hope?’�
’�Better than Tharavad?’�
’�No doubt!’�
’�How was life there?’�
’�Quite boring. Without you, what life?’�
’�There’re others.’�
’�Yes. Parents, aunts and uncles! Not good substitutes!’�
She laughed.
’�But, there’re still others.’�
’�What! Who? Others?’�
’�Others, many boys, cousins there and classmates.’�
’�What about them?’�
’�You could’ve ’� entangled ’� one of them.’�
’�How could you say such a thing? Were you doing that here? So many girls!’�
Tears appeared. Voice changed.
’�Who knows what you’re doing? I believed you!’�
Jayaraj laughed shortly.
’�Didn’t mean that. I only joked.’�
’�Joke? Joke!’�
’�Just teasing you. You think I’m serious?’�
’�I don’t know.’�
’�Don’t weep, silly.’�
’�Please, don’t say such ’�’�
’�No. It’s only joke. No more, I wouldn’t!’�
’�How much do I love you!’�
’�I know!’�
’�You know?’�
’�Yes.’�
’�No, probably not. I love you much more than you think.’�
’�Yes.’�
’�I trusted you, still do!’�
Jayaraj believed her.
Again, gradually, the meetings turned monotonous. Jayaraj had nothing much to tell Radha. She always had something to say.
’�You’ve nothing to tell me?’�
’�I’ve told you all I know. I’ve to repeat it.’�
’�Actually, silence’s sign of wisdom! No?’�
’�Yes. You know so much!’�
’�Hum. You think I’m a fool! I talk much.’�
’�You see, my world’s just medicine. What can I tell you?’�
’�Only medicine?’�
’�And, of course you!’�
’�Then tell me about me.’�
He laughed. That was how the small talk should go. He should enjoy the parlance that carried no sense. But, he did not. He got tired soon.
’�Look, can we go out?’�
’�What?’�
’�Go out, a cup of coffee?’�
’�Go out?’�
’�No one will see us. Just up to that corner.’�
’�Are you saying, we go together?’�
’�Yes, why not?’�
’�Did you ’� have you thought about it?’�
’�Thought? What’s to think about it?’�
’�I’m scared.’�
’�Scared of me, ah?’�
’�No, silly!’�
’�Then?’�
’�If someone sees?’�
’�No one, I tell you.’�
’�Still it’s not proper.’�
’�Proper! What’s improper?’�
’�Actually, I like to go out with you.’�
’�Good. Come.’�
’�No Jayettan, not today, please.’�
’�Why not?’�
’�Another day, I promise.’�
Finally, one afternoon they were ready. Radha got the warden’s permission to go out. The evening coffee became an infrequent break to the monotony.
’�Shall we go and see a cinema first?’� one day Jayaraj asked.
’�Cinema!’�
’�Yes.’�
’�You’re mad!’�
’�What’s your worry?’�
’�Actually, it’s not right.’�
’�Why?’�
’�Not proper!’�
’�Nonsense. We’re just going to movie.’�
’�If someone sees us?’�
’�Let them see!’�
’�Oh, God!’�
’�Okay, okay. Calm down. No one will see!’�
’�Right, if you say. But ’�’�
’�You’ll see. Nothing will go wrong.’�
After the movie, they walked to the restaurant in an upbeat mood. Their hands brushed each other’s. Years ago playing in the Tharavad they fought and wrestled, and thought nothing about it. Now just grazing hands titillated them both. The magic of the age! Cynically Jayaraj thought that after a few more years the romance might disappear, the touch would be routine and unexciting. He should enjoy the amour while it lasted. He was enjoying his private dream when he heard a harsh, familiar feminine voice, ’�Jayarajan!’�

Chapter 34

A lull in political activity followed the college elections. But, the new College Union became active. They staged literary and cultural events. Debates, artistic performances, musical evenings, scholastic presentations and such activities became frequent. This was the fulfillment of George’s expectations.
Life seemed to settle down to a pleasant rhythm when political turmoil burst out. The immediate and apparent provocation was a fare hike for students in the ferryboats. The DF led the agitation. Students picketed the boat terminal, government offices and public utilities; police used force to break the blockade.
As a member of the DF, George was expected to participate. But he was scared. He had heard stories of police brutality. Discoursing political philosophy on the backbench or debating human rights under the rain tree were not revolution. George loved ivory towers, not street fights. He was mortally frightened about persecution and torture.
His family was another inhibition for George. They would never approve his participation, even if the police did.
’�Participate in picketing,’� urged a party colleague, ’�I mean, go, get arrested at least once. Without that, your position in party will be weak. Your future will be spoiled. This is a wonderful opportunity!’�
’�Yes, but ’�’�
’�What? Are you scared?’�
’�No. Not scared.’�
’�Not scared. Only afraid!’�
’�Really, no.’�
’�Without some suffering, you can’t achieve anything.’�
’�Suffering?’�
’�That’s right. Look at our leaders. All of them have gone to goal.’�
’�But, who wants to be leader? I don’t!’�
’�Think. You wouldn’t get another chance like this.’�
’�Yes?’�
’�It’s for your benefit. No dearth of political warriors here.’�
’�I know.’�
That much George knew. The ’�rightwing’� reactionary movement was now fighting against the ’�leftwing’� establishment. That added glamour to the fight. The correct label was important. Many wanted to take advantage.
Finally, the decision was thrust on George. The very next day, Muthalali came.
’�How’re your studies, Georgekutty?’� the usual question.
’�Good.’�
’�You’ve classes now?’�
’�Yes, we’ve.’�
’�But the strike?’�
’�Yes. Many classes are cancelled. Still some classes go on.’�
’�I heard they’re closing college.’�
’�No!’�
’�So let it be. You come home with me. You’ll come back when it’s all over.’�
The revolution was not for George.
’�Mone,’� his mother asked, ’�How’re the studies?’�
’�Good, Amma.’�
’�Eeshoye! Which’s your favorite subject?’�
’�I like all.’�
’�What’ll you do next year?’�
’�I don’t know.’�
’�Don’t know? You wanted to be doctor!’�
’�I’ve no idea.’�
’�Then I’ll tell you! You’ll become a doctor.’�
’�Hum.’�
’�How’re your marks in biology?’� asked Muthalali.
’�Good, I usually get around 40 out of 50.’�
’�Is that good? To get admission for medicine?’�
’�Yes.’�
’�Get good marks in finals. That counts for admission.’�
’�Yes, Appa.’�
The tempo of the student’s struggle came down considerably within weeks. George went back to the college to pursue his studies. He wrote the final examinations with confidence. And then he went home and waited.
George was in a predicament. He had no aim. Going purely by his present interests, he would study literature. However, that was difficult.
’�Amma, what do you think of lawyers?’�
’�Lawyers? I don’t know! Why you ask?’�
’�If I become a lawyer? Like that?’�
’�No, Eeshoye! Certainly not. You’re going to be a doctor!’�
’�Yes. But, law’s good. Successful lawyers make lots of money.’�
’�I don’t like it.’�
’�But, I like it.’�
’�Law? Eeshoye. Like it?’�
’�Yes.’�
’�I don’t know. Talk to Appa.’�
’�You do, please, Amma.’�
’�Let’s see.’�
She brought up the subject when the three of them were together.
’�Do you know Georgekutty wants to be lawyer.’�
’�Lawyer?’�
’�Yes.’�
’�What’s it Georgekutty? Want to study law?’�
’�No, no! Just saying it’s a good profession.’�
His mother laughed.
’�Oh, good for what? For whom?’�
’�Some lawyers make a fortune, Appa. And, look at the judges.’�
’�Study in law college? You know the condition of the law college? Only rowdies go there. No.’�
’�But ’�’�
’�No but. You go for medicine.’�
The results came in. Georgekutty passed with good marks. Paradoxically he was disappointed. If only he did not have good marks! But, then his father would pay money and secure admission in a private medical college. He felt reckless and intentionally delayed his application, his first major act of disobedience.
When George was not selected for medicine, Muthalali was perplexed. Then he learned the reason.
’�Why didn’t you send application in time?’�
’�I thought the last date was ’�’�
’�You thought! You’ve started disobedience. Not good. Not good at all!’�
’�No Appa, I ’�’�
’�Don’t talk. You’re a shame to this family.’�
Silence.
’�What you think you’re going to do now?’�
’�I’ll ’�’�
’�You’ll what?’�
’�I’ll send early next year.’�
’�Ha! And waste one year?’�
’�I’ll study for BA.’�
’�I know, that’s what you want. Go for some good-for-nothing course!’�
Silence for some time.
’�Let me see,’� said Muthalai.
Muthalali took George to a private medical college, paid money for admission. However, there was no seat that year. They advised him to study the one-year pre-medical course in an arts and science college and start MBBS next year.
George was devastated. If he were in the state medical college, he would have been in the Maharaja’s College for his premedical course. Now he will be in some godforsaken hick town. His father took him for admission in a smalltime college in an unknown town.

Chapter 35

Jayaraj would not believe his eyes. First, a fantasy, he and Radha were having a good time, and then this horror. Right in front of him were his parents. No one spoke for what seemed an eternity. Surely, he would wake up any moment and realize it was a nightmare! Then he felt Radha trembling by his side. As he did not wake up, he realized it was real.
They were standing in the crowded street. But, Sarojini Amma had no respect for public place or privacy.
’�So, this is what you’re doing! We thought you’re studying. But, no, you’re fooling around with this girl. Right in daylight, in public! In front of people! Who knows, what all you two ’�ve done? This girl ’� she ’�’� Sarojini Amma chocked.
Then she turned to her husband, ’�Now, you see, this is your son. You said he’s studying. This is how he studies!’�
’�I thought ’�’�
’�You thought! What did you think? I told you all these days Jayarajan should not stay here after examination. You wouldn’t listen. You believed he was preparing for housesurgency. Now you see how he studies.’�
People were staring. Except Sarojini, everyone was embarrassed. They just wanted to end the spectacle. Somehow, Jayaraj and Nair steered the group to a quiet nook.
Sarojini’s wrath now turned to Radha.
’�We’ll take this wretched girl to hostel. Her parents ’�ve just let her out to do whatever she wants!’�
Radha was weeping.
Sarojini turned to Jayaraj, ’�You’re coming with us back home right now.’�
By night, Jayaraj was home. Sarojini continued shouting.
’�You’re a good for nothing delinquent. I’m ashamed of you. Wouldn’t obey your parents. Didn’t we tell you not even to talk to that wretched girl? But, you wouldn’t listen! You wouldn’t obey! Did you think about your sisters? We’ve to get them married!’�
’�Amma! I didn’t ’�’�
’�You shut up!’�
Sarojini Amma then turned to Radha’s parents, ’�You’ve let loose your daughter. That’s your business. Don’t spoil my son. He’ll get much better girls!’�
Savithri Kunjamma responded ’�We sent our daughter to college. Do you think only your boy can go to college? Anyway, she’s a good girl! She always stayed in hostel. Why did he go and see her?’�
She looked at Jayaraj evocatively, an assurance that the talk was just polemic. His face turned crimson. He figured out the charade. Radha’s parents considered him their collaborator! Now Jayaraj was sure that they sent their daughter to college with just one intension. But, Radha did nothing to allure him.
Jayaraj marveled how much more refined he was than these people. He owed it to his education and exposure. With a pang of gilt, Jayaraj remembered that his mother was responsible for that. But, that did not make him her slave for the rest of his life.
’�My son’s a useless fellow. That’s why he fell to seduction! Worthless fool!’� She turned to Savithri, ’�Why should I talk to you? It’s your nature!’�
With that she walked off.
Savithri started shouting. But, Jayaraj fled.
Life in the Tharavad was pure hell for Jayaraj. Yet he had one advantage; he could write to Radha freely. He felt no thrill; writing had become a tiresome chore. But, it was an act of defiance.
Jayaraj now was confident. He would be independent. He will earn money, first time ever in life. The stipend was small, ridiculously small. Jayaraj in his innocence, mixed with the newfangled conceit, believed that he had become self-reliant.
When the results were out, Jayaraj had passed. This did not surprise him; but he was pained that no one in the Tharavad seemed to notice. As he was about to go back, Sarojini Amma increased her tempo, ’�I’ll not allow you to go until you promise.’�
’�Amma, I told you. I promised.’�
’�Don’t say anything!’�
’�You ask me to promise and then tell me not to talk.’�
’�What?’�
’�No, nothing!’�
’�Ha, now promise that you’ll not meet or talk to that girl! You’ll marry a girl we select!’�
’�I told you!’�
’�Just obey.’�
Jayaraj was cornered. ’�Why promise? I’m no longer a child.’�
’�I’m your mother. You better obey me.’�
’�You’re unreasonable. You pester me unnecessarily.’�
’�Pester? Now, that’s how you talk to your mother! A parent’s like God. You respect them, obey them. You shouldn’t raise voice. When we’re children ’�’�
’�First, parents and children should love each other!’�
’�Now you teach me.’�
Jayaraj bolted from the room, turning her more furious. She continued to shout.
Jayaraj knew he lost control. He could not believe that he talked to his mother that much. Should he tell her that he was determined to marry Radha? He could not. Whatever happened, he would remain subservient. He could disobey, but should never disrespect, his mother. Avoiding her was the easiest way out.
Jayaraj was happy to leave. The farewell was not pleasant. His mother did not even walk up to the front door to bid goodbye. Jayaraj had a premonition that he would not cross that door again.
When Jayaraj reached his old hostel, he remembered his first day there. He was full of dreams. He was more confident now. The immature, arrogant boy had matured, tempered by experience.
With a heavy heart, Jayaraj moved to the house surgeons’ residence. He had crossed one important milestone in life. Unfortunate, at this glorious juncture in life, broken family relationships hung heavily in his mind. Yet his mood was upbeat. He was about to prove how good he was. It was no examination. It was the real thing.
Next day he reported for his posting. There again surprise and disappointment awaited him.

Chapter 36

’�Georgekutty, this place’s just like our eastern hi-ranges!’� Thomas Muthalali told his son.
Having seen very little of the hill areas, George made no comment. But, he noticed the distinct landscape, very different from his costal village.
Dharwar was in Karnataka State, northern neighbor of Kerala. Dusty, rugged and unrefined, it was the seat of a well-known university. George was about to start his premedical course.
The town was spread on small hillocks and valleys. George thought that it could have been a beautiful place had it been planned and maintained with imagination and esthetic sense. But, as it often happed in his country, both were totally absent. The town center was a dirty, rugged stretch of road lined with small nondescript shops and restaurants. Buses and cars competed with horse carts.
Muthalali left after admitting George in the college. Once again, George felt the loneliness of an outsider. The hostel was comfortable. But, the food was inedible. George, accustomed to coconut oil, found the all-vegetarian local fare, cooked in the quaint gingili oil, nauseous.
George’s classmates had the single-minded aim of pursuing medical education. No one was interested in literature or arts. Most of them were indifferent to political issues. Whatever spare time they could muster, they spent chasing girls.
The college had a good library. He spent many hours reading a wide array of subjects. For the first time he saw English-language periodicals. With disgust, he read about the discrimination against the blacks in the US; the resistance movement, the fight against the inequity and inequality, fascinated him. He was proud that rather than arms and bloodshed, the doctrine of nonviolence, originated in his country, guided the movement. Gandhiji had adapted the basically bodhisattva principle and gave it political and social significance. Remarkable, people of a country that produced Abraham Lincoln, turned to his land to learn the noblest way of fighting.
George learned about South Africa and its abhorrent practice of apartheid. The poetic injustice was that the country, where Gandhiji started his public life with nonviolent struggle against apartheid, continued the practice even now. But, George did not forget, nor did he condone his country’s dismal history of human right negation, untouchability, sati, dowry. But, that was changing, not fast enough, he thought, but substantially.
George found no one to share his views, ideals and aspirations. Disappointed and lonely, he went on long hikes in the evenings appreciating the beauty of the land. Many areas were unspoiled and charming. People were simple, helpful and friendly. Gradually his perception about the town changed. Now he was sorry he would be moving away pretty soon. Then he saw it. The incident influenced his life profoundly.
Very often, much too often for his comfort, George recalled the experience that was etched in his mind permanently. The fact that this event turned out to be such a terrifying, haunting memory, reflected his mental makeup. One evening during his lonely walk, George noticed a small crowed in front of the police station. He went closer to watch. What he saw chilled his body, every cell of it. At the entrance a middle-aged man in his undergarments was chained to a pillar. Two hefty men, half-naked themselves, were brutally beating him with batons, continuously and systematically. There was total silence, but for the cadence of the batons falling on the hapless man’s body. The atmosphere was eerie, surreal. Fear hung there like smog.
The whole episode had such an intense, utterly irrational, inhumane and absolutely brutal presence, that George, until he witnessed it, would have had difficulty believing that it could actually happen. To this day, he shuddered at the mere thought of it. He continued to hear or rather feel the rhythm of the beating with all the accompanying tumult of chilling supra-natural terror. The man, George was surprised to note, did not cry out loud. It was astonishing self-control! Or probably he was gagged. That would symbolize the real repression, silencing by violence! The prisoner simply bent and half twisted as each blow fell on his body. He meekly submitted to the torture and humiliation.
George watched this episode in stunned silence. But, what frightened him was the crowd, or more precisely the attitude of the proletariat. About half of them were impassive, no emotions on their face. Later, he realized that they were simply helpless. In any case, life might have taught them to keep away from such matters. The implied sense of helplessness frightened George still further. Unresisting acceptance of fate, sheer unadulterated defeatism, did not envisage a bright future for the society. A section of the crowd, to his astonishment, was actually enjoying the diabolical, frightening show. And the rest had pity written on their face. They too perhaps learnt not to interfere in such matters. The power to react forcefully and effectively was the fundamental sign of a vibrant society. Tired and miserable, this crowd exhibited cowardice and decadence.
It happened at a time when the world was not particularly alert to fundamental human rights. Even those countries that later became champions of human rights and watchdogs of its violations ignored them at that time. But, even then, George cherished such ideals as freedom and equality. He lamented that during those tumultuous years when ethnic and cultural minority groups in countries such as the United States, were questioning and ravaging the basic fabric of existence, his country was in slumber. But, then George was driven by idealism those days. It was the idealism of the young and uninitiated, the idealism of the innocent, of the ignorant. Fresh breeze with that lovely fragrance of equality and freedom, irrespective of cast, creed, language and color, was drifting through many countries all over the world. And it had touched the core of his conscience in no mean measure.
But, here, now, right in front of him, an instrument of the state was abusing official power flagrantly to oppress personal freedom. In front of a sizable crowed the basic rights of the citizen and just simple dignity of the individual were being so ruthlessly destroyed. And all these people could do was to watch in helpless silence.
In his naiveté, George thought he should go and tell those policemen that they were doing something wrong and illegal. They had no authority to punish anyone. This was an opportunity to endorse his respect for the rule of the law, an opportunity to ascertain his intense disapproval of brutality. George was not altogether out of touch with reality. The cowardice that prevented him from taking part in the student struggle surfaced once again. He could not put one step forward. He was conscious that he should not behave like the child in the church. Here the stakes were different. If he interfered, his action would bring in not just ridicule but, injury, physical suffering and possibly torture and even death.
Later, George recalled Gandhiji’s struggle in South Africa, much before he became the revered Mahatma. Gandhiji had the courage to ascertain his right to travel in a first-class rail coach when he held a ticket. He refused to leave the compartment reserved for the whites. The railway attendant threw him and his luggage out. At another occasion Gandhiji was brutally beaten up when he tried to hoist a flag. Now George had a genuine opportunity to show his courage and commitment. But, no, he was no great leader. Then again, he corrected himself. One need not be a phenomenal leader like Gandhiji to do such an act. Rosa Parks was no leader, either before or after she sat in one of the whites-only seats of the public commuter bus, in Montgomery, Alabama, USA on a December morning in 1955, catalyzing a movement that reshaped history. One need not be a Gandhiji, Patrice Lumumba, Che Guevara, Ho Chi Minh or Martin Luther King to start a revolution. They could start and sustain a revolution. George could have at least started it in front of that police station.
In front of that police station, in that atmosphere of frank, naked and intense terror, George was, stated simply, frightened, intimidated. The most forlorn conclusion was that the situation was impossible to manage. The custodians of law were flagrantly violating it. Who then will protect it? It was frightening in a way nothing else could frighten.
For a while George put himself in place of that hapless quarry. What he saw was not pretty. He could have illusions of his heroism. He might dream up leading a gallant resistance movement against brutality. But he was too frightened to move. If he possessed courage and a gift for leadership, he would have taken the crowd with him and encountered the policemen, becoming a genuine hero. If he had no courage but had the charisma of leadership, he could have remained at the rear and sent the crowd to encounter the police. He would be a leader, and with some luck, a hero. If he had courage, and nothing else, he would have gone into that police station right then, no matter what. Then he could end up dead. He was none of those.
George was mortified by shame. He was no leader. He was a coward. He was also practical. Even if he tried to stop the brutality, he might not have succeeded. Then again, momentous movements started from such small and symbolic acts. He had failed. He understood. He had no future in heroism.
George realized that this was a plane where courage and altruism met, not quite but almost. Courage would have allowed him to do what he thought was right, no matter what. But, even if he had courage, selfishness might still have prevented him from doing that. He would have placed his safety above everything else. Was he selfish or cowardly? He was both. Unselfishness and courage were an unbeatable combination. Courage provided the power to be selfless. At that level, courage and altruism met. If his selfishness was sufficiently strong and if his motivation was adequate, he might just have used that situation to his advantage. He might be a leader later! Courage was a positive quality, not just the absence of fear. John Kennedy was noted to be trembling, just as he was about to deliver what turned out to be his last speech. Amazing! The young, charismatic president, innumerable speaking engagements behind him, was uptight on the rostrum! The author of ’�The Profiles in Courage’� vanquished this fear so well that some of his speeches became world’s all-time greats. So, determination, George mused, could help conquer fear, motivated selfishness playing a positive role. The drive to excel was a self-centered force, just a shade away from selfishness. The chemistry was not simple. Courage, motivation, determination and selfless devotion were all ingredients or catalysts. George could not figure out which of these failed him.
Standing in that crowd George perhaps moved. A police officer saw the movement. He turned towards the crowd, took out his service revolver from the holster and raised it skyward. It was a casual, careless and aimless maneuver. Yet it effectively conveyed the message that the police meant business and that the crowed better kept away. It had its immediate intended effect. People, George among them, moved back a couple of feet. Again, he realized that he could never become a revolutionary. He was an armchair revolutionary, nothing more.
After sometime the policemen, sweating profusely, lead the man still in chains inside. The crowed lingered on for some more time. No one seemed to know the provocation for the torture. Nor did George try to ascertain. He was too immersed in his failure.
Chapter 37

House surgeons rotated through different specialties. Jayaraj was to start in medicine. Raj Mohan allotted the units. Jayaraj was certain about his posting in the professor’s unit. He was Raj Mohan’s blue-eyed boy.
With this confidence, Jayaraj went in for the allotment.
’�C’mon, Dr. Jayaraj!’� The stress was on the newly acquired title, ’�doctor.’�
’�Sir.’�
’�Okay, you start medicine, in unit four.’�
’�Oh, no! Sir.’�
’�What?’�
’�Sir, I want to work under you.’�
’�I know, I know. I would’ve liked to have you. You know that! I would’ve taken you in if it’s possible.’�
’�You’re not taking anyone?’�
If the professor was annoyed, he did not show it. ’�No, not even one, none this term. Slots are full. No chance. You understand that?’�
’�Yes sir.’�
’�It’s not important, where you work now.’�
’�Yes sir.’�
’�Try to learn all the tricks. Read up as you see patients. Later, we’ll see what’s possible. You’re just starting.’�
’�Yes sir.’�
’�Now you work in unit four.’�
’�Sir! Some other unit?’�
Raj Mohan looked up. He was a shade annoyed.
’�There’s a shortage there. You can be of help. Now start immediately.’�
The rejection was bad enough; but the allotment rubbed it in. A posting in unit four was regarded a punishment. When Peter Roy, the unit chief, was an assistant professor, he acquired a nickname, ’�Asspro.’� The name stuck; many considered it appropriate. Even today he was better known as Asspro.
Rosily was in unit one. She could be the reason for his rejection. She was a good student and had more clout than a fresh house surgeon will ever have.
Junior doctors named unit four ’�Wasteland’� or ’�Battlefield.’� When posted, most of them tried to get out. Many would use influence and recommendations, successfully. Jayaraj had no clout. In fact, he had thought that his source of influence was the Professor. He was wrong.
The professor’s last comment, that he will be of help, did not pacify Jayaraj. Cynically, he tried to believe that he was sent to the ’�Battlefield’� because he was a good solder! But, he would in the ’�Wasteland.’� This was the wage of success!
Jayaraj was outraged. Now he felt sure that Raj Mohan was displeased with him. Jayaraj looked at human relationships in a simplistic way. Only two types of people, either friendly or hostile, existed. No gray zones. Indifference was hostile. Now he shifted Ram Mohan from the ’�for him’� to the ’�against him’� slot. The Professor was in good company; Jayaraj’s parents were there too.
Jayaraj, in that mood, started in unit four. Later he resigned to the punishing task and resolved to get the maximum out of it. It was like a righteous penance for no sin of his.

Chapter 38

’�Now, what’d you find in this woman?’� Roy was taking rounds, ’�What’s your diagnosis?’� He asked the Senior Tutor.
’�Iron deficiency anemia. The blood picture ’�’�
’�Alright. But, cause of iron deficiency?’�
’�Bad nutrition and hookworm infestation. Here it’s, the test results.’�
’�No blood loss?’�
’�No.’�
’�Strange! What’re you going to do?’�
’�We prescribed iron and vitamins; Alcopar for deworming.’�
’�That’s all? No blood transfusion?’�
’�No, sir. No need, hemoglobin’s seven. Chronic anemia, not acutely ill. No need for transfusion, potentially hazardous.’�
Roy did not dissent. His habit was to torment juniors when they were unsure. He shifted his gaze towards the postgraduate students. ’�What’s Alcopar?’�
There was an uneasy silence. Roy pointed his fingers towards one of them.
’�It’s a drug, in powder form ’�’�
’�Ha, wonderful. That’s all?’�
’�It’s a deworming agent, specifically for hookworm infestation.’�
’�Great, just great. When’s your exam? I’m asking the name of that drug. If you know, say. If you don’t, keep quiet! Don’t give stupid answers.’�
The pharmacological names, usually tongue twisters, were not all that important in practice.
Jayaraj, had joined the unit days ago. Roy’s gaze moved to him. He stammered out, ’�Bephenium hydroxynaphthoate.’�
Roy stared at Jayaraj; he was surprised.
’�Hum, good,’� just about the best compliment he ever paid.
Others in the group looked at Jayaraj as if he was an ugly alien.
’�Do you know how it works?’�
’�It paralyses the worm’s muscles.’� He had just a vague memory. He could even be making it up; he could be wrong. ’�Paralyzed worm’s then purged.’�
This incident elevated Jayaraj’s mood. He imagined that it helped to create a rapport between him and Roy. It was a good start, worth keeping.
After the rounds the junior doctors gathered in the duty room. That was their relaxation time, gossip time and Roy-bashing time.
’�Hey Jayaraj, you knew that funny name?’�
’�I’m fresh from classroom. It’s in my mind.’�
’�Even in college I didn’t know it.’�
’�Look at our PG. He too bungled.’�
’�One way or other everyone bungles.’�
’�Yes, that’s true.’�
’�That’s one thing we’ve in common.’�
’�Sure.’�
’�Jayaraj, does it look strange to you?’�
’�A bit,’� agreed Jayaraj.
’�But you studied here. You should know.’�
’�yes, boss’s reputation has traveled wide and far.’�
’�Reputation you say?’�
’�I know it’s notoriety.’�
’�Is he always like this?’� asked Jayaraj.
’�Oh no! This is one of his good days.’�
’�Oh, I see.’�
’�He’s a sadist.’�
’�yes, when he gets up mornings, he decides on whom and how he would denigrate that day.’�
’�Really?’�
’�He finds fault with anyone and everyone.’�
’�For minor, often imaginary mistakes.’�
’�Pity’s, in other units doctors enjoy work.’�
’�We too enjoy.’�
’�Great enjoyment!’�
’�Yeah. It’s Asspro against everyone else. Isn’t it?’�
’�Yeas that’s true.’�
’�But in other units, they really enjoy. They’re treated with respect.’�
’�Really?’�
’�Yes, very friendly.’�
’�That’s bad. I mean our plight is.’� Jayaraj was sorry.
’�Roy gets us do work by shouting and abusing. That’s what he thinks.’�
’�But many leave, given a chance.’�
’�Worst thing’s whenever a patient becomes serious or dies, Asspro would blame us. Negligence, mistake.’�
’�Makes us feel guilty.’�
’�But if we’ve done nothing wrong, then why feel guilty?’� asked Jayaraj.
’�In this job, with critically ill patients, finding fault’s easy.’�
’�Actually Asspro feels insecure.’�
’�Careful. He hates that Asspro name!’�
’�I know! That’s why I use it.’�
’�Ha, whatever. He never ever gives an opinion; he’s afraid.’�
’�He’s very weak in clinical side.’�
’�He knows that. He hates to commit a diagnosis; more often he’ll be wrong.’�
’�If forced for a decision he becomes ferocious.’�
’�He’s insecure.’�
’�Jayraj, oh boy, you should see him in that mood!’�
’�You either ’�ve thick skin or get out.’�
’�How can I get out? No influence.’�
’�None?’�
’�I thought the Proff might help me. But, this is what he did,’� Said Jayaraj.
’�Raj Mohan?’�
’�He’s hell of a politician.’�
’�Agreed.’�
’�I see,’� Jayaraj was surprised.
’�But nothing like Roy.’�
’�He asks stupid questions like, Alcopar. No one, or very few,’� the PG looked at Jayaraj, ’�answers. We develop inferiority complex.’�
’�That’s what he wants. Demoralize everyone.’�
’�But, you know we’ve a collection of his old tricky questions.’�
’�Really?’� Jayaraj was surprised.
’�Yes. It’s in our cupboard there. Go though them.’�
’�But he comes up with fresh ones.’�
’�Yes, look at alcopar! It’s not in there.’�
’�One thing about Asspro! He treats everyone equally. Everyone gets the dose.’�
During his early days, Jayaraj bore the humiliations with stoical detachment. A kind of bond, camaraderie, developed among the junior staff. Jayaraj found this appealing, especially because it was devoid of the usual social obligations. It was strictly limited to the hospital wards. He took it as a compensation for his misery.
Roy was a shade soft on Jayaraj. He was less rude. But, then, Roy usually ignored the junior house surgeons. To him there were menials meant for scuttle jobs. Initially Jayaraj was not sure if Roy ignored or spared him. It could be either. Soon it became clear.
The whole team was standing around a patient. They were reaching nowhere with the diagnosis. It was too complicated. Roy contributed very little. The set practice in such situations was for a junior doctor, usually a PG student, to study the case and prepare a special presentation.
’�Jayaraj,’� called Roy.
’�Sir! Yes, sir.’�
’�Prepare this case and present tomorrow.’�
’�Yes, sir, sure.’�
’�Take detailed history, examine thoroughly and read up. If you need time, skip the rounds.’�
There was a hushed silence.
’�Yes, sir.’�
Then the significance sank in. Jayaraj will be presenting in front of these people, all of them his seniors. They will ask penetrating questions and make fierce criticism.
After the rounds, when the chief left, the junior staff gathered in the duty room. They chatted with doctors from other units and with the nurses.
’�Our baby’s growing up fast!’�
’�Who?’�
’�Jayaraj ’�
’�Congratulations, Jayaraj!’�
’�What for? He passed exam?’� a nurse asked.
’�No. Much more important. He’s Roy’s favorite!’�
The tempo of conversation went up.
’�Oh.’�
’�What’s that?’�
’�He’s asked to present case tomorrow.’�
There was a collective, jovial ’�ah,’� showing a mix of taunt and appreciation.
’�I say, arrange a party!’�
Jayaraj took the banter with restrain.
’�Okay, anything you say. Let’s ’�ve a party; we go to the cafeteria?’� Jayaraj was unsure and was worried about money.
’�What you mean? Everyone leave ward and go? No, no! We’ll have it here.’�
Just at that moment, Sister Juliet James walked into the room. A tall, handsome woman in her early forties, she was the sister-in-charge. She ruled her kingdom with an iron fist. The duty-room was her bastion. The nurses were under her charge. She considered the doctors, at least the junior doctors, were her subjects too.
’�What’s going on here?’� she demanded. Suddenly the clamor stopped.
’�Oh, we’re going to have a party.’�
’�Please join us.’�
The sister turned to the nurses.
’�Girls, you’ve nothing to do? Why are you making so much noise? Don’t you realize you’re on duty? Be responsible.’�
’�We’re just congratulating Dr. Jayaraj.’�
’�What for?’�
No one talked.
’�If congratulation had to be this loud, reason must be great!’�
’�No,’� a doctor said, ’�Jayaraj’s going to do his first case presentation, so soon after joining!’�
’�Oh. Great, congratulations, doctor. Now, you girls go and start working; don’t waste time. And don’t make noise!’�
She turned on her heels and walked out.
The nurses went out of the room. The doctors were embarrassed. They could still have their party; but no one had the mood. Jayaraj was disappointed that his day of accomplishment had now turned into a sour memory. However, in a way he was relieved. His money was safe in his pocket!

Chapter 39

Jayaraj, vowed to fix Sister Juliet when he would get a chance. He recovered soon. Quietly he went about preparing the case. The young patient had recurrent abdominal pain, occasional abnormal behavior and involuntary movements. Jayaraj could not put everything into one diagnosis. He examined, read, reexamined and discussed with senior colleagues; but, no progress.
When he thought of a possibility he rushed to Dr. Geeta Kumar, a tutor.
’�It’s Munchhausen’s syndrome?’�
’�I don’t think so.’�
’�Everything fits in.’�
’�Munchhausen’s is deception or self-injury for personal gain.’�
’�Oh, yes, but ’�’�
’�I don’t think that chap’s pretending. It’s not artificial.’�
’�How’d we know?’�
’�It’s a difficult diagnosis. We’ve to rule out every other cause before labeling. It’s dangerous, diagnosing Munchhausen’s and denying treatment! Suppose he’s ill! Risky, isn’t?’�
’�Suppose so.’�
’�It should be the last option.’�
’�Oh.’�
’�Still doubt?’�
’�No madam. You’re right.’�
Jayaraj saw the patient again. The abdominal pain roughly coincided with alcohol ingestion. That triggered a spark in his mind. He even recalled when and where he read it, in his hostel room one evening just before the final examination. Excited, he ran to the library. As he read, his heart raced. Then he examined the patient’s urine and clinched the diagnosis.
That night Jayaraj could hardly sleep. Presentation was tricky. Anyone could challenge the diagnosis. Others might bring out something new or strange, something he did not recognize, something he missed. But, he now had a reasonable diagnosis.
The next day, they gathered in the frugally furnished small conference room. Jayaraj recited the history and his findings. A brief discussion followed. Then Roy, who was listening morosely, asked, ’�Your diagnosis?’�
’�Porphyria.’�
Silence for sometime. Then everyone started talking.
’�Convulsions are not common.’�
’�May be rare, but it’s a feature of porphyria.’�
’�Yes, but ’�’�
’�Abdominal pain’s classic.’�
’�And abnormal behavior.’�
’�Yes.’�
Grudgingly they complimented Jayaraj. Roy alone remained silent. Jayaraj was excited. It was his victory.
After a couple of weeks Roy summoned Jayaraj to the out patients department.
’�Today you stay here. See the cases, write up and then send to me. You understand?’�
’�Yes sir.’�
It was common practice to have a junior doctor to assist the chief. A learning opportunity, it was a PG’s privilege. But no one rated working with Roy a learning experience or a privilege.
’�Ha, Jayaraj one more feather!’� friends teased.
’�Lucky we’ve Jayaraj.’�
’�How come?’�
’�Otherwise one of us will be with Roy.’�
’�Ha, ha! True! But boy’s shining!’�
After a few weeks, unit four was agog about a patient with a rare disease of the nervous system. Jayaraj saw the patient first, in Roy’s clinic. But, they did not diagnose. Dr. Cyriac, the enthusiastic, young neurologist, seeing the patient in consultation, did. A PG subsequently took care of the patient.
Cyriac later suggested, ’�Disseminated Sclerosis is thought to be a European disease. Not known to exist in India. But, now some of us think that it does. May be rare, very, very rare, but, not unknown. This case’s DS, no doubt. Fairly typical. You should publish it.’� He looked at Roy.
It would have been appropriate to entrust that privilege to Cyriac or to the PG managing the case. But, Roy turned to Jayaraj.
’�Look Jayaraj, you write it up. Show it to Dr. Cyriac.’�
There was a stunned silence. Jayaraj was desperate. He clearly did not deserve it. It was painful to face the angry looks. But, who would tell Roy?
Despite these sensitivities and embarrassments, Jayaraj gradually gained importance disproportionate to his seniority and rank. Towards the end of his posting, Roy allotted some patient-beds for Jayaraj. That was unusual too. Usually a junior house surgeon worked under another junior doctor.
A week later a patient complained to Jayaraj, ’�I’ve severe pain here.’� He pointed to his right hip.
’�Where?’�
Jayaraj examined carefully.
’�Did you injure yourself? Hit somewhere?’�
’�No, Doctorsar. It started after that injection!’�
’�Injection?’�
’�Yes.’�
’�When did you get injection?’�
’�Day before.’�
’�Only once?’�
’�Yes.’�
There was something wrong. No injection was prescribed for him. It was a mistake; it was done without aseptic precautions, infecting the patient. Jayaraj did not tell anything to the patient.
As Jayaraj hoped, he found the haughty Sister James in the duty room. But, he just ignored her.
’�Who gave the injection to bed 12?’�
Suddenly the room was quiet. One young nurse stepped forward.
’�Yes, I did sir!’�
Jayaraj felt pity. She was nice, polite and ready to learn.
’�But, why?’�
’�Sir?’�
’�Who ordered?’�
The nurse turned pale. Another nurse brought out the treatment book. The injection was for the patient in the next bed.
Sister James was watching the drama initially with interest and then with concern. She walked to Jayaraj, ’�I’m sorry doctor.’�
’�Not only wrong injection to the wrong patient, it produced an injection abscess!’� Jayaraj corrected himself. Accurately, it was the right injection to the wrong patient. But the infection! So, that was a wrong injection after all. Juliet, in charge of the ward, was responsible though she personally did not err.
’�Sir, I’m sorry. It shouldn’t have happened!’�
Jayaraj stopped it there. He did not want to castigate the young nurse. As he left the room, he heard Sister James, ’�I hope the brat will leave soon.’�
The nurses giggled. They probably enjoyed Sister James’s discomfiture.
’�I think he’s finishing his posting. I’ll be happy the day he leaves.’�
Jayaraj bitterly thought that she will see him back soon.
Even early during his career, Jayaraj was thorough, if dogmatic. He demonstrated remarkable commanding power. Suddenly he found nurses taking him seriously and following his instructions meticulously. Direct patient responsibilities nurtured his confidence leading to dogmatism, obstinacy and egoism. In a sense, intentionally or accidentally, Roy groomed him for greater responsibilities. In the process, Jayaraj picked up his chief’s traits.
Roy was incapable of demonstrating affection or admiration. He constantly displayed impassioned anger and irritation. Jayaraj was not treated differently. But a bond did grow. It was a special bond. Each of them understood the other.

Chapter 40

The police-station incident terrorized George. Yet that was not his first encounter with torture, not quite, but the most intense. So far torture was in the form of a nurse with a syringe, and later, the schoolteachers with cane. The ultimate torture weapon was the dentist’s drill. He juggled their roles in his mind. When he was waiting for the injection, he would think of his teacher. How kind she was! After all, she caned him rarely and only to correct him. Oh the nurse, she looked so cruel. When in front of the punishing teacher he reversed the roles. The nurse was an angel; she was merely carrying out a doctor’s orders. It was to cure him.
But, the dentist’s drill beat both of them hands down. The scene, replayed in his mind, was ghastly. Sitting on the chair, helpless and frightened, a powerful light focused on his face, George was in a torture chamber, though he knew nothing about torture chambers then. The dentist, bend down and peeped intently into his mouth! Now memories of another horror, a real-world, real-time terror, occupied his mind. It was one nightmare to remember, recall and despise, time and again.
Now that he failed, a failure he considered ultimate, he might be less exacting in his demands from others, less harsh in his judgment. Walking back to his hostel, George felt dirty, slimy. He told his classmates, just the bare facts, not his role.
’�Beating, ha?’�
’�Yes.’�
’�Who was he, prisoner?’�
’�Prisoner? It’s not prison. He’s in police custody!’�
’�Whatever, who’s he?’�
’�Who knows?’�
’�Why was he arrested?’�
’�No idea.’�
’�He must have done something nasty.’�
’�Yeah, without a reason no one beats.’�
’�He must be crooked.’�
’�Yeah, thieves. Unless they’re given a good dose they’ll keep create nuisance.’�
’�But police has no right to do that,’� shouted George.
’�Why?’�
’�Why! The court punishes, not police!’�
’�Then why the police at all?’�
’�To investigate crime. Keep law and peace.’�
’�This is how they do it.’�
’�That’s improper, illegal.’�
’�Why, police’s allowed to ’� ’�
’�Beat up people? No!’�
’�Then why are they given lathies?’�
’�To prevent arson, unlawful ’�’�
’�You mean police cannot beat.’�
’�Only to keep order, prevent crime.’�
’�This is one of them.’�
’�No, it’s not.’�
’�C’mon, I would’ve asked who he was, what did he do.’�
’�Asked whom?’�
’�Police.’�
’�They’re mad.’�
’�Only when you’re hostile to them.’�
’�Tell us, how did they do it?’�
’�Did he cry out?’�
’�I wish I could see!’�
’�Did they beat him on the back or buttocks?’�
’�Now shut up.’�
’�If you’re so sympathetic, why didn’t you try to stop?’�
George felt guilty. He did not help the victim. Maybe his classmates were misanthropic but they were honest. Was it wrong to have fun out of something that had already happened? It was. That showed an attitude, which was dangerous for the society. He was sad that his friends’ reaction was less than idealistic. But, he was poorly qualified to judge. George now understood how the idealism of the youth cooled down to the pragmatism of the mature.
That incident haunted George. What was the victim thinking about? He would be utterly helpless, for sure. He must have felt absolutely lonely. Was the physical pain worse than the humiliation, helplessness and fear, intense fear for the future? Did he dread that he might die, see death face to face? Or did he pray? Pray for divine help, pray to a God he believed in? Or did he long for death as an escape from pain? As the time ticked by, did he fear another session of pain? Was he tortured again? Did he regret or repent?
What hurt George ultimately was the conclusion he painfully reached, and reluctantly accepted. Despite his compassion for that man, ultimately his concern was for none but himself. For, somehow he visualized himself in that hapless man’s position. To his shame he tried to find comfort in the belief that he belonged to a different socioeconomic class and might never be in that man’s position. Comforting self-assurance, but not exactly lofty idealism.
George became more introspective. Several past decisions were not appropriate. But, then, they were not entirely his. His parents influenced him. That, with his timidity and cowardice, guided him. Was he afraid of his parents? He surely loved them. He wanted to be rated as a good son. Once he wanted to study medicine. Then he changed. And he intentionally delayed his application. That was defiance. Now, his future course was clear. Nothing heroic. A mundane, safe profession such as medicine was appropriate. That would embalm his conscience. He will serve humanity! At the same time no risks at all.
George successfully completed his premedical. He decided to study in his state. This time he made no mistake. He sent the application in time and joined the Regional State Medical College.

Chapter 41

Jayaraj worked for one year as house surgeon and became a fully accredited doctor. Then he opted for postgraduate studies in general medicine and was selected.
Raj Mohan summoned the candidates to assign the units. They provided cheap labor in the hospitals. The usual adage was, the more they work, the more they learn.
Jayaraj was first. Positions in all the units were available. He could have got in any unit.
Raj Mohan and three other professors formed the committee responsible for unit allotment.
’�Come in Jayaraj. Sit down.’�
’�Good morning, sir.’�
’�You know, you select the unit now. Look, all units have opening; it’s your pick.’�
’�Yes, sir. I want unit four.’�
Jayaraj thought the silence that followed was loud and clear. The faces registered surprise and disbelief. But, they accepted without question.
’�Want your old unit, ha?’�
Jayaraj wondered if Raj Mohan took it as vengeance. Jayaraj did not want to offend the professor. It was not vendetta for the earlier rejection. Yet he felt the taste of revenge. He tried hard not to show the smugness.
’�Alright, you get it. Good luck!’�
It was not an impulsive decision. Considerable thought went into it. Jayaraj was scared now. These were powerful men; any one could be his examiner.
Jayaraj waited outside for his friend, Abby John who had gone in. John had hoped for anything but unit four. Now he might even get unit one!
A gentle tap on the shoulder startled Jayaraj.
’�I say,’� John was exuberant, ’�I got unit one! Don’t believe. See, we’ll be in the same unit!’�
’�I don’t think so.’�
’�What?’�
’�Look, I joined unit four.’�
’�What? You ’� what?’�
’�Unit four.’�
’�Wasteland? You must be joking!’�
’�No, it’s true. Promise!’�
’�Are you mad?’�
’�Calm down. I worked there last year. Remember? Old man, well, he’s crazy, agreed. We didn’t exactly get chummy. But, what could I say? He was considerate enough!’�
’�Rubbish! Leave everything else. You know he’ll never be an examiner! You thought about that?’�
’�How can you be so sure? Three years! Long time.’�
’�Now, don’t argue; your usual stuff, argue about anything! You know what I mean. You know I’m right.’�
’�If so why did I select that unit?’�
’�I don’t know. I don’t understand!’�
’�Yah, now don’t tax your little brain figuring out adult affairs!’�
’�I don’t understand you. Why’d you do that?’�
’�I’m an enigma.’�
Jayaraj sounded as if he was announcing he just won the Nobel Prize.
’�My foot.’�
’�Listen, I worked in that unit. Experience wasn’t all that bad.’�
’�Why lie? You’ve no conscience at all, you bum!’�
’�No. One thing, in ward you’re independent; hardly any interference. Investigate, as I like. Treat, as I like. Agree rounds are nightmares. He’s a pain. But, I don’t care. Dog can bark, why worry? I’ve time to read, see, workup patients and to treat. As I like. A known devil ’�’�
’�You enjoy work because you get freedom and power? C’mon, tell the truth.’�
’�It’s true. As junior house surgeon, I had power. Now I’ll run that unit. You just wait and see.’�
’�I still don’t believe it!’�
’�Ok, I’ll let you into a top secret. Roy could be an examiner after three years.’�
’�’� off. Roy an examiner? Not in three decades, no he wouldn’t.’�
’�If you don’t believe, what can I do?’�
’�C’mon tell me the reason.’�
’�It’s a gamble, a calculated gamble. Examiners are important. Agreed?’�
’�Of course, most important!’�
’�All chiefs, except Roy, were examiners so far. And now his turn has to come. Cycle shows it’s his turn. In two to three years he’ll become examiner. Once appointed, he’ll continue for three years. So! Get it?’�
’�Well, yes and no! It’s a long shot.’�
’�No PG opted for unit four. Now that I did, I should be his favorite. He’ll have to pass me. Can’t you see that he couldn’t afford to fail me?’�
’�That much I agree. But he becoming examiner!’�
’�To university, he’s a professor, not Asspro. His turn has to come now.’�
’�I don’t know.’�
’�It’s worth the risk.’�
The postgraduate medical examinations were not always unbiased, unprejudiced, impartial and fair. Over a few hours’ time, a few examiners determined the fate of a specialist at the end of her long and arduous training. Nepotism, bias, discrimination and retribution played important roles. Therefore, students tried into the good books of potential examiners. The route to the good books varied from peer to peer and student to student.
Jayaraj had another reason. Privileges. They were as important to him as passing the examination. Privileges came easily in unit four.
Yet another reason was his sympathy for Roy. On the rare days when Roy was not in his usual foul mood Jayaraj tried to talk to him on personal matters. The old man had no friends. That was his own making; but how did he acquire that trait? Not his fault. No one would willingly be unfriendly and hostile. He inherited his character, at least partly. Why did some people inherit undesirable persona while others acquired good qualities? Jayaraj felt a tender compassion for the isolated, reviled, tragic figure.

Chapter 42

’�Yes,’� asked Peter Roy, ’�What do you want?’�
’�Sir, I came to join your unit,’� said Jayaraj. ’�I’m a new PG.’�
’�Oh, I see. So you’re posted to this unit. Why? You’re last on the list?’�
Jayaraj did not understand. Surely, Roy knew that Jayaraj opted for unit four. Instead of taking it as a rare gesture, Roy was degrading himself. But then, that was Roy.
’�No, sir. It’s my choice. I’m first on list.’�
’�Oh, I see. So congratulations.’�
Jayaraj did not feel congratulated. He kept quiet.
’�Why’d you come here?’�
’�Sir, I was a house surgeon here. I like to continue.’�
’�You think you’ve less work here, don’t you? You want to have a ball!’�
’�No sir. I like to work. I enjoy taking care of patients.’�
’�You married?’�
’�Er, no sir.’�
’�Hum. If you come here thinking that you could smuggle out a lot of free time, you’re mistaken.’�
’�Sir!’�
’�If that’s your aim, get out fast.’�
’�No sir, I want to work. I’m prepared to work hard.’�
’�Do you plan to leave soon?’�
’�No, I plan to work and complete MD.’�
’�Okay. When do you join?’�
’�I’m starting today. I’m here to join now. If you permit.’�
’�Right. Go and start in male ward.’�
That was it! A PG student was starting his first day. Jayaraj was an old-timer; no introduction was required. But, even a stark outsider would not fare any better. A pleasant gesture, a cheerful word, a welcome smile, it did not take much to make life pleasant.
Disgusted with what happened and distressed about the future Jayaraj walked slowly to the male ward. He had doubts now, if his choice was foolish. But then he should not be surprised. He could have anticipated nothing else.
As Jayaraj reached ward 14 his mind was heavy with memories. The place did not change much. He left only about a year ago. But, it appeared eternity.
Jayaraj knew all the nurses; they welcomed him pleasantly. Even Sister Juliet James had a friendly smile, ’�Welcome, doctor, welcome to ward 14!’� Everyone knew Jayaraj’s choice of unit four.
Geeta Kumar was seeing patients. Jayaraj thought it was pleasant to have a woman around. It made the workplace vivid and charming. He liked Kumar. She received Jayaraj with an attractive and open smile.
’�So you’ve joined?’�
’�Yes. I’m coming right from the boss.’� He wanted to say, ’�The lion’s den,’� but was not sure how Kumar will take it.
’�What did he tell you?’�
’�To come here.’�
’�He asked you to come here?’�
’�Yes, he did.’�
’�Then what?’�
’�Then nothing. You know, he’s not a great talker!’�
’�Ha! I don’t know what he wants.’�
She might have feared that Jayaraj was usurping her authority. As a house surgeon he had upset several seniors. Now he did not want to start by hurting Kumar.
’�I think he wants me to learn from you.’�
’�Oh.’�
’�I shall hang on, shall I?’�
’�Okay.’�
Jayaraj was not good at expressing compliments or showing respect. Except in exceptional situations, he was not submissive. This situation was exceptional.
Together, they continued the rounds. Jayaraj was keenly aware of the feminine presence. On such occasions he was not unlike the adolescent boy in the village school. He wondered if working with her would lead to an affair.
Soon Roy came for his rounds.
’�This 55 year-old ’�’� Kumar started.
Roy stopped her and turned to Jayaraj, ’�Now you tell us about patients.’�
’�I don’t know the cases. I just joined. I hardly had time to walk in.’�
’�So you don’t know. Geeta, go ahead.’�
It was unfair. Then, fairness was not part of Roy’s character. Jayaraj felt sheer contempt for his chief. Not for nothing was Roy known as Asspro.
Jayaraj immersed in ward work; that was his reprieve. He literally lived in the wards, making himself available for every emergency, every demand from every patient. All through his studies, he waited for this, work and study without examination. It was intense, dramatic, exciting.
’�Hey, how’re you faring in four?’� asked Abby one day.
’�Well ’�’�
’�Don’t sound too enthusiastic!’�
’�You know, Asspro.’�
’�You knew too! You went, knowing well.’�
’�Yes, yes.’�
’�Then?’�
’�I’m not allotted beds yet.’�
’�That’s usual. I don’t have beds in unit one.’�
’�Yes, but I thought I’ll get.’�
’�You thought!’�
’�I still follow Geeta Kumar.’�
’�That’s good. Any chance?’� Abby laughed.
’�Shut up.’�
’�So what you do?’�
’�Scuttle errands, attend Roy’s rounds.’�
’�No work?’�
’�Writing charts.’�
’�We’ve enough work. We work up new admissions and present them.’�
’�I know.’�
’�Chief’s just great.’�
’�Yes.’�
’�You work up cases?’�
’�Yes.’�
’�Oh, good. You present to chief?’�
’�I present to Kumar.’�
’�Oh?’�
’�It’s menial work. And females! Good company, but not exactly great superiors.’�
’�Why?’�
’�They’re, after all, inferior to men!’�
’�Rubbish. You belong to middle ages!’�
’�It’s a fact. That’s okay. But chief!’�
’�But you knew that.’�
’�I’m a lightning rod. Kumar has responsibility. She treats, but questions come to me, and blame.’�
’�Oh, that’s usual Asspro.’�
’�Yes, but, worst is open criticism in front of patients and nurses.’�
’�We’re lucky. We’re treated well. Professor’s decent. We enjoy work.’�
’�I know. We’re not just students, we’re doctors. If we’re scolded in open ward, what respect patients and nurses ’�?’�
’�But you’re prepared.’�
’�I planned it. But something went wrong.’�
’�Nothing wrong. You made it happen.’�
’�Yes.’�
’�Then why weep?’�
’�I thought I could put Asspro in his place.’�
’�You can’t.’�
’�Don’t say that. It’s still early. I might still.’�
’�You dream! Be realistic.’�
’�I wouldn’t allow anyone to spoil coming three years.’�
’�What’ll you do?’�
’�Just wait and see.’�

Chapter 43

The PGs joked that a posting to unit four was a visa to the US. Most of them dropped out and went to the United States, where demand for resident doctors was high those days. When a PG was forced to continue in Roy’s units, she started preparing for the test run by the US agency for licensing doctors. Once successful, the doctor could easily get a US-hospital appointment, often with a plane ticket.
Jayaraj had no intension of going away. Therefore, he had to work out a relationship with Roy, without suffering too much. He started planning.
One morning Jayaraj stood by a bed near the entrance to the ward. A medical student was seeing a patient on the next bed. As Jayaraj saw Roy walking in, he, holding an X-ray film, said loudly, as if talking to the student, ’�pleural effusion!’� The student actually looked up. And Roy heard it. Jayaraj made the illusion that the patient he was seeing had fluid collection in the chest.
Roy started his rounds from that bed. A junior doctor recited the history. Roy examined the patient. Usually he did not commit. That day he was bold.
’�He’s pleural effusion!’�
There was an uneasy silence. Roy looked up. He found no support. He looked steadfastly at Jayaraj, who looked back nonchalantly.
’�What did you find?’�
Jayaraj elaborately described his findings, which did not include fluid collection.
’�Are you sure?’�
’�Yes.’�
’�I see.’�
’�Do we’ve an x-ray?’�
’�Yes, sir.’�
The film was produced. No fluid, not a trace.
’�Hum. I’m pretty sure! I ’� How old is x-ray?’�
’�Done yesterday, sir!’�
Roy muttered something and moved to the next bed.
Similar unpleasant incidents embarrassed Roy from time to time. He responded by scolding and shouting. But, Jayaraj was beyond care. Frequently he found something to irritate Roy with.
’�Why this high dose? Where did you learn this?’� shouted Roy one day.
’�Goodman and Gillman, sir.’�
’�Don’t show western books. Our patients are different. Give him half that dose.’�
’�Why, sir?’�
’�Books recommend dose for whites. They’re western books. Indians require smaller doses.’�
’�Sir, where can we read about Indian doses?’�
’�That’ll come from experience. You can’t get from books.’�
Usually all junior doctors tailored their prescription to Roy’s standard. Jayaraj doggedly held on the textbook dose.
Roy realized he could not win. He gradually gave in. First, he ignored Jayaraj. But, that was difficult. Jayaraj was through with the cases. Roy and Kumar depended on him.
Slowly Roy accepted Jayaraj as an inevitable, even imperative, nuisance. Even when he was nasty, he ignored Jayaraj. Jayaraj responded right away. He stopped rankling and started cultivating a cordial relationship with Roy.
One early morning Jayaraj went to Roy’s room. Roy looked at the unusual visitor with irritation.
’�Yes, what’s it?’�
’�Sir, I thought I should tell you about bed one. He’s critically ill, continuous convulsions!’�
Roy wondered what was coming up; he suspected the usual mischief. He started, ’�Get out!’� but checked.
’�So what? Why are you here? Do something for the patient!’�
’�We just stopped convulsions; he’s deeply sedated.’�
Roy cooled down.
’�What’s the diagnosis? What does the patient have?’�
’�I think it’s meningitis. We need to do an LP.’�
’�So do it.’�
’�Sir, before that if you just see ’�’�
’�Okay. Let’s ’�ve a look.’�
The ward staff was surprised to see Roy.
’�Okay. Now go ahead and do an LP. Fundus?’�
’�Normal.’�
’�Have you done an LP? No?’�
’�Yes, sir. I’ve done.’�
’�Anyway, have Geeta around when you do. She should be here anytime now.’�
Jayaraj cursed silently. Yet he waited for Kumar. She was unhappy.
’�Why didn’t you inform me first?’�
’�How could I? You’re on your way, perhaps.’�
’�You could wait!’�
’�But, patient was getting worse. If something happened without a senior seeing ’�’�
’�Okay, Okay. What now?’�
But she could not blame him; he acted quickly to help the patient. He used the opportunity. Frustrating.
’�Everything’s ready for LP. Let me do it.’�
With Kumar by his side Jayaraj did the procedure. He was aware of the feminine presence, close to him. He thought how excited he became. These encounters were inevitable working in a hospital. Jayaraj was not this excited usually. There was something special about Geeta. He was happy. This should make his work more exciting. Life was looking up.
Jayaraj credited Roy for the timely diagnosis.
After a few days, Jayaraj again was in Roy’s room early morning. He briefed Roy about the seriously ill patients. They discussed the undiagnosed problems and possible solutions. Thus, Roy came to the ward well prepared. Rapidly this became routine. Roy dealt with patients more confidently.
Events moved the way Jayaraj wanted. One day Roy announced, ’�I’ll divide this ward.’�
Kumar’s face turned red.
’�Geeta will look after the first half. Jayaraj, take care of the other.’�
Jayaraj looked after the patients directly under him; but, he saw all the patients. During the rounds, Roy depended on him heavily.
As months went by, Jayaraj had growing sympathy for Roy. He saw a human being with a terrible sense of insecurity. Jayaraj could work out a rapport with Roy. He was amazed at his own skill to manipulate people. He learned to turn adverse circumstances to his advantage. With increasing confidence, he believed that he could control his destiny.
’�Look Abe, I’ve all I want now!’�
’�Really?’�
’�I’ve my own beds.’�
’�Your own?’�
’�Yes. Divided beds between me and Geeta?’�
’�Great. What does she say?’�
’�Say? Who cares?’�
’�You don’t care? For Geeta?’�
’�I don’t care what a female says, stupid. I do care for her! Ha.’�
’�Care or crave?’�
’�No, no.’�
’�Both, right?’�
’�Shut up.’�
’�I’m right!’�
’�But Roy is putty in my hands.’�
’�You trained him?’�
’�Of course!’�
’�I’ve beds. I’ve my own house surgeon.’�
’�Really? I don’t believe.’�
’�No? I can show. Come to ward.’�
’�She or he.’�
’�What?’�
’�House surgeon.’�
’�Ho, he.’�
’�Disappointed?’�
’�No. Now I can be very firm.’�
’�I see.’�
’�I get him do all work.’�
’�He must be cursing you.’�
’�He should be grateful. He’ll be a good doctor.’�
’�I’m not sure.’�
’�I’m sure.’�
’�If he does all work, what you do?’�
’�Teach, work up difficult cases, read up, that sort of thing!’�
’�Big boss, ha?’�
’�Yes. That can happen only in Roy’s unit.’�
’�I see you dropped his name, Asspro.’�
’�Hum I understand him.’�
’�Great.’�
’�Working with him has certain advantages. No interference. Juniors just obey, no questions.’�
This confidence was turning Jayaraj a despot. Ward 14 was his kingdom; he ran it at his whim. He savored the taste of power. He saw the advantages of undisputed authority, immunity from criticism. The three years he spent in Roy’s unit would change him for ever.

Chapter 44

Saturdays were almost holidays for unit four. Atmosphere was easy right from morning. Work was over by noon. The doctors on duty alone stayed back. Jayaraj used to relax for some time and then returned to the ward. Later he visited Radha.
One Saturday when Jayaraj reached his hostel, his parents were waiting. He did not hide his surprise. He was happy to forget the past.
’�Amma, Achan! How come? Waiting long?’�
’�About half an hour.’�
’�Didn’t know you’re coming. I could’ve come earlier.’�
’�Busy?’�
’�No. Not at all. Saturday afternoon, free.’�
’�Mone, did you eat?’� asked Sarojini.
’�Oh, I’d lunch. How about you?’�
’�Yes, we ate.’�
’�Let’s go to my room.’�
He led them to his sparingly furnished room.
’�How’s everyone at home?’�
’�Fine, just fine.’�
There was an awkward silence. His parents looked at each other.
’�See mone, you’re a doctor now. You’ll be an MD doctor soon,’� his mother said.
’�So?’�
’�It’s time to think about your marriage.’�
’�Marriage? I’m still studying!’�
’�So you study. Rama, Rama. We’re not asking you to stop.’�
’�In one year or one and a half years that’ll be over,’� intervened his father, ’�Then what?’�
’�We’ll think about that then.’�
’�Even if we start now, it may not be ready in one year.’�
’�Look, kutta,’� Sarojini smiled. ’�Tell us, do you have anyone in mind? Bhagavane!’�
She laughed as if she was joking. But, Jayaraj knew she was serious. Radha was fresh in memory, his and their.
He just smiled.
’�You stop joking.’� admonished Nair, ’�Get serious and tell him.’�
’�You know, mone, I’d predicted; I knew this. Didn’t I tell you years ago?’�
’�You get on ’�’� Nair urged.
’�Wait! Let me ’� I’m getting to it.’�
’�What’s it?’�
’�Last week a proposal came. Guess from which family?’�
She smiled, anticipating Jayaraj’s eager demand to know. Jayaraj was nonchalant. She was disappointed.
’�From the Kattoth family. Bhagavane. Know about them?’�
The family was rich and famous all right. But, still Jayaraj showed no interest.
’�She’s in collage. Good looking, beautiful. Fair, very fair, pure gold! They’re keen because you’re a doctor, going to be MD. Wedding now. Then both of you’ll study until you finish; then you live together. What do you say?’�
’�Doesn’t he ’�ve to see her?’� Nair intervened, ’�He hasn’t seen her.’�
’�Rama, Rama. Let him see her. When? We can arrange. Go to her house next week. You’ll like her.’�
Jayaraj could virtually hear, ’�You better like her! Or else!’�
This was so unexpected that Jayaraj had no immediate answer. This appealing proposal was the only reason why his parents came and talked to him oozing love.
Jayaraj thought about Radha. He had to refuse his parents’ demand as gently as possible.
’�Amma, I’m not sure ’�’�
’�No, don’t give excuse. We demanded nothing so far. Now, you must obey.’�
’�If that’s what you say, why see the girl?’� His anger was getting hold of him. ’�You’re saying I should marry her!’�
’�What?’�
’�If you say I must marry her, why should I see her?’�
’�So you don’t want to see? You agree without seeing?’�
’�How much are they paying?’�
’�Oh, we haven’t discussed that. They’ve lot of property, estates, paddy fields, coconut groves and a big house, truly a palace, right in town center. She’s the only daughter! You don’t ’�ve to work!’�
She smiled.
’�I see.’�
’�She’s very rich. Shall we fix it? We can decide date and other details later.’�
’�No, no, no. Let me think. I’m busy with work and examinations.’�
’�What happened to you? We know what’s good for you; we’re doing it for you! Why don’t you listen?’�
Jayaraj did not respond.
’�When we’re your age nobody even asked. Ask your Achan! Elders just fixed date!’�
Nair nodded in agreement, but then added, ’�Sarojini, those were olden days. Times changed. Why bring that now.’�
His wife stopped him with a stern look.
Jayaraj thought frantically. He regained his composure and mustered some courage.
’�Give me some more time. Please.’�
’�Time? Rama, Rama! Time! For what?’�
’�For what? Because I’m the one marrying, that’s why!’�
Jayaraj realized that his voice was rising. It was automatic. He knew he had to respect his elders. With great effort he controlled.
’�Give me some time, please.’�
He did not look at them.
’�We’ll wait, but how long? Not a day more than two weeks!’�
Clearly she would not take no for an answer.
’�Okay. I’ll contact you.’�
’�No. We’ll come and see you, in exactly two weeks. Not a day more!’�
They left. Jayaraj wondered why his parents did not leave him alone. To be fair, not something that came naturally to Jayaraj, his parents were doing nothing others were not practicing. Arguably they were not doing it for their personal benefit. They belonged to a generation and a society that believed that the elders knew best what was good for their children.
Still Jayaraj did not condone them. They kindled the desire in his and in Radha’s mind. The usual arguments for and against arranged marriage were too complicated. His marriage with Radha was an arranged one. But in a way, Radha was his find too. Maybe she was setup for him to find. They both were setup, to fall in love with each other. It was chaperoned romance. Now he was not prepared to smash that fairy tale.
A physician’s life, in many ways, was down-to-earth drab, abrasive, cruel and often, punishing. To see, feel romance in that world, took certain kind of outlook on life. It was like a water bubble; it will bust any moment. Jayaraj in a way was aware of the vulnerability. He was not prepared to allow the bubble burst. He thought for some time and took a decision.
That Monday morning Jayaraj took leave, a rare event. Though PGs were entitled for leave, they seldom got it. But, this was absolute necessity.
Jayaraj went to a prominent lawyer, who was a patient in his unit. He was hopping that the lawyer would not charge any fee. By about eight in the morning, he met the advocate’s clerk.
’�I would like to see Mr. Gopinatha Menon.’�
’�Who’re you?’�
’�I’m Dr. Jayaraj. I just want to see him.’�
’�Is it about a case? I don’t think he’s time today.’�
Jayaraj realized he wasted a precious morning.
’�I just wanted to ’�’�
At that moment, Jayaraj heard a shuffle behind him. He turned around and looked at Menon.
’�Hello doctor, you here?’�
’�Hello, sir. I came to see you. Just for one advice.’�
’�Advice? Is it something lengthy?’�
’�No. Just one small thing, it’s brief. If you’re busy now, I’ll come later.’�
’�C’mon, doctor. I’ve seen how hard you all work. I wouldn’t send you back.’�
He gestured Jayaraj to his office.
’�See, sir, this is very private, confidential.’�
’�Look doctor, discretion and professional etiquette are not your profession’s monopoly, you know!’�
’�I am sorry. I didn’t mean ’�’�
’�That’s alright. Now tell me.’�
’�Yes. See, I want to get married!’�
The advocate was astonished. After the first shock, he was amused, and bewildered; he tried hard not to laugh. He did not have a daughter. If he had, he would have thought the request was for her hand.
’�But, doctor, you want?’�
’�See, I want to register marriage!’�
’�Oh, I see!’�
’�Actually we’re supposed to get married, traditionally. But, there’s a problem. Want to marry in the court.’�
’�In the court? No, no! Marriages are not registered in courts. You want a civil marriage. It’s in the Registrar’s Office, the same office where we register documents, sale of property etc.’�
’�Oh! Not in court? I thought ’� I’m sorry. So we don’t need advocate?’�
’�No, no, not at all. No chance we can charge fee! Ha, ha. You go with the girl and apply in the prescribed form. Both of you’ll sign in the office; with some witnesses.’�
’�That’s it?’�
’�No. You’ve just made the intension known officially. They’ll put it on the notice board for one month.’�
’�One month! Wouldn’t be married for one month!’�
’�That’s right.’�
’�But, in movies couple goes to the court ’� err the office and, pronto, come out married. I thought that’s it.’�
’�Son, life’s not cinema.’�
’�Yes.’�
’�You wait for one month. The notice will be on the board.’�
’�Why?’�
’�Anyone can make a valid objection during this time.’�
’�Oh, anyone can object? What objections?’�
’�Yes, anyone may, but, only valid objections, legally valid. For example, if one of the couple is a minor, under age, that couple cannot get married.’�
’�I see.’�
’�But practically, to object, one should know about the notice! Register-Office Notice Board is not a popular reading site. Chances are no one will know, in ordinary circumstances; but, circumstances may turn extraordinary; someone somehow might learn about it.’�
Jayaraj grasped the reality.
’�After one month, if no one objected, you’ll again sign in the office. That’s final. You’re married legally.’�
’�So, it takes one month. Too bad! In movies it’s done in a jiffy.’�
’�Life’s different. And you don’t need a lawyer.’�
’�I’m sorry to have bothered you.’�
’�Not at all, no problem. Get a document writer. You may find them around the Register Office. They’ll arrange everything. They know. Who’s the girl, if I may ask?’�
Jayaraj told him about Radha.
’�Thank you, sir. Your fee ’�’�
’�Oh, no fees. I did nothing. Next time I’m in the hospital treat me well!’�
Jayaraj arranged everything, got three of his friends there and went to Radha.
Radha had grown into a city girl. Now walking to her college Jayaraj smiled.
’�What happened? Why? Something at home?’�
’�Nothing serious.’�
Jayaraj told her about the marriage proposal. She kept staring at his face. She was loosing him. Her eyes swelled up.
’�You’re telling me, you’re getting married!’�
’�Yes, I’m getting married.’�
’�Oh Bhagavane! How could you?’�
’�What? You don’t want to marry me?’�
’�What?’�
Jayaraj outlined his plans.
’�Today’s not April first!’�
’�I forgot that!’�
’�Don’t try to fool me!’�
’�No. I’m serious. It’s true. Hurry, my friends are waiting!’�
Radha wanted to take Jayaraj in her hands and hug him tight. He, on the other hand, was too involved with details and too tired to fall into romantic mood.
They registered their intension to marry.
’�First time I’m doing anything like this,’� one of his friends said, ’�I hope no one will beat me up! Radha, how hefty is your father? Brothers? Will they come after me?’�
’�Don’t worry about her parents,’� said Jayaraj. ’�Why should they? They’re happy to have a great son-in-law.’�
’�They haven’t seen you lately, ’�ve they?’�
’�But, my reputation traveled far and wide.’�
’�Ha, if your parents hear,’� Radha teased him, ’�You’ll be beaten up. House arrest.’�
’�Look, they shouldn’t hear about this for one month. This is serious.’�
Jayaraj took Radha to her college. They were pensive. Weddings were special events in the family. Relatives and friends, lots of them, gathered for the occasion. The arrangements would go on for days or weeks, a time to celebrate. Here, now, Radha and Jayaraj completed an official formality in a dreary government office. After one month, they will repeat it and that was it! What a way to start a family.
Jayaraj did not visit Radha for some time. He knew it was cruel. But he had no time. At last when he went she was cross.
’�Where’re you all these days?’�
Jayaraj tried to smile.
’�I know, I know. You’re busy saving patients, serving humanity, too busy for lowly creatures like me!’�
’�I’m sorry.’�
’�Jayettan! Please.’�
’�I’m with you now.’�
’�What’s our future?’�
’�Civil wedding will go off smoothly. We’ll go to the temple, later.’�
’�Then life as it’s now?’�
’�Afraid so.’�
’�Not very exciting, no?’�
’�Yes, but, this sudden ’� it became necessary. Understand that.’�
’�Yes. Still, can’t we spend a few days or at least a day together? How do we feel we’re married?’�
’�But, where would we go?’�
’�Hotel, lodge?’�
’�Good hotels are expensive. The less expensive are not safe. Don’t want to take any risks.’�
’�Yes suppose so. Look Jayettan, are you disappointed? Are you repenting?’�
’�What for? What’re you talking?’�
’�You could have married rich girl. Made your parents happy. You could’ve stayed in good hotel.’�
’�Now, shut up. Nonsense!’�
’�No, I really mean.’�
’�Mean what?’�
’�You’re making a sacrifice for me, that’s what!’�
’�No! No sacrifice. It’s to get you, not for you!’�
Jayaraj was surprised. This girl was bitterly complaining a second ago. Now she was all compassion for him. She was a chameleon.
Radha was silent. He noticed her eyes were moist. Suddenly he felt a tender empathy, perhaps love, perhaps passion, towards the girl who had offered her whole life to him. How he wished he could take her, after their wedding, to the flower-studded bedroom traditionally prepared for the newlywed.

Chapter 45

Once in the medical college, George took up studies with single-minded devotion. He had already forgotten his armchair politics. He had forgotten the college politics. Yet he had heroes to look up to. Prominent among them was Albert Schweitzer the legendary missionary doctor. His sacrifices to serve in Equatorial Africa, outside the fringes of known civilization, were the stuff of allegory. George had to have heroes of his own to keep life meaningful.
George finished his first MBBS with distinction. But, it was in clinical studies that he excelled. He was discovering new pastures. The glamour of academic medicine allured him. Here his idol was Raj Mohan. The professor’s showmanship, by the bedside and on the rostrum, fascinated him. Once again George turned into the lonely boy lost in dreams about parades and pageants. The icon just changed.
George’s final clinical posting was in medicine. To his great disappointment, he was in the notorious unit four. Roy was bad, but even worse was the PG, Jayaraj. He did not care for students and did not help them. George wondered how such a young doctor, just a few years senior to him, could be so haughty and arrogant.
During this stint in Ward 14 George pulled off a remarkable feat, leaving pleasant memories for years.
One day George examined a young patient with unexplained fever. George was surprised to note the patient’s heart in the right side of the chest. With rising excitement, and reassuring satisfaction that he was able to detect it unassisted, he checked the patient’s chart. To his disappointment, the heart was marked as normal. George was confused. After all, several doctors at different levels, all senior and experienced, must have examined that patient. Surely, they would have detected the anomaly if present. Again, he examined the youngster.
The patient in turn was rattled; why was this ’�doctor’� examining him that long, carefully and repeatedly? He must be having some serious disease. If the patient got too concerned and upset, word might travel right to the top; and the top here was Roy. If the news reached him, the consequences would be very unpleasant. Yet George was not willing to let go of this rare opportunity.
The patient was admitted only a couple of days ago, on a heavy admission day. The problem was fever, nothing exciting or life threatening. So far, the seniors concentrated only on the fever and nothing more. They could have missed it. Could they?
Suddenly George remembered the chest X-ray. His heart sank. The X-ray would have definitely confirmed heart’s position. With failing hopes, he fished out and examined the X-ray film. Surprise again! The heart was on the right side! But, someone thought that the radiographer marked the film wrongly and corrected the label. Now a ’�left’� mark was on the original right side.
Meekly, apologetically, George went to the assistant professor. George tried to explain his big ’�discovery’� to him. But, the haughty academic curtly dismissed George, ’�Do you think all those examined him are careless fools? Even if heart’s in head, they would’ve detected it.’�
Castigated and humbled, George quietly left the room. But he could not forget it. Who will help? He considered the PG student. But, Jayaraj was no ordinary PG.
Timidly he approached Geeta Kumar. First she too was skeptical. But, George pestered her.
Kumar finally agreed to settle the issue. She, with the patient and half a dozen students, went to the fluoroscopy room. They saw the patient’s heart live on the X-ray screen. The heart was dancing in beautiful, fluid motion, right there in the right side of the chest!
George felt the heady tang of success. That vindicated him over so many of his seniors. Kumar put the machine off, moved the patient to a nearby wheel chair and turned to George. ’�Congratulations, that was good! You make us look foolish.’�
She could say that with relish, because she was not the treating doctor and did not miss the abnormality.
’�Well, boys, if you’re careful you too can do it. Don’t blindly accept what others say or write.’�
At that moment, Roy, along with Jayaraj, walked into the room. When informed of George’s feat, Roy, in a voice reverberating with over exaggerated, mocking appreciation, commented, ’�Ha, he should be awarded a Padma Bhushan!’�
A slow, subtle ripple of laughter followed this statement. There was no apology for the missed diagnosis, no adulation for a student’s achievement.
What Kumar did annoyed Asspro. She was infringing on his authority. But, he could not blame her. They had missed an important finding, though that had nothing to do with the patient’s disease.
But Kumar with unusual courage intervened, ’�Boys and girls, this calls for a celebration; come, I shall buy you coffee.’�
An awkward moment followed. Roy frowned and walked off. Jayaraj followed him. It was clear they would not join the celebration.
Roy had the ability to demolish someone’s achievement with a short comment, superficially complimentary but cynically derogatory. George was livid. He expected a congratulatory comment, a few words of appreciation, even from Roy. No wonder he was called Asspro. The pronunciation would change depending on Roy’s current popularity rating. Very often the emphasis was on the first syllable. George had no doubt, it was, ’�ass’� as in ’�donkey’�.
George’s anger turned into disappointment; that lingered on for some time. Finally, as it often happens under similar circumstances, the disappointment turned into a kind of satisfaction, mixed with hatred and hostility.
George considered himself a tragic figure, a deprived person. He came to believe that destiny played tricks with him; turned his flashes of triumph into hours of frustration. He never had a complete victory. Frustration had become so much a part of life, he came to expect it even at the zenith of achievement. He was not only prepared for them, but was satisfied only when that happened. Until then he would be edgy, anticipating, waiting for it. But, ultimately, the repeated frustrations, the recurring disappointments, made him unhappy, even when the achievements should have made him cheerful. He was bitter, angry and sad.
Like the multicolored umbrella, the right-sided heart too became a symbol, an icon representing inequity, part of existence. But, unlike the umbrella, this experience did not altogether dampen his enthusiasm or fascination. He showed off his achievement to his classmates and friends. With considerable gusto, he described again and again how he did it.

Chapter 46

Jayaraj remained anxious and worried. The decision was right, he was sure, the only one he could have honorably taken. He reached the conclusion fast and implemented it quickly. Yet, he was now jumpy. Usually, once he decided, Jayaraj would be unperturbed, but not this time.
The enormity of the act was sinking in. Jayaraj defied his parents. Radha had no reason to keep her parents in the dark. But Jayaraj commanded her silence. The clandestine weddings flaunted the norms of the society; it was an unusual and serious affair, something never happened in his family. It would shock his elders and would evoke harsh and ruthless reaction. He was frightened.
Jayaraj became irritable and slapdash; his performance in the ward suffered. He was morose and impolite. The change was noticeable.
One day, while seeing a patient, Roy asked, ’�Jayaraj, show me the coagulation workup. Have you got it done?’�
Without even looking in the chart Jayaraj responded, ’�It’s not done.’�
He immediately felt a firm tap on his shoulder. He looked back and saw George, the new house surgeon, pointing towards the patient chart. Jayaraj realized that there was something wrong; perhaps it was done. But, he did not care.
’�Why?’� Roy contained his anger.
’�We’ll get it done.’�
That was usually reason enough for Roy to blow his fuse. Jayaraj was waiting for that, to pick up a fight. But, surprisingly Roy remained unperturbed.
’�Who’s the house surgeon in charge of this patient?’�
’�I’m, sir,’� answered George.
George had started house surgeoncy in unit four.
’�Get coagulation studies. Inform me as soon as it comes in.’�
George hesitated just for moment.
’�They’re sent for. The results have come in just now.’�
The implication was that Jayaraj had no opportunity to see the results. That type of cover-up among junior staff was usual.
’�Good!’�
A compliment from Roy made George’s day.
Roy continued his rounds with an unusual calmness. He depended mainly on George.
Though his work, ward and colleagues had nothing to do with his anxiety, those were the only places, and they were the only people, Jayaraj could rebel against or quarrel with. Defiance provided a sadistic fulfillment.
That evening Roy summoned Jayaraj.
’�What’s happening?’�
Silence.
’�What’s wrong? Never seen you like this before, all these years.’�
’�It’s nothing, sir, nothing at all.’�
’�Look, you don’t have to tell me. You might say it’s none of my business. But, there’s something in your mind. If I can be of help ’�’�
Roy was gentle, a side of his persona rarely seen. Jayaraj never thought Roy was capable of compassion. Maybe he was pragmatic; he did not want to loose Jayaraj’s efficient help.
Jayaraj considered for some time. Then he opened up. He talked about the wedding. Roy listened without interrupting.
’�Do you want to take a few days off?’�
’�No.’�
’�Something else you want?’�
’�No sir. I’d rather keep busy, can’t sit idle, especially now; don’t worry. I’ll be okay. I’ll do my duty properly. I’m sorry.’�
’�Alright.’�
’�Thank you, sir.’�
’�Let house surgeons do routine work. That new chap, what’s his name?’�
’�George Thomas.’�
’�Is he any good?’�
’�Hum, yes, I think so. He’s a good student, among the best in his batch.’�
’�That’ll not make a good house surgeon.’�
’�He’s the one who detected the right heart.’�
’�Oh I see!’�
’�I think he’s hardworking.’�
’�Okay. He’ll be around for about three months. You just supervise. You’re right. Work’s the best tonic.’�
’�Thank you, sir.’�
Roy’s concern and understanding shook Jayaraj to tears.
But, that did not improve Jayaraj’s temperament. He went straight to the ward and with house surgeons and students started seeing patients.
’�Who’s seeing this patient?’� He was by the side of a patient with high blood pressure.
George came forward.
’�What do you think you prescribed for him?’�
’�Aldomet.’�
’�What’s that?’�
’�Alpha mythyldopa.’�
’�Do you know how much it costs? You want to give the more expensive medicine?’�
’�He was on Adalphine, but that did not control his BP.’�
’�So.’�
’�Further, he developed depression.’�
’�Hum ’� what dose?’�
’�Of adalphine?’�
’�No, methyldopa.’�
’�’� 500 mg three times a day.
’�That’s too high!’�
’�Recommended dose is up to 2000 mg a day.’�
’�Don’t show western books. Our people are different. Give him 250 mg three times.’�
’�If BP is not controlled?’�
’�It’ll be controlled! BP might be high in the hospital. When he goes back home, it’ll be normal.’�
His temper was reaching danger point.
’�Yes, sir.’�
George was perplexed; PGs, even senior PGs, did not behave this fashion. If this hospital worked this way, it was not good enough for him. He will leave after the house surgeonsey.
Two weeks went off quickly. Jayaraj managed to avoid his parents. He informed them that he was going off on an urgent assignment.
Then the day arrived. He, with Radha and their friends, went to the Registrar Office and signed the papers. The officer congratulated them and they walked out as husband and wife.
’�Where’re you two going for your honeymoon?’� his friends teased.
It was a cruel joke. Jayaraj smiled weakly. Radha was demure; she looked down as girls from the conservative families were supposed to do.
They then went to a nearby temple, for a religious ceremony. Jayaraj tied the ’�thali’� and they garlanded each other. They were husband and wife in front of God and law.
Jayaraj had arranged a simple lunch, in an ordinary restaurant, for their friends. After that, they were alone.
Jayaraj looked at Radha and smiled. That was the first time he saw her properly that day. She looked pale and anxious. Her skin was greasy with dried sweat. She was dazed. He called in half jest, ’�Hallooo ’� my wife!’�
Radha looked up and smiled. But, her face was like a tousled flower. The emotions, excitement and strain had taken their toll. Her looks made Jayaraj anxious. But, he knew how stressed he was. He suddenly felt the void; there was nothing to do.
’�What do you want to do now?’�
’�I just want to lie down; I’m so tired.’�
Gone were the usual exuberance and levity. She was, once again, the simple village girl.
’�You realize this is our wedding day?’�
’�I’m sorry Jayettan; I’m so sorry. But, I’m so tired; and a terrible headache.’�
’�Take Aspro tablets. I’ll get some. It must be just tiredness.’�
’�No, no. I don’t want any medicine. No, please, let me go to my hostel.’�
’�Okay. I’ll take you there.’�
But, Jayaraj did not relish the idea of walking to her hostel and then walk back to his room.
’�You could’ve gone with your friends, then.’�
’�I can go alone, Jayettan. You needn’t come. You go and take rest.’�
’�No, no. We’ll go together. I’ll drop you there.’�
’�No, don’t.’�
’�I want to.’�
So, on their wedding day, they walked in the hot sun to her hostel. He said goodbye. By that time, he had a severe headache.
Jayaraj wondered if she was afraid of him. Both of them waited for years for this day; but now she waned to get away! Was she afraid of sex? Did she think that he would demand sex? But, he accepted that she was tired, exhausted. Even he, completely drained, wanted to lie down.
What a day! And what a wedding! Funny, this was not even a marriage of convenience! What a cruel joke! This night he will be sleeping in his hostel room alone!
Jayaraj reached his hostel ready to pass out. And he did pass out. Next morning he got up as usual, just another ordinary morning. But, a rude surprise awaited him.

Chapter 47

Morning after his wedding Jayaraj left his room early. As he reached the foyer, he saw them. Radha’s parents were standing there. Jayaraj was startled.
’�So you think you’re cleaver!’� Savithri Kunjamma pounced on him, ’�Smart! You could do anything without your elder’s help or blessing. How could you? We’re fond of you. We’re always considerate.’�
’�We loved you as our son. Now look! What’ve you done?’� Karunakaran Nair added, ’�You married our daughter secretly, in government office. Like thieves! What did we do to deserve this? We would’ve arranged a grand ceremony! With dignity!’�
Jayaraj was conscious of his colleagues in the room. Everyone was in a tearing hurry. But, they stopped, seeing the commotion. Jayaraj was ashamed.
When Jayaraj regained composure, his immediate thoughts were about Radha; he wanted to protect her from her parents. Later he was proud about this concern. Just married and he had already developed a protective instinct.
’�I was afraid,’� intervened Jayaraj, ’�Radha’s not responsible. I told her not to inform. Sorry. Don’t blame Radha.’�
’�We know, she wouldn’t do this on her own,’� Kunjamma continued, ’�She’s a gentle, cultured girl.’�
Jayaraj was angry. All these years these people desperately, shamelessly schemed to get him marry their daughter. Now they were talking virtue. He wanted to scream what an obnoxious bunch of hypocrites they were. But, he had to show respect; they were his elders, now his parents-in-law.
’�Ammava, Ammayi,’� he started with as much politeness as he could muster. He was not sure how he should address them. Radha’s parents were his too. But, uncle and aunt, were fine for now!
Again, Jayaraj remembered Radha. He had to make peace with her parents. He was again conscious of the boys watching them. He did not think twice, but bent down and touched their feet, one after the other. That was the ultimate show of reverence. He could see satisfaction on their face.
’�Mone,’� Kunjamma called, reminding Jayaraj of his mother. With this wedding, he had lost her. But, Radha’s mother substituted for her.
’�You two got married,’� continued Kunjamma, ’�We’re happy. But, could’ve informed us. We would’ve arranged everything. We would’ve given off our daughter to you! How much we wanted to do that! You should’ve informed.’�
’�It’d to be secret. Anyone could’ve objected.’�
’�Who? How? Radha’s adult, a major. None can object.’�
’�But, what about me? My parents! They would’ve. They could’ve even called in police! I couldn’t help. I’m so sorry.’�
He did not feel sorry at all.
’�No, no, mone, we understand,’� said Nair.
’�It’s alright,’� added Kunjamma, ’�We’re happy you’re married. That’s decided by birth, wasn’t it?’�
Slowly their face brightened. Nair placed his hands on Jayaraj’s head and blessed him, ’�Mone, everything good will be showered on you. God bless you.’�
Kunjamma engulfed Jayaraj’s face in her palms and kissed him on the forehead. Jayaraj was aghast. Unaccustomed to open demonstration of affection, Jayaraj felt uneasy. That display right in front of his friends embarrassed him.
’�Can’t you see? He’s a nice obedient boy, as I told you,’� Kunjamma beamed.
Nair struggled hard to hide his surprise. Even to him his wife’s summersault was too fast.
’�I knew, I knew. I always liked Jayarajan. If he’s done this, he must’ve a reason.’�
Jayaraj had to act up his part of the charade. ’�You know it. My parents! They would’ve never allowed this. That’s why ’�’�
’�We understand, but you could’ve ’�’�
’�Now remember, you can count on us, for anything!’�
’�How did you know this, wedding? So soon?’�
’�One of our relatives, do you know Raman Kutty?’�
’�Raman Kutty?’�
’�No?’�
’�No.’�
’�No? He’s our relative, works in Registration. He’s transferred here last week.’�
’�He told you?’�
’�He left the office as soon as you reached. He knew only then!’�
’�He came to Tharavad?’�
’�Of course. He’s very faithful. He told everyone.’�
’�I see.’�
’�Your parents are very angry. But, what could they do? It’s over.’�
This Raman Kutty must be pretty much interested in the family affairs. If he was in the office one month ago he would have informed the family. Jayaraj thanked his Gods.
So his parents knew. He had planned to inform them later. He did not know what to do now. He was confused if he should go alone or with Radha, now or later. He decided to think about it later.
After a couple of weeks, Jayaraj still had not mustered enough courage to face his parents. But, they did not wait for him. They reached his hostel.
’�So that’s why you avoided us all this time,’� shouted Kesavan Nair. ’�You’re cheating.’�
Jayaraj kept quiet. He bent his head, as a chastened yet obedient son would.
’�We came to see if it’s true! What we heard, Rama, Rama!’� his mother said, ’�Is it true? We’ve to hear from you.’�
’�Yes, it’s true.’�
There was total silence. Minutes ticked away. It appeared hours.
’�Rama, Rama!’� she said, ’�C’mon, let us go! We’ve no more business here.’�
But, she did not move.
’�We don’t have a son. Bhagavan didn’t give us a son. If that’s God’s will, let it be. Not having a son’s better than having bad, disobedient one.’�
She turned and started walking.
’�Amma ’�’�
’�You heard me. Bhagavane! You’re not our son; I’m not your Amma!’�
’�Janu,’� called Nair.
’�What?’�
Nair said nothing.
’�Are you coming?’�
They walked out of the room and from Jayaraj’s life.
None of them knew it then, but destiny would bring them together once again, just once.
Jayaraj stood there stunned. Even though he anticipated this, he was shaken. He was also relieved. The encounter was over. It was brief and quite.
Radha’s parents came to see Jayaraj after a couple of weeks. They traced him to the hospital.
’�Mone,’� asked Karunakaran Nair, ’�Do you ’�ve some time? Can we go to Radha?’�
Jayaraj did not have time, but he managed to go with them.
Radha was in good spirits.
’�These days youngsters are independent,’� Kunjamma had not forgiven. ’�Like in America and England. They decide their own affairs, even marriage!’�
’�Savithri,’� called Nair.
’�Amma, I told you earlier ’�’� added Radha.
’�Yes, yes. But, we’re not like certain others!’� said Kunjamma.
’�We’re now glad. But, your parents! Very angry, disowned you!’� added Nair.
’�I knew it,’� said Jayaraj, ’�What could I do?’�
’�You did right. I didn’t know you’re so brave!’�
Radha looked at her husband with admiration. Somewhat embarrassed, Jayaraj looked at some distant point and smiled.
’�But, there’re problems,’� continued Kunjamma. ’�Your parents misled our Valliammavan. He’s angry with you and with us. You tell us, what’ve we done? They’ll abuse us now if they learn of this visit. Can’t we see our children?’�
Jayaraj felt sympathy for her. She wanted this wedding to happen, longed to celebrate it. Now they could not even take their daughter and her husband home.
’�What’re you two going to do now?’� Nair asked.
Jayarajan laughed; the irony struck him.
’�We’ll continue as we’re now, until I clear exam. After that we’ll see.’�
’�After examination you can work in a private hospital. They pay well. You live comfortably.’�
They had already decided his future.
’�How much, Amma?’� asked Radha.
’�As much as thousand five hundred or even two thousand rupees!’�
’�Really! That’s very good!’�
’�They’ll even give a house near the hospital.’�
’�We’ll see when we come to that,’� said Jayaraj.

Chapter 48

After the wedding, Jayaraj continued his life precisely as it was before. If he lived with Radha even one night, his perception might have changed. In a way, he liked this. He did not want any change until he passed the examinations. No distractions. The wedding was unavoidable.
Roy surprised Jayaraj by inviting him and Radha home for tea. There were no other guests.
Roy introduced his wife. She was gentle, reserved and shy. She smiled at them but did not say much.
’�So, how’s married life?’� asked Roy.
’�Hardly any married life. We don’t live together.’�
’�Don’t worry,’� Roy said looking at his wife and laughing, ’�You don’t miss much!’�
Jayaraj laughed politely.
’�You didn’t say that then, soon after wedding,’� retorted Mrs. Roy. ’�You say that only now.’�
Radha looked at her in approval.
’�We grow wiser, you know. I know so many things I didn’t know then!’� He laughed again. He appeared unusually exuberant.
’�But, everyone has to experience and learn, personally,’� said Radha.
Jayaraj was surprised.
’�So you’re going to experience that now?’� Roy joked.
Radha looked at Jayaraj. He kept quiet.
Later, Roy asked Jayaraj, ’�What do you plan now?’�
’�No change, sir. We’ll continue as it was. Living in hostels.’�
’�That’s perhaps wise.’�
Jayaraj thought Roy was relieved. Jayaraj would continue working as he used to.
No one was a good conversationalist; talk was agonizingly slow. Jayaraj was painfully aware how socially awkward he was. Medical studies left very little time to sharpen social graces.
After an hour, Jayaraj and Radha left.
’�He’s so blunt,’� Radha was nettled, ’�How could he talk so, to a newly wed?’�
’�He’s only joking.’�
’�Hum, that’s no joke. Even his wife’s angry.’�
’�Naturally. His comment was against her.’�
’�Actually, she’s a nice lady. She asked me to visit her. I think I’ll go. Can I, Jayettan?’�
’�Of course you may, provided the invitation was genuine, not just being polite.’�
’�How do I know?’�
’�Well, you should know by the tone, by the way she talked. Was it sincere? You should know.’�
’�I think she meant it. Hope I’m right. I’ll go there once. I’ll know then, wouldn’t I?’�
’�Yes, of course.’�
’�How long are we going to live like this?’�
Radha looked at him longingly.
’�Just nine months!’�
’�Nine months! That’s almost a year.’�
’�If it’s almost one year, it could also be almost half an year! Three months plus or minus!’�
’�What?’�
’�Never mind! You think I like this? I want to live with you. That’s why we got married, remember?’�
’�Yes, but, I was just saying ’�’�
Jayaraj left Radha in her hostel. Walking back, he was lost in thoughts. He wished Roy did not invite them. Visit to a family together was an experience. That made him conscious of his marriage. He was sure Radha was stirred into a materfamilias, not entirely appropriate at this time. He was trying to live like the bachelor. This visit reminded him the life he was missing. The illusion was burst.
Days went by. Jayaraj was well into the final year of postgraduate course. The work pressure had slightly eased. The emphasis was more on studies.
Radha was getting impatient. ’�What life’s this, Jayettan?’� asked she during every visit.
’�The most wonderful part of married life. Lucky, aren’t we?’�
Radha lifted her hand, in a mock action to hit him.
’�You’re joking all the time. For you life’s a joke!’�
’�That’s a healthy way to live. See everything as joke, take life as a charade.’�
’�Do you take your job as a joke?’�
That hit where it pained. She scored the point.
’�Hum. You know it’s not possible.’�
’�So it’s possible with our life? Our life’s a joke? Heard of anyone living like this?’�
’�So many!"
’�I’ve seen husbands leave home after wedding; go away to work. But, they’d live together for a few days, at least. We haven’t lived together even a single day, but we’re living in the same town!’�
’�See, our marriage was not expected. I mean, not planned. We’re forced; it’s an emergency! I told you that, now, how many times? Why don’t you understand that?’�
’�Why are you shouting? Don’t shout at me.’�
’�I told you ’�’�
’�But, now we’re married. Let’s at least spend some time, a few days, together!’�
’�I’ve my duties; I’ve to be in hospital.’�
’�When’re you free? Anytime without duty?’�
’�I’m off now, I’m free. That’s how I came.’�
’�Actually, why did we get married?’�
’�You don’t know?’�
’�I don’t understand.’�
’�How many times I told you this! One more time, last time, I’ll explain. Because if we didn’t now, we would’ve never got married. Never! I would’ve been someone else’s husband. That’s why! I know you know that.’�
’�Yes, you’ve an answer to everything.’�
’�Once I pass the exam, you just see, we’ll live together.’�
’�Actually, I’ll believe when it happens.’�
’�Why don’t you be happy that we married at all.’�
’�What’s the use, like this?’�
’�Better than never getting married!’�
’�Actually, I don’t know.’�
’�Now you keep praying that I pass first attempt.’�
’�I always do that.’�
’�Now it’s time for me to go.’�
Jayaraj thought he did a sacrifice by marrying Radha. Now she should be patient. She’s married to a doctor; should adjust to that life.
Many times when Jayaraj saw Radha, she was morose and indifferent. At times, he thought that was understandable. However, often he got angry that she did not understand.
Jayaraj failed to visualize a newly wedded girl’s aspirations. Understanding other’s perspective, Radha’s or anyone else’s, was not his forte. His attitude was different; now that they were married, they could wait some time to start life together. He was waiting patiently. She should too.
Problems kept creeping up.
’�Come Jayettan, let’s go for a movie.’�
’�Hum. Okay, we’ll go tomorrow. Tomorrow evening I’ll be off duty.’�
’�Why can’t we go today? Actually, tomorrow I’m not free.’�
’�What do you’ve?’�
’�I’ve special classes.’�
’�Okay, some other time. I should be studying now, not seeing movies!’�
He did not offer another day; she did not suggest either. The nuptial discord was obvious.
Jayaraj realized that they were behaving like children. Then they were actually children, not mature. But, fleetingly, he felt guilty; being comparatively more mature by virtue of better education and older age, he should take initiative to appease raffled feathers. However, he brushed those thoughts aside. He was the husband; wife should be submissive to her man. In that unpleasant mood, they parted that day.
Jayaraj was busy and could not see Radha for about ten days. When he did go, Radha started weeping. He remembered their quarrel; but surely, it was not important enough for her to remember and weep over. There must be something else.
’�What happened? What’s wrong?’�
She refused to talk.
’�C’mon, tell me.’�
’�Nothing.’�
’�Tell me!’�
’�You’re cruel. You quarreled. Then you kept away all these days. You didn’t even bother to come.’�
’�I didn’t quarrel with you. I couldn’t come. I didn’t have time.’�
’�You’re busy. But, I’ve plenty of time. To reminisce, to be sad, to be alone, to weep!’�
’�Oh, why? What’s happened?’�
’�Happened? You’ve no concern about me! I doubt if you love me!’�
’�Silly! You don’t mean that, do you?’�
’�Oh, Jayettan! Don’t know! I’m confused.’�
’�Don’t loose faith in me and our marriage. That’s a fact. Nothing can change that.’�
’�I’m sorry. I’m sorry.’�
’�You’ve to study! You also ’�ve an exam. What’s happening?’�
’�Oh, studies! I don’t feel like studying. I don’t care! C’mon Jayettan! Now what’s the use? Exams aren’t important.’�
’�See Radha, nothing’s changed. I told you. You study. You should pass, with a class!’�
’�You should’ve married me only after your exam.’�
’�Then I would’ve been someone else’s.’�
’�Why? I don’t know. You could’ve refused! That’s not my fault.’�
’�Now be a good girl. Go study and pass exam. Then we’ll live together.’�
’�If I don’t pass?’�
’�You’ll pass if you study!’�
’�I don’t know.’�
Jayaraj knew he had a problem in hand. He tried to get Radha study. He begged her, threatened her and offered her rewards. But, she remained uninterested. Finally, he gave up. Her examination was not important. That would have given her an aim in life, though. She would be off his back. It was not going to work.
A couple of months before the examination the PGs were relieved of their clinical responsibilities, allowing them to prepare for the examination. They become pure students. The joke was that they could relax only when the examinations approached. It was not just a joke either. After the strenuous, continuous ward duties, study was a relaxation.
During these weeks, Jayaraj had plenty of time to think about Radha and their future. Slowly he was growing more and more fond of his wife. Perhaps it was not love. May be, it was just the attachment that developed between people distained to spend the rest of the life together. Or, it was the bond between two, who were together, and because of that, were isolated from the family.
The chemistry of love was different. Often it took just a second for one to fall in love. Friendship depended on compatible temperament and personality; it took time to develop. At this stage, Jayaraj was not sure of his feelings. He doubted if he ever loved Radha passionately. He even wondered if it was a rebellion against his parents.
Normally Jayaraj’s power of concentration was formidable. But, now he found his mind wandering. Radha always hovered in the background. Now he could visit her daily. He found it impossible to stay away from her. Every evening, automatically, he would head towards her hostel.
Radha was always waiting for him. The daily visits and the anticipation of the imminent life together kept her going. Occasionally he took her out for a quick coffee. He came back invigorated.
Jayaraj was distressed because his studies were disturbed. In another sense he enjoyed it. He started believing that he was capable of love.
Abruptly he had an idea. Radha’s examination was getting over. He had no duties. Now he wondered if he and she could live together. He could rent a cheap accommodation somewhere. It did not have to be near the hospital. Anyway, after his examinations, they had to do that. He had a small amount of money, a pitiable savings, from his meager stipend. She can save her hostel expenses also. They could scrap through.
Jayaraj was excited. He asked around for a small dwelling for a family of two. He built castles in his mind; he was, for the first time in life, going to live like a family man. Maybe in a single room, but so what? He and his wife would be together. That was what mattered. With growing excitement, he dreamt the future. In that elated mood he even found it easy to concentrate on studies.

Chapter 49

Within a week of planning a home, Jayaraj had visitors. He was surprised to see Radha and her parents.
Radha had finished her examinations. She did not do well. But, she was sure of one thing; she will never write it again. Jayaraj had resigned that it was her, or rather their, destiny.
Jayaraj had not found an accommodation; but he was sure he could. His studies were progressing well.
Radha’s parents were happy.
’�Mone,’� Kunjamma started, ’�You’re so thin; are you alright?’�
’�Oh, yes. I’m fine.’�
’�Aren’t you eating well?’�
’�But, you know,’� Karunakaran Nair intervened. ’�How hostel food is!’�
’�But, I’m alright,’� protested Jayaraj. ’�I eat well.’�
Jayaraj was eating hostel food for ages. No one took notice before. Yet he felt good when they fussed over him.
’�Can’t you do something about it?’� asked Nair.
’�Yes, yes. Now, very soon, this’ll be over. Mone, a great relief for you, for all of us, no? Someone will take care of you soon.’�
Jayaraj was glad; they too were suggesting that he and Radha live together. Who knows, they might give him some money, or perhaps find a house. Then it struck him that they might have already found a house for them; they were here now to surprise him. He had that exciting feeling when one’s wild hopes were about to be realized.
’�Now he’s busy with work and studies. Aren’t you, mone?’�
All the more reason for them to help him out and for Radha to take charge!
’�Radha’s finished her exams. Nothing to do here.’�
Jayaraj was beaming.
’�Shall we take her with us home?’�
’�No!’� Jayaraj thought he shouted. But, no, he was not sure if he did. He probably did, much louder than was necessary, frustrated and agonized.
They were looking at him intently. Then he knew that he had not spoken at all. He stood there looking at Radha.
’�No, they can’t do that,’� his mind kept repeating, ’�no one may take my woman away.’�
Jayaraj was angry. Radha was his wife. They cannot interfere, meddle in their life. Suddenly he regained his composure. He calmed down. He had to agree with her parents. They were reasonable. At least they asked his permission. He was grateful.
’�Oh, I think ’� well, I haven’t thought about it.’�
’�It’s just for a few weeks.’�
’�Yes.’� Said Nair.
’�As soon as your exams are over, she’ll be back with you in your house!’�
’�It’s good suggestion,’� dragged Jayaraj. ’�But, how’ll they treat her in Tharavad? I mean, it’ll be unpleasant. You know, she’s never been there after wedding.’�
’�No. That’s alright. It’s our house too.’�
’�What do you think?’� Jayaraj asked Radha, ’�Want to go?’�
She did not hesitate. With an enthusiasm that dampened Jayaraj’s spirits, Radha replied, ’�Yes! I can meet my cousins and friends. Actually, I haven’t been home for long, after our wedding.’�
Then Radha noticed the disappointment and agony in Jayaraj’s eyes.
’�Actually, you’ll be busy with your exams!’� stuttered she.
’�No, no. I’ve study-holidays. You know I’ve more free time.’�
’�Your examination’s most important,’� intervened Kunjamma. ’�You study; she’ll only distract you.’�
Jayaraj felt weak and listless. The three of them had already taken the decision. He thought he had realized a bond with Radha; now she did something that shattered the trust. The bond was his imagination. The optimism of recent weeks disappeared suddenly. If Radha wanted to go, he should not stop her.
’�You’ll ’�ve to face my parents there,’� his last attempt to dissuade her.
’�Actually, I can handle that. I’ll go. I can face all of them. What can they do?’�
That settled it. Radha went home. Jayaraj was bitter; he felt cheated. He found a big void in life. By evening Jayaraj got restive. He walked by her hostel, half expecting to see her there. Lonely but for the vivid memories, thinking about, and missing Radha, he was forlorn. She deserted him. The loneliness was unbearable. Then he tried to cheer himself up, this was only temporary. She would join him soon.
Jayaraj tried hard not to neglect his studies. The hard pragmatism, the determination to do well, habit and will power, helped him to concentrate. By then he was fairly well prepared. More important, his teachers knew that. That was imperative. He could expect sympathy and help in the all-important clinical examination, should he happen to make some mistake.
When the theory papers were over, Jayaraj was happy. He had done well. But the important part was the clinical, where the candidate presented to the examiners, the patient he examined.
Roy was not an examiner. Yet Jayaraj hoped his chief would be in the hall. It was not unusual for senior teachers to do that. They could influence the examiners in favor of their candidates.
Jayaraj was reassured to see Roy in the hall. The examination went on without a hitch.
Once it was over, the candidates gathered to discuss the cases. Someone pointed out, ’�Look, Asspro was there throughout!’�
Everyone looked at Jayaraj with antagonism and resentment.
’�Jayaraj, you don’t have to appear for viva. You’re already through.’�
They laughed derisively. Jayaraj hoped they were right!
Then the results came out and Jayaraj passed. He was disappointed that Roy might get the credit for his success. Analyzing his performance, he now thought he would have passed on his own. He overlooked the confidence Roy’s presence gave him.
Jayaraj now wanted to get full credit. He detested sharing it with Roy. He conveniently overlooked what he planned three years ago! His plan succeeded; but he felt cheated. Ultimately, none of these mattered. Passing the examination did. Jayaraj felt he had conquered the world. He was at the pinnacle of academic achievement.
However, his problems were just starting.

Chapter 50

Successful completion of postgraduate training was a major event in a physician’s life. It gave Jayaraj a sense of achievement and a direction in life.
Jayaraj had to choose his future path. He could join his alma mater, emulate Raj Mohan and climb up the ladder of academic medicine step by step. That would offer opportunities to hone his clinical skills, master expertise in research and rake up years of teaching experience. But, starting at the lowest rungs, progress will be slow. He would be an underling, working for years under several layers of hierarchy. To top it, the salary was meager.
The alternative was a small community hospital. There, as a specialist, Jayaraj would occupy a much more important position. He could have independent charge, and take decisions all by himself. The financial reward was much better. Yet it was a limited opportunity. The future growth was restricted.
Jayaraj did not discuss it with Radha. In his male-chauvinist world, wife’s wishes had no place in decision making. As a youngster, he aspired to amass wealth and enjoy life. However, somewhere along, his attitude changed. Students often idolized their distinguished teachers. Jayaraj too had icons.
His mind was set. Several posts of tutor, the entry-level teaching job, were perpetually vacant. He just had to walk in; it was that easy.
The opening was in Ram Mohan’s unit. Actually, that was a plum position. But Jayaraj wanted Roy’s Unit; there was no vaccency there. He started in ward 10, Ram Mohan’s male ward. He was starting a new life, beginning a journey. Ward 10 had been a substantial part of his dreams and memories.
Ward 10 received Jayaraj politely. The atmosphere was friendly and informal. Accustomed so much to the surly air of his previous workplace, he found the new ambiance abnormal.
As always, Jayaraj took charge immediately. He left no one in doubt about his intentions. The assistant professor and the professor were hierarchically above him. The house surgeons and the PGs worked under him. Now he expected respect and compliance from them, something he demanded even as a PG. But, now when that was not forthcoming, he was uncomfortable; that reflected in his behavior.
’�This is myocardial infarction, third day,’� recited the PG. ’�No complications.’�
When he joined unit one as a PG, George Thomas was happy. He found the atmosphere congenial. After his experience in unit four, he considered going elsewhere for studies. But, his friends persuaded him to continue here. Till now, he was happy. Now he developed doubts. He knew Jayaraj.
’�BP?’� asked Jayaraj.
’�One forty by eighty.’�
’�Treatment? What medicines?’�
’�Phenobarbitone at night; and bed rest.’�
’�Why phenobarbitone? That’s what you use here?’�
’�Yes.’�
George was startled at Jayaraj’s pedantic questions.
’�No anticoagulation?’�
’�No.’�
’�Why?’�
’�We don’t use it, at least in uncomplicated MI.’�
’�I see. Now we’re using it. Start warferin!’�
’�But, the Copenhagen study ’�’�
’�Never mind studies.’�
’�Professor doesn’t use ’�’�
’�Now you do what I ordered.’�
This was not the style of unit one. Decisions were rational not arbitrary; issues were always discussed not imposed.
During the Professor’s rounds later, the atmosphere was relaxed and friendly.
’�Ha, warferin! You believe in anticoagulation for MI?’� he asked George, ’�Since when?’�
’�Sir, Dr. Jayaraj ’�’�
’�Oh, Okay! Jayaraj, so you want to anticoagulate? Why? Old habits, eh?’�
’�Sir.’�
’�We’ll discuss it, again. We did recently. But, Jayaraj might’ve something new to tell us. After all he uses it. Jayaraj, you tell us why. Let’s see if you can convert us! George, tell us why you don’t want to anticoagulate.’�
Differences of opinion reflected intellectual vivacity, essential for growth and progress. Unit four settled disagreements arbitrarily. Now Jayaraj saw a different approach at work.
Yet another matter bothered Jayaraj. He noticed that some patients received preferential treatment. Often less fortunate had to give up their beds to the privileged. When questioned he got the standard reply, ’�Professor’s orders!’�
Some younger doctors did resent. However, they did not go beyond a perfunctory criticism. Jayaraj knew such things happened in all the units, but not so frequently and not so blatantly. Even in Roy’s unit, he had accommodated patients, usually low-level government officials, on orders from Roy. But, they were very rare.
Here, in unit one, this was far too frequent. Jayaraj also noticed that the number of VIP patients was high. That was understandable. Ram Mohan was a superb doctor. However, Jayaraj was disillusioned. This was blatant disrespect to norms and decency. Raj Mohan should utilize his considerable clout to run his unit correctly, honorably. But, cynically Jayaraj thought, people like Raj Mohan derived their influence from doing the wrong thing. The society worked that way.
However, Jayaraj did not rebel. Ram Mohan was an idol he carried in his soul. The veneration was too deep and too firm. It was difficult to shake it of.
Meanwhile one day in the emergency ward, Jayaraj ordered an infusion of glucose, insulin and potassium for a heart-attack victim, standard treatment in unit four.
Later, Jayaraj found that the patient did not receive it. He asked George, ’�Why no GIK? I ordered it.’�
’�Noorsar said no. We don’t use it!’�
Jayaraj was mad. Noor Muhammad, the assistant professor had overruled Jayaraj’s instruction. That was bad enough. But, the worse was George counterchecking his orders. He forgot the circumstances, the consequences.
’�So you checked with Dr. Muhammad? I’d ordered; you should’ve just followed it.’�
Even before he completed the sentence, he thought it was wrong. Noor was his senior. Jayaraj could not blame George for seeking guidance from Noor, when the order went against the unit norms. At the same time, if George had full faith in Jayaraj, he would not have counterchecked.
’�Sir, we don’t use GIK. We discussed this recently and decision was against it. That’s why I checked.’�
’�That’s too bad!’�
’�I couldn’t get you at that time.’�
Jayaraj, in his conceit, was hurt, partly because he was overruled and partly because he could do nothing about it. He wanted to confront Noor immediately. After the rounds, he set out.
’�Hallo, Jayaraj. Come in, sit down.’�
’�Dr. Muhammad.’�
’�Hey, we’re very formal today!’�
Jayaraj was uncomfortable. He did not go there for friendly talk. But, that man’s spirits were infectious. Jayaraj sat down.
’�Incidentally, I stopped that GIK you ordered.’� Noor took the sting off.
’�Oh, I see; but why?’�
’�Yeah, we don’t believe in that stuff. You were using it in Roy’s unit, weren’t you? But we don’t!’�
’�Why?’�
’�You see,’� Noor enumerated the reasons. ’�We’d a unit session on it about two months ago. Very interesting, I mean, the discussion.’�
Jayaraj did not reply.
’�I think Professor will have it discussed in the medicine conference.’�
’�Oh!’�
’�Let’s go for a cup of coffee.’�
They found the junior doctors in the cafeteria. Without hesitation, Noor steered his way to their table. The doctors stood up. Noor eased the atmosphere with a jovial gesture. ’�Yeah, we caught you guys; running away from ward work, ha?’�
Everyone laughed.
Jayaraj was stiff. He wanted to be friendly, but could not. Anyone watching him would think that he was aloof and arrogant. However, he was miserable with fright, people fright. Nervous and shy, he went through pure agony. In professional circumstances he had no difficulty. In social settings he was tongue-tied. In contrast, Noor led the small talk with the dexterity of a seasoned compère. Jayaraj watched him with grudging admiration.
As days went by, Jayaraj had occasional arguments with Noor. He could not lead a friendly argument. To him every issue was a personal passion, each argument a crusade. Noor would forget the argument as soon as it was over.
But, Jayaraj was careful not to offend Noor. The Assistant Professor had the privilege of seniority. The junior staff held him in high esteem. In contrast, they had reason to dislike Jayaraj. When they needed guidance and advice, they invariably approached Noor. Raj Mohan was too senior. Jayaraj was hostile and pedantic. Noor was just right for them.
’�Noorsare, this unit’s a bit weird,’� Jayaraj said one day.
’�Weird! Strong words!’�
’�I mean, unusual.’�
’�How?’�
’�Maybe I should’ve said, improper!’�
’�You’re talking about our practice?’�
’�Practice?’�
’�Yah, the treatment ’� GIK and such things!’�
’�Oh, no. I’m talking about other things!’�
’�What other things?’�
’�You see, Noorsare, many patients get special treatment. Too many of them.’�
’�You mean their number’s high?’�
’�Not really. Why do they get preferential treatment?’�
’�Ah, it’s chief’s prerogative, isn’t it? He wants it that way. Who’re we to stop?’�
’�Still, it’s immoral, isn’t it?’�
’�I don’t know. Such things happen. You’ve to be flexible!’�
’�Flexible?’�
’�Yes. Flexible, adaptable, practical.’�
’�Practical? For being practical we do something we know wrong?’�
’�You bend a bit, without breaking.’�
’�I see.’�
’�See, Jayaraj, life’s cruel, unfair. It’s full of injustice. You and me, we can’t set it in order.’�
’�But, we could do what’s right!’�
’�We’re not doing anything wrong.’�
’�No?’�
’�No. We’re just part of the system. We’ve no existence outside the system.’�
’�Sare, what type of existence, this!’�
’�What other type of existence do you know?’�
Jayaraj kept quiet.
’�We know just one profession. We can’t leave it and try uplifting humanity.’�
’�I don’t know; I’m not sure!’�
’�What’d you do when a VIP comes and asks you for a favor?’�
’�We could help them, of course. But, not at the expense of others!’�
’�Why worry now? No VIP will come to us!’�
Both of them were reluctant to continue. Jayaraj knew that, if continued, it would soon slip into an unpleasant clash. He did not want to go beyond a friendly banter.
While Jayaraj’s hospital career was taking a bumpy ride, his family life was not going smoothly either.

Chapter 51

Jayaraj rented a tiny house, in a shabby, poor neighborhood. Even the low rent was difficult for the limited budget allowed by his meager salary. He collected some basic furniture. Then he wrote to Radha and her parents. He was not prepared to go to his house, not ready to confront his parents.
Radha joined him. Her parents gave them some money and kitchen utensils. Thus, the young couple set up their first home. To Jayaraj this was an idyllic heaven; and he thought that it would be to Radha too. Being together, living under the same roof, after the long wait, was itself a reward.
One evening when he returned from the hospital, Jayaraj found his wife all dressed up.
’�Jayettan, shall we go out today? Actually we haven’t gone out since we moved in!’�
Jayaraj readily agreed. They walked down to the shopping area, roamed in the streets and looked at the shop windows.
’�Jayetta, can I get a saree? Please buy me one. Actually, you haven’t bought a piece of cloth for me!’�
Jayaraj had not given her anything at all. It was unfair.
’�Oh! I don’t have money with me. You know how it’s!’�
Radha was disappointed.
’�Anyway you’ve enough saris to wear,’� added Jayaraj.
That was absolutely the wrong thing to say. Buying sari, providing cloths for his wife, was his basic responsibility. It was symbolic. ’�Providing cloths’� was a synonym for wedding. But, he had a ready answer. Their marriage was not normal.
’�Oh, enough, you say?’�
’�You know I’ve no money.’�
’�Actually, I just asked one saree.’�
’�You know ’�’�
’�Actually ’�!’�
The evening turned sore. By the time they were about to return, Radha was tired.
’�Can we ’�’�
’�What’s it?’�
’�Nothing.’�
Radha wanted to eat something. But she did not want to face one more rejection. She was too angry to ask.
Jayaraj too was aware that they could have had something to eat, nothing very expensive. However, he was in a foul mood. Radha’s behavior upset him. Silently they walked back. He was angry with himself for fowling up the evening.
Moodily Radha and Jayaraj ate their simple supper, thinking about the past, the life they had started together and the dreams for the future. But, their aspirations were different.
To Jayaraj living together was important. He believed that the present life style was transient. The difficulties were part of the career he chose. They would move on to bigger, better places. That belief made life bearable.
But Radha’s outlook was different. Paradoxically, now the village life appeared better. This was slum life. At least the tharavad was in prime location, in a vast compound. Radha could dream. Her prince would come to save her. Her attitude then was not unlike Jayaraj’s now. Radha had blissfully watched Jayaraj turn into a specialist. She did not share his driving ambition. Her prince did come, but not her salvation. Instead of the rag-to-riches life, Radha felt even the rag was snatched away from her.
Radha’s image of future life came from the romantic stories serialized in the popular periodicals. Life was an idyllic tale, spun by an imaginative mind. She daydreamed about going out wearing expensive saris, with her husband, to shop or to visit relatives. Occasionally she even fantasized clinging boldly to her husband’s arm, something unthinkable in her village. She wanted to showcase her new life! Now disappointment showed on her face, and reflected in her life.
This upset Jayaraj. He did not have the equability to understand Radha’s immaturity. She was incapable of analyzing and understanding life’s profound issues. She did not realize even her immaturity. Without knowing her limitation, she tried to assert her will. Jayaraj had little experience of life outside his profession. Understanding an immature girl was not his forte and not his priority. Friction was inevitable. They were bewildered at the conflicts early in life. He demanded understanding and patience. She dreamed earthly pleasures, comforts and indulgence.
Yet, there was one area, where both of them found harmony, early during their wedded life.

Chapter 52

Sensual indulgence was an imperative, if not the central, part of early-married life. Jayaraj and Radha started married life only when they started living together. Earlier, sex was something they both look forward to but never discussed. Whenever Radha lamented how long they were to live separately, the hint was unmistakable. They both knew what they were missing.
Once Jayaraj and Radha set up home, sex developed into an important and binding force in their life. It started rather hesitantly as a curiosity, was nurtured by mutual concern and care and grew into an all-consuming passion. Jayaraj and Radha thought that was one of the greatest rewards of their life together. They understood why their society placed a taboo on premarital sex. The ecstatic rewards of the first-ever experience, in the totally uninhibited atmosphere of their home, with the freedom allowed by the society, were beyond words.
Radha enjoyed sex as much as Jayaraj did. During the daytime, when she was lonely, she weaved fantasies of sensual escapades. She eagerly waited for her husband’s return. She was happy that they shared something and savored it. That was her fulfillment as a woman and wife.
Radha did not have sustained interest in anything. She was enthusiastic about almost anything initially. But, once the novelty wore off her interest also withered. Gradually, as months went by, Radha’s interest in sex dwindled. Sex became something she bore for her husband, just one of her nuptial responsibilities. Living in conservative society in pre-permissive times, she considered sex uncomely and repellent. Fed by folklore she suspected that too much sex was harmful. Initially she accepted that some sins were permissible and risks justified for worldly pleasures. As her interest diminished, she bore it for her husband. But her fear about her and her husband’s physical and spiritual health was genuine. That led to a guilt complex. She did not realize that real reason behind the fear and guilt was her lack of interest and her husband’s sustained desire. Later, her perception changed; she had to sacrifice; she suffered, morally and physically, for her husband’s pleasure.
’�If sex was taboo,’� Jayaraj asked, ’�Why get married at all?’�
’�Marriage’s only for sex?’�
’�Not only for sex. But, also for sex!’�
’�Actually, you’re interested only in sex.’�
’�You’re not interested? Earlier, you seemed to enjoy as much as I, perhaps more.’�
’�But, not always! There’s to be a limit!’�
’�Who set the limit?’�
’�Actually, too much of sex’s bad. It’s immoral.’�
’�Immoral? A little sex’s not immoral, it’s good, ha? A little more and it’s immoral. Don’t be childish!’�
’�But, bad for health, no?’�
’�Leave health alone; it’s not bad for health. Suppressing emotions is bad for health.’�
’�Ah, now you’ll say sex’s necessary for good health.’�
’�You’re right! Good idea!’�
’�Actually, not good at all; to me it’s downright bad!’�
’�Sex between married couple’s normal; there’s nothing bad.’�
’�I knew you’d say that!’�
Jayaraj did not understand her change. He dismissed the thought that she might have another man in life. He remembered his old doubt. He did not want to believe that she disliked him. But, it kept him worried. Deprivation and worry took their toll.
A tutor had the right to practice at home. However, patients rarely went to a junior doctor. The senior doctors, especially those who had admitting privileges, enjoyed such patronage. But an occasional patient, from the neighborhood, would go to Jayaraj. Jayaraj set the evenings as practice time and refused to go out. Radha’s life became increasingly miserable.
But, Jayaraj found nothing unusual. The prevailing idée fixe of reigning orthodoxy that molded his mind considered a wife’s primary responsibility as waiting on her husband. Jayaraj had his profession, nothing else, no other interest. And, he did not grumble. Why should she?
On days they quarreled they still slept together. But they made sure not to touch each other. This was a terrible punishment for them both. Jayaraj missed the sensual part of being together. Radha, even though had become less and less voluptuous, enjoyed hugging, and getting hugged. They, both, were miserable. Still, quarrels were frequent.
Radha could feel Jayaraj’s discomfort at emotional deprivation. Often she even enjoyed his unease and awkwardness. This was a lesson for Radha. Denial of sex was a punishment. Slowly she started using sex as a weapon. Initially Jayaraj would take the cue and made amends. But, soon he also turned his back on the uncooperative wife. Jayaraj’s amorous demands became less frequent.
’�You’ve no interest in me. Don’t even touch me now,’� Complained Radha.
’�Oh, really! Surprising! How much interest do you’ve?’�
’�Why are you asking same question I asked?’�
’�These things are mutual.’�
’�Actually, you’re different. You’re so very interested, earlier!’�
’�You made me like this!’�
’�Now, blame me?’�
’�Yes, it’s true.’�
’�How often you touch me?’�
’�It’s because of you.’�
’�You’re interested before.’�
’�You too were so very interested, soon after our marriage!’�
’�Soon after our marriage we didn’t even live together!’�
’�You know what I meant. When we started living together, here, in this house. But, you’re different. You’ve completely changed!’�
’�Actually, you’ve an answer for everything, an argument for anything; you’re good at it. I complain, you’ll turn it around and make me feel I’m at fault! You make me miserable.’�
’�You want me to agree to everything you say! Okay agreed.’�
’�Look how we live! Actually, this house’s a cowshed. Our Tharavad has better cowshed. There, at least a compound to walk. Here I’m a prisoner!’�
They stopped arguing when they got tired.
Jayaraj wondered if this was the same lively girl he grew up with, the same Radha he married. The change was drastic.
Divorce was not a viable option in the society. The peer pressure was intense. For Jayaraj and Radha absence of peers was a problem. But marriages were for life. This was drilled into every mind. The question, what after divorce, was difficult to answer. The society had not even heard about single parents or alimony.
If divorce was an option, they might have respected each other more. They would have tried hard not to hurt each other, lest it led to separation. Because divorce was untenable, they made no effort to avoid it.
A couple of years went by, marked more by arguments and squabbles than by love and concern. But, the major blow was that Radha did not bear a baby. A child might have brought peace and harmony sorely lacking in their life. Discreetly they saw specialists; but none could help.
’�What’s happening? You people don’t want a child?’� Kunjamma asked Radha.
’�Of course we want! You think we don’t?’�
’�But you’re not pregnant. After all this time, why, more than - how many years now? - living together and still haven’t conceived.’�
’�But, not because we don’t want.’�
’�Then?’�
’�We don’t know. We’re doing no, I mean nothing to prevent pregnancy!’�
’�Oh! God! Why? What’s it due to?’�
’�We’ve seen doctors. No one knows.’�
’�Oh, my God! Wouldn’t we see a child’s feet in this house? I’ll die without seeing a grandchild!’�
’�See Amma don’t make fuss; we’ve our troubles. Don’t add.’�
Radha could stop her mother. But, others continued talking, on her face and at her back. Society blamed women.
Jayaraj wanted a baby. More than that, he knew how much Radha wanted a child. A child would have filled the vacuum in her life, in their life.
Though unhappy, Radha’s parents sympathized with Radha. They knew she was living in relative poverty.
’�Mone, Jayaraja, how long are you ’� continue like this?’� Nair asked.
’�I’ll get promotion.’�
’�That’ll take years,’� Radha said.
’�Promotion? God! To what?’� Kunjamma asked.
’�Actually, Assistant Professor.’�
’�Ho, how much ’�’�
’�Actually, pay is not much more than now.’�
’�It’s foolish to continue here,’� declared Nair.
’�God! Now, a private hospital?’�
’�Ernakulam Kayemmam is looking for an MD doctor; I know.’�
’�Kayemmam?’� Jayaraj was curious.
’�Yes. KMM, Kumara Menon Memorial Hospital.’�
’�It’s a small general hospital. No equipments.’�
’�No. Better than medical college! The best there!’�
’�Acha you don’t understand. Compared to this it’s a dispensary.’�
’�They pay you well.’�
’�Why don’t you go there?’� Radha asked.
’�You don’t understand. That’s not what I want.’�
’�Actually, what do you want?’�
’�See one day I’ll become a professor. Then I ’�’�
’�How long you’ll wait?’�
’�Actually, you make others suffer too.’�
’�Can’t you wait a bit?’�
’�Wait for what? Actually, how long?’�
’�Job’s one thing,’� added Nair. ’�But who wants to work for nothing?’�
’�Only for a short time.’�
’�I don’t know.’�
Fleetingly Jayaraj wished he had married a doctor. But a doctor need not share his aptitude.
’�Jayaraja, mone, you just listen,’� Nair repeated, ’�Why do you suffer like this?’�
’�You know, Acha, told you before. I like this job!’�
’�But ’�’�
’�I know problems, difficulties. Early on there’re some hardships. But, it’ll be over. Then, it’ll be compensated, money, position!’�
’�God! You’ve to live now. How’ll you meet expenses? When you’ve a baby, expenses will double; you’ll see.’�
’�Actually, we’ve difficulty now. Even for our simple needs!’�
’�My practice might improve.’�
’�But, you said only chiefs get practice.’�
’�That’s the usual. But, it might change. My patients like me. They’ll come.’�
’�Your patients? Actually I don’t see many of them here!’�
’�Not now. But, they’ll come.’�
’�Who’re your patients? How do you know they’d come?’�
’�See, patients I see and treat in hospital, they like me. Eventually they’ll come. Only a matter of time.’�
Jayaraj did not change.
But, everything changed suddenly. Just one incident and Jayaraj’s perspective transformed radically.


Chapter 53

It was the admission day for unit one. The unit managed medical emergencies and admissions for 24 hours. The house surgeons and the PGs did the routine work. Jayaraj was on call duty.
That afternoon Jayaraj was summoned to see a seriously ill patient. It was a procedural detail. Nihilists mocked that this was just passing the responsibility. They were partly right. A good junior doctor could diagnose and treat the emergencies correctly. Despite, the outcome could be disastrous, inevitable even if a senior treated. Yet, a senior physician would reassure the patient and relatives. It saved the situation. Often, the senior physician just endorsed the junior’s decision. Unless she wanted to meddle, ascertain her authority.
Nevertheless, experience counted. Inexperience could lead to omissions or mistakes. Experience, years of observation, helped to spot such mistakes. Whatever, it was mandatory to call in the senior to treat serious patients.
Jayaraj found a hive of activity around a bed, in the emergency room.
Jayaraj looked at George Thomas, ’�Epilepsy?’�
’�Yes, sir. Status. Had several convulsions, almost continuous. Stupors now. We’ve given him iv amylobarb.’�
George was sorry that Jayaraj, and not Noor, was on call.
’�Right. You can also use paraldehyde.’�
’�He’s unconscious; can’t give orally.’�
’�Per rectum, about 45 ml. But, amylobarb is fine! We don’t have injectable dilantin, do we?’�
’�No.’�
The question was just a show off. They all knew it was not available; but Jayaraj established he was aware of the newer medicine.
’�Okay. See that convulsions are controlled. Then, start phenobarb.’�
’�Yes, sir.’�
’�Make sure he doesn’t injure himself.’�
’�Yes.’�
’�Check blood sugar, urea ’�’�
’�Already sent.’�
’�By the way, we’ve bed with side rail, right? Remember ’�’� No one wanted to remember, or reminded of, that tragic incident.
A similar patient was treated; and, when the convulsions stopped, was left alone. The heavily sedated patient fell down from the cot and sustained head injury. The patient later died. It was a lesson. The often-overlooked precaution to use beds with side guards for unconscious patients was strictly enforced.
An uneasy silence followed. Jayaraj looked at the nurse in charge.
’�Well, sister, will you shift this patient to ’�?’�
It was a question and a command rolled into one.
’�We don’t have bed with side guard. I mean, not vacant. We’ve only one. It’s occupied, other status, admitted this morning.’�
’�How’s she?’�
’�Getting better; but had one convulsion this noon.’�
’�We cannot shift her, can we?’�
’�No!’�
’�We’ve a problem here; sister?’�
’�I’ve been asking for cots. Asked Superintended. Not sanctioned so far, it’ll take time. I’m sorry, doctor.’�
’�Right, sister,’� answered Jayaraj with uncharacteristic understanding.
George smiled and whispered to the house surgeon, ’�She’s good looking. So Jayaraj’s full of mild of human kindness!’�
’�Milk?’�
’�Never mind!’�
’�What do we do now?’� demanded Jayaraj.
’�We can keep him on floor,’� George suggested, ’�When fits stop.’�
Keeping patients on mattresses spread on the floor was not unusual in the crowded hospital.
Jayaraj agreed and started walking back. But, the house surgeon unobtrusively joined him and said in a hushed tone, ’�Dr. Jayaraj, I think that patient’s related to a VIP, some high official.’�
’�What’s the solution?’�
’�Keep the other patient, morning’s epilepsy, on the floor!’�
’�No.’�
’�See, we could get into trouble.’�
’�No. I take the responsibility.’�
’�Right, sir.’�
George liked the way Jayaraj met the problems head on; but George lacked the courage. Young doctors, with their innocent idealism, usually appreciated such courageous acts. Yet only a few actually demonstrated fearless fortitude. George knew Noor and Raj Mohan would have tackled differently.
Jayaraj was annoyed, later, when he was summoned urgently to the emergency ward. But, he immediately resigned to that important responsibility and rushed there.
The scene surprised him. A distinguished-looking elderly man was standing there surrounded by doctors, nurses and hospital officials. Raj Mohan was among them. Jayaraj made his way to the center. The professor saw him and asked, ’�What’s happening? You’re the doctor on call, aren’t you?’�
’�Yes, sir!’�
’�So you’re responsible!’� Raj Mohan pointed to the patient on the floor.
Jayaraj assumed that the patient had died and Raj Mohan was demanding explanation. Jayaraj recalled the treatment; sure, it was right. Still death could lead to problems. This was any doctor’s nightmare. He remembered the patient’s VIP status.
But, at that moment, the patient moved. A startled Jayaraj blurted out, ’�What?’�
The relief was phenomenal.
’�Why’s this patient on floor?’�
Jayaraj understood. He calmed down, confident of handling this. For a moment, he reflected that he was up against the Professor, his idol. Perhaps he should apologize and make amends. That was a poignant moment; but it lasted just a moment. He felt reckless.
’�He had convulsions, almost continuously. It was controlled; he’s comatose. Can’t keep him on the cot; he might fall down.’�
’�Great! Isn’t it simpler to have a bed with side-guards?’�
’�We don’t have one.’�
’�We don’t?’�
’�Not available!’�
’�What’s happening?’� He looked at the nurse.
’�I’m sorry, sir. But, we’ve just one, sir.’� the nurse answered.
’�We need only one for him! Why didn’t you use it?’�
’�Sir.’�
But, Jayaraj intervened, ’�There’s already a patient on it; she’s admitted earlier. Same problem.’�
’�So what? Could’ve made that bed available! How would you keep him on the floor?’�
’�What else could I do?’�
’�Stupid! You could use that cot!’�
’�But, there was already one ’�’�
’�Okay. Leave it. I’ll manage!’�
’�Amazing,’� thought Jayaraj. The man who said that was his hero. Generations of students and doctors looked up at him for guidance, inspiration.
In a hushed voice Raj Mohan asked the nurse, ’�Why didn’t you get some more beds?’�
’�We’ve asked for them; not sanctioned yet.’�
’�Sir,’� professor addressed the distinguished looking man, ’�Sir, We’ll arrange a safe bed with side-rails for your cousin!’�
Someone nudged Jayaraj and whispered, ’�That’s the Chief Secretary!’�
Jayaraj now recognized the face. It appeared periodically in newspapers. He also understood the great fuss. The most senior and arguably the most powerful bureaucrat in the state would command attention and deference from anyone; a government servant like the Professor would bend over backwards to please him.
Jayaraj was sick. He felt contempt for Raj Mohan. Here was a man, at the crest of professional achievement, with generations of doctors as his students, stooping down so shamelessly in front of power. In one stroke, the scintillating idol that Jayaraj carefully created, reverently preserved and frequently worshiped crumbled. Jayaraj suddenly lost his love for academic medicine. If, after all the struggle and hard work, it came down to this, he did not want it.
At that moment the Medical Superintended appeared. He looked harried. Raj Mohan briefed him in hushed tone. The Medical Superintendent cleared his throat and addressed the Chief Secretary, ’�Sir, I’ll arrange a coat immediately. That’s no problem,’� He turned to the nurse, ’�Borrow one from the surgical ward. I’ll see that it’s brought down immediately.’�
Jayaraj felt some relief. The Superintendent showed more dignity than Raj Mohan did.
Everyone visibly relaxed. The Chief Secretary asked, ’�Why’s this scarcity for cots?’�
’�We’ve asked,’� answered the Superintendent. ’�The file’s in the secretariat.’�
’�Oh, I see,’� The Chief Secretary understood the red tape. ’�I shall ask the health secretary. If you don’t get them in a fortnight remind me.’�
’�Yes, sir! You’re very kind!’�
Jayaraj watched the senior doctors escort the bureaucrat out of the ward. With ill-disguised embarrassment, he looked at his junior colleagues. They kept looking at their feet. No one said a word. Finally, the nurse addressed Jayaraj, ’�I’m sorry Dr. Jayaraj. I never thought it would come to this.’�
’�Yes. But what could you do?’�
’�Proff was very angry!’� said George.
’�Yes!’�
Jayaraj walked out. But, halfway through he turned around and asked, ’�Any other problem? Any serious patient?’�
’�No.’�
Discreetly, George followed him.
’�I’m sorry Dr. Jayaraj,’� he said. Usually PGs addressed junior tutors by name, without the prefix ’�doctor.’� But, no one was sure of Jayaraj; none wanted to take a chance.
’�What for?’�
’�You did the right thing!’�
Jayaraj was surprised.
’�Hum.’�
Jayaraj could not concentrate on his work. His first instinct was to go straight to Raj Mohan and demand an explanation. However, that was preposterous! Yet, this event merited a confrontation. He could not decide how. He decided not to meet Raj Mohan now. Nevertheless, he had to see him some time. He was torn between the hero-worshiping diffidence and the righteous indignation.
But, Jayaraj did not have to decide.
The Professor came his way.
’�Ah,’� he cleared his throat. ’�What’s happening to you? Why did you get into that?’�
’�Get into what, sir?’�
The rhetoric reflected defiance. They both understood that.
’�You shouldn’t have kept that patient on floor!’�
’�I couldn’t ’�ve done anything else!’�
’�Why not?’�
’�There’s no cot with side rails; the one available was occupied. What could I do?’�
There was an uneasy silence.
Finally, Raj Mohan started, ’�You could’ve,’� ever so softly he continued, ’�made that one bed available for this patient!’�
’�Other patient came first!’�
’�But, you could transfer that patient. You’d authority.’�
’�What! It’s not right!’�
Raj Mohan’s face turned red. He was not used to his authority questioned by junior doctors.
’�You can’t succeed in life with that type of insolence.’�
’�Maybe. But, still can’t do that.’�
’�Your future success depends on your ability to handle such situations.’�
Jayaraj itched to say that if this was success he did not want it. But he kept quiet.
’�Jayaraj, you’re young. You’re just starting your career. You try not to get into this type of maze.’�
’�But, how? I didn’t get into it. It came.’�
’�You find who the patient was. That’s your responsibility. When you know he’s a VIP, say he’s too ill to be on the floor and shift!’�
’�I see.’�
’�Yes, see, it’s easy, isn’t it? Learn to get out fast, if you’re in trouble!’�
Raj Mohan turned the benevolent teacher guiding his student.
’�Sir,’� Jayaraj took a deep breath, hesitated a moment but continued, ’�With respect, I’m not sure if I want to do that!’�
Jayaraj was trembling; his voice was irresolute. Raj Mohan looked as if he was struck on the face. Both of them knew the bond was broken; neither could retrace their feet.
’�You’re an adult, now a qualified physician. You should decide what you want to do!’�
Jayaraj was devastated. His idol failed him. At the same time, he had doubts if he was shadow fighting.
Jayaraj needed support. He thought he should turn to someone who, he was sure, would not fail him. Roy!

Chapter 54

George was perplexed. He disliked Jayaraj. Now, however, George saw Jayaraj behaving heroically. Something difficult for George to do. But difficult not to appreciate. The drama in the emergency ward roused his conscience. Reluctantly he admired Jayaraj.
Then George remembered Noor Muhammad, the right person to turn.
’�Sir, heard what’s happened?’� George asked Noor.
’�What?’�
’�You didn’t hear? In the emergency ward ’�’�
’�Oh, that, What about it?’�
’�Unfortunate, don’t you think?’�
’�Yes, sure, most unfortunate.’�
’�Could’ve been avoided?’�
’�Oh, yes, that fool, Jayaraj! What a mess!’�
’�But, Jayaraj didn’t do anything.’�
’�Exactly. He didn’t do what he should’ve.’�
’�What?’�
’�How can you keep Chief Secretary’s relative on floor?’�
’�But, there’s no bed.’�
’�Unfortunate. But, you, I mean Jayaraj, should’ve found one. You’re junior. It’s Jayaraj’s responsibility. He should’ve solved the problem. Instead he blew it up.’�
’�Now, how could he?’�
’�That’s an ability you, we all, should develop.’�
’�I don’t know.’�
George was disgusted. They were all the same. The culture was infectious. He had to leave; if he stayed long, he too would get corrupted.
’�See, unless we compromise, we can’t succeed. Learn to compromise successfully. There lies success.’�
Repeatedly George heard that incantation. He did not want that kind of success. He would get his MD soon. He vowed to leave immediately after that.
Next day George told Jayaraj. ’�Dr. Jayaraj. I’m sorry about yesterday’s ’�’�
’�Why? Why sorry?’�
Same haughty arrogance.
’�What happened was wrong. Shouldn’t have happened.’�
’�Oh, now you advising me?’�
’�Not really. I’m trying to say that you did the right thing.’�
’�Oh.’�
’�Yes. Shameful! Senior doctors’ behavior.’�
’�Look, George. You’re still a PG. Don’t meddle in these affairs. Could cost you your MD.’�
That advice made George mad. Yet it was true.
Most evenings George met his close friend and classmate, Murali. They spent hours together, learning, discussing and gossiping.
’�You heard what happened today?’� asked George.
’�What?’� asked Murali.
’�In the emergency ward,’� George recounted the incident.
’�Too bad! But that b’� b’� Jayaraj deserved that!’�
’�Yes, right person, but wrong reason! For once he did something right! I never expected this.’�
’�You too feel strongly about this? I’m sure you do!’�
’�Yes. Don’t you?’�
’�Well, I don’t know. Difficult to fight and win.’�
’�But how can we do such a thing?’�
’�Okay for Jayaraj. He completed his MD. Before that would he have done it?’�
’�True, fighting professor now is suicidal.’�
’�Yes. It had happened. So many examples of failures, ruined careers.’�
’�It took some courage, even after MD. Agree.’�
’�Yes, you always talk about compromises. This is one more!’�
’�Yes one more compromise, now, for the sake of MD.’�
Next day in the corridor George saw Raj Mohan coming his way.
’�Good evening, sir.’�
’�Good evening, George. Going to the ward?’�
’�Yes sir!’�
’�Good. Work hard; that’ll pay off.’�

Chapter 55

Jayaraj did not knock. When he walked into Roy’s room, his mind was numb. Perhaps that, or possibly the rapport he thought he had with Roy, helped him to walk boldly in. Very few junior doctors did that unhesitatingly.
Roy was his morose best.
’�Yes?’�
Jayaraj hesitated.
’�What Jayaraj? What brings you here? From the exalted heights?’�
’�Nothing sir; just to say hello!’�
’�I see. Say hello, then!’�
Jayaraj laughed nervously.
’�Well, how’s life treating you?’�
’�Not too well.’�
Jayaraj came for consolation. But he did not find any.
’�Oh, really? But, I hear different. You don’t treat life with respect! If life’s ill-treating you, it’s your making. Don’t blame life!’�
’�Oh, you’ve heard?’�
’�Oh, yes I’ve. Tell me. Why did you make a fool of yourself?’�
’�Sir!’�
’�What do you expect? You’re playing hero?’�
Jayaraj was blind with fury. He overlooked the seniority and forgot the etiquette. ’�What do you mean?’�
He said that so loud, Roy was stunned.
’�I mean,’� Jayaraj said more softly, ’�What else could I do?’�
’�You could do lot of things. For one you could’ve avoided that scene!’�
’�How?’�
’�How! How? You could’ve kept that bloody patient in a cot! That’s how!’�
’�Are you suggesting that I should’ve got that bed vacated? Shift other patient to the floor!’�
’�I’m not suggesting, I’m asking, advising you to do just that!’�
’�Marvelous! Have you thought about that other patient?’�
’�No! Why should I?’�
’�What? Aren’t you concerned? About propriety? About fair play?’�
’�Are you trying to save the world? My dear fellow, this world’s full of injustice, inequality and discrimination. Can you do anything about it?’�
’�No, not really. But I can try to do the right thing!’�
’�So you do the right thing! You could’ve given a cot for that patient. You should’ve avoided the confusion.’�
’�How could I? I’m not the MS!’�
’�Look, your ability not to get caught in such situations is important. That’ll make or break you!’�
’�Ha! Same counsel! Dr. Raj Mohan said the same thing.’�
’�Don’t compare me with anyone!’�
’�I’m sorry.’�
Jayaraj waited for a few seconds and then walked out, a distressed and disappointed man. He found the prevailing tenet, that ability to compromise was essential for success, loathing.
Jayaraj was not sure if he was celebrating or mourning. Or he might be looking for a reason to get out of the place. He was about to give up his dreams.
If Jayaraj was pensive and irritable, more than usual, Radha hardly noticed it. He did not confide his difficulties and discuss possible solutions with her. Locked up in her own world, she was preoccupied with her comforts.
Jayaraj decided to say goodbye to academic medicine. He ascertained that it was not good enough for him; he was too good. His old longing for luxury was rekindled. Professional achievement and material gain need not be mutually exclusive.
Jayaraj was embarrassed to admit his failure in academic medicine. He thought for days. And then he casually told Radha, ’�I know, you don’t like it here. You’ve no life.’�
’�Oh, you’ve noticed. At last! Opened your eyes!’�
’�Yes, I realize that.’�
’�So?’�
’�We’ll to move from this place.’�
’�What?’�
’�I’ll work somewhere else.’�
’�Oh God!’�
’�Life’s rotten here. You, we, can’t continue like this long!’�
’�Why? Why this sudden change?’�
’�No, not sudden. I was thinking for some time.’�
’�Actually, thank God!’�
’�No money, no life, no nothing at all!’�
’�Oh God. My Deities have heard my prayers.’�
’�You know that hospital in Ernakulam? Your ’� ah ’� Achan was talking. It’s Kayemmam. We could try there.’�
Then things moved fast.
Within a week, Karunakaran Nair came to their house with another man.
’�Jayarajan in?’� Nair asked.
Radha assumed that he brought a patient.
’�Yes, Acha. He’ll come now.’�
Nair went inside and saw Jayaraj.
’�Acha, when did you come?’�
’�Just now! I’ve brought Sreedharan with me. He’s a partner, one owner of Kayemmam. They want you. I brought him to talk to you!’�
’�Oh!’�
Jayaraj was dazed. Too soon, too fast. Though he had committed, he was not entirely ready for the change. With a pang, he remembered that he was committing his life, perhaps forever, to a career he did not fancy.
’�Come. He’s waiting!’�
Sreedharan was a VIP.
’�Wear your shirt properly,’� Radha reminded Jayaraj.
Sreedharan stood up. That impressed Jayaraj; obeisance from his future employer was gratifying.
’�Hello, doctorsar,’� Sreedharan started, ’�I personally came to invite you to our hospital. All of us want you there!’�
Jayaraj just nodded his head.
’�He’s ready to join,’� intervened Nair. ’�All of us have decided!’�
Jayaraj was not pleased. He did not want anyone else to decide.
’�Good,’� said Sreedharan. He went on to describe the compensation. To Jayaraj, the offer appeared extravagant. Radha and her father were impressed too. The furnished house near the hospital was a great attraction. Little did they realize that the doctor living near the hospital was an advantage to the hospital; he would be available whenever needed, day and night.
’�Doctorsar, you come one day soon and see our hospital. You’d love it!’�
Jayaraj was not enthusiastic. His was leaving the present job. Kayemmam just happened to come by; its merit was superfluous. Morosely he answered, ’�That’s not necessary.’�
’�He knows Kayemmam!’� piped in Nair. ’�Who doesn’t know? No need to see!’�
Obviously, Nair and Sreedharan had already reached an agreement. Now he repented that he declined to visit the hospital. He could have negotiated his own terms.
’�As you wish. Thank you very much doctorsar! We’ll take care of you well. You’ll see! You wouldn’t repent.’�
Sreedharan thanked Nair and then addressed Radha, ’�Madam, you’ll be happy that your husband joined our hospital!’�
Then Sreedharan left with a triumphant Nair.
Looking at them walking to the car, Radha exclaimed, ’�Actually, he’s cute!’�
’�Cute?’�

Chapter 56

Jayaraj resigned his job and moved to Ernakulam. The hospital management and Radha’s family were great believers in auspicious date and time. Therefore, a date and time were carefully chosen for Jayaraj to put his right foot on the steps of Kayemmam.
It was a 200-beded, cramped facility, neither well equipped nor efficiently organized. A family of businesspersons owned the hospital. Four cousins, known as ’�Partners’� took care of the administration. They were poorly educated, but shrewd, members of a traditional business family that ran diverse ventures and industries. The elder one, Govindan, about 60 years old, appeared the first among equals. He was level headed, unassuming and was soft-spoken. His cousin, Sreedharan was in his mid-fifties. He wore fashionable, though a bit dated dress, spoke well and was sleek. Hariharan was in his late forties. He was shy and simple. A man of a few words, he was the sharpest brain among them. The youngest was Parameswaran. He was brash, indecorous and loud.
All the four cousins seemed to wager equal power; and they ran the hospital on whims and fancies. There was no clear-cut chain of command. Everyday at least one of them, whosoever was free, dropped in and spent three or four hours looking after the administrative details. Sometimes, two, three or even all the four came. The older staff joked that the partners enjoyed their hospital visit; it was their recreation.
The hospital was right in the center of the town, enjoying the advantage of an excellent location. The buildings were not well planned. The original structures were three four-storied towers that formed the corners of a triangle. They were called the ’�East,’� ’�South’� and ’�North Tower.’� Low, single-storied, long buildings connected the towers. These structures formed the side of the triangle; they were simply called ’�North,’� ’�West’� and ’�South Wings.’� Poorly maintained and shabbily painted, the buildings were altered several times in the past. The central court of the triangle also had some hastily constructed small structures. They housed the reception and patient registration.
All the three Wings had a door each allowing access from the outside into the corridors that ran the length of the Wings connecting the Towers. From the corridors doors also opened into the central courtyard. On either side of these corridors were rooms and wards.
The South Wing faced the main street. Close to the busy street, it was noisy and dusty. Jayaraj, on his first day, entered through this wing. All the four Partners and the Director, official head of the hospital administration, received him. The high profile reception took Jayaraj by surprise, but he relished it.
As he went around the hospital, VIP style, Jayaraj noticed how badly the buildings were planned. Three separate towers; each with a stairway! By combining towers, two staircases could have been avoided. The corridors were the main concourse between the Towers. No privacy to the wards on either side of the corridor.
The administrative offices were in the North Wing and the ground floor of the East Tower. Next door to the Director’s room was a medium-size hall with a long table and several heavily upholstered chairs. This was ’�the Conference Room,’� but, hardly used for conference. The Partners held court there.
Jayaraj joined the doctors and senior staff in the Conference Room. After the introductions and a simple tea, everyone left. Jayaraj started his first day.
The Director was a retired army doctor; everyone called him, ’�Colonel.’� He was indebted to the Partners for the lucrative job in his hometown. He was eager to show his gratitude by helping them. The Partners, on the other hand, were pleased that they got a retired army officer to head the administration. Armed forces had a reputation for discipline and efficiency.
The Medical Superintendent, known as MS, took care of the day-to-day administration. Dr. Achuthan was a middle-aged doctor who tried to practice medicine for a few years and, later, changed over to full time hospital administration. He was good at neither. Jayaraj got the impression that the hospital just limped ahead on habit.
Jayaraj started as physician and cardiologist. He had no training in cardiology. The study of heart disease was in its infancy.
The senior-most doctor in Kayemmam was an elderly, old-fashioned doctor. Dr. Paulose had no postgraduate training or expertise in any specialty. Indeed, he was a specialist in non-specialization. Patients flocked to him with various ailments; he disappointed none. He treated all medical problems, did minor surgery and attended childbirth; he took care of skin, ear, nose, throat and eye diseases.
Paulose’s career went back to the starting days of the hospital. As a fresh medical graduate, and a very clever one at that, the young Paulose carefully crafted his career according to the prevailing ethos. Specialization was a rarity. Paulose enjoyed the variety of his practice and the heavy demand for his service.
The patients, those days, did not demand specialist doctors. For decades, Paulose was the most trusted doctor in town. Nevertheless, as times changed, other doctors resented what they considered an infringement into their domains. The patients’ attitude also changed. They sought out specialists, the reason for Jayaraj’s appointment.
Jayaraj waited a few weeks before attacking the system. He went to Colonel.
’�Sir, the system here’s not right. How can one doctor see all patients with different diseases belonging to different specialties?’�
’�See, doctor, I’m really studying the problem.’�
Young Jayaraj was brusque; but Colonel approved his spirit and enthusiasm.
’�How long?’�
To Jayaraj everything was obvious, nothing to study.
’�I joined recently. Give me some time.’�
’�How much?’�
’�You’re really impatient, aren’t you?’�
’�Yes, Colonel. I’ve little time to waste.’�
After chatting for some time, Jayaraj left. He thought that Colonel was very unmilitary. But despite their age difference, they understood each other. That was the beginning of a friendship. Colonel was in fact very uncomfortable about the prevailing arrangement. His unruffled appearance was a façade developed over the years.
Colonel quietly went about building the ground to organize the specialty system. The new medical unit under Jayaraj was widely publicized.
Within months, a general surgeon joined the hospital. Dr. Mukundan was young. Patients needing surgical treatment were sent to him. A slow but steady erosion of Paulose’s patient population was inevitable.
Paulose reacted vehemently. But, he could do very little. Times were changing. Still he and some of his friends and faithful patients let out a vitriolic attack on the newer, unsafe treatment introduced in the hospital.
’�Oh, Colonel, what’s going on here?’� Paulose demanded, ’�This hospital was running smoothly, full of patients. Now, what’re these brats doing here? You’re encouraging them!’�
’�Look, doctor, specialization has really arrived. How can you and I prevent that?’�
’�Oh, I see. So far, I was good enough. Now the youngsters have come and you receive them with open hands.’�
’�That’s progress! We, old people, shouldn’t stand on the way.’�
’�You still stand here!’�
Colonel could not help but laugh! ’�See, really I’m also giving way to youngsters!’�
’�You can easily say that. Your position is not threatened.’�
’�Your position’s not threatened either. You’re still working here and will work as long as you can and want!’�
’�My dog will work, under these circumstances!’�
’�C’mon, doctor. Don’t use harsh words.’�
’�I speak truth.’�
’�See, we really want you to work here as you work now, see your patients. Partners appreciate your services. We respect your seniority and stature!’�
’�I want to know what Partners think!’�
’�I’m really speaking on their behalf!’�
’�They want specialists?’�
’�Do you really think anyone will be appointed without their approval?’�
’�Let’s see what happens!’�
Colonel was neither surprised nor perturbed; he had anticipated this. Progress demanded changes. Changes always affected people. Benefited some and hurt others. Inevitable.

Chapter 57

George entered the final year. His family started looking for a suitable bride for him. Finding a spouse was a family responsibility. The boy just saw the girl and approved. He had the right to refuse. Nevertheless, he also understood that ’�good children in respectable families’� did not usually say no at that stage.
A few months before the examination, Thomas Muthalali came to see his son.
’�Georgekutty, we’ve seen a girl for you. Good family, wealthy, good girl, educated, good character, good looking. We’re satisfied. Now you see and tell us if you like.’�
’�Now? I’m busy with exams.’�
’�No, not now, not so fast. Ha, ha. Wedding will be after examination. You just see her now.’�
George was intrigued. Marriage. A wife for him! Suddenly he wanted to know the details. What did she look like? Slim? Tall? But he could not ask his father these details.
’�See here. I’ve her photographs!’�
George almost snatched them up. Two photographs, wrapped in pink tissue paper, trembled in his hand. Who wrapped them? Did she? She knew that he would see it, handle it. What did she know about him? Name, of course. Age? Height? Did she see his photo? That he could ask his father.
’�Did you give my photo?’�
’�Yes. One of your old photos.’�
’�Which one?’�
’�The one you’ve taken after house surgeoncy.’�
’�They were old.’�
Muthalali was amused at his son’s interest.
Trying to keep his hands steady, George unwrapped the photographs. The first one showed an interesting, attractive face, in profile, looking at a distant spot. Behind that was a full-length photo of a slim, pretty but ordinary girl, looking straight at him. The eyes reflected innocent sincerity. George scrutinized to see it there was a glimmer of mischief in them. No, not really, they showed dignity. George looked at the photographs for a long moment.
Fleetingly George thought about the Nun. A flicker of smile appeared on his face. That did not go unnoticed by Muthalali, who thought that amounted to approval and acceptance. George was undisturbed by memories of his first love, which, he emphatically dismissed immediately. It was just childish prank of an immature mind. If he ever loved one, it was the girl on these photographs. He had already fallen in love with her. Love at first sight! Falling in love with a photograph! No dating, no living together, not even talking. He was ready to live with this girl for the rest of his life. Now, he wanted to see her, meet her, talk to her, immediately.
Next Sunday, George with an uncle and an elderly cousin went to see the girl he was all set to marry. He worried if she would accept him. A girl rejecting a boy was unusual, almost unheard of, in his society. Finding a handsome boy of good character and education from a good family was a difficult task. It was a boy-dominated ’�market.’�
George with his concern for social justice was against dowry. However, that was not his prerogative. He was sure it would not come in the way of this wedding.
The girl’s relatives received George warmly. It looked like a celebration. George understood that they too considered his visit perfunctory. The alliance was already fixed.
George remembered, time and again experienced, this first meeting. He hardly heard the small talk around him. Suddenly a shuffle by the side; he did not turn, but he felt her presence.
Mercy’s mother said something by way of introduction; George did not hear. He was intently looking at the girl. There she was; the face in the photograph, live here in front of him. It was etched in his mind. Soon everyone else left the room. Suddenly George remembered his attempt to talk to the Nun. He became self-conscious and tongue-tied. They looked at each other.
’�What’re you studying for?’� stammered George.
’�BSc.’�
Sweet voice, thought George. ’�Subject?’�
’�Home science.’�
’�Oh.’�
Silence for a few moments. He had nothing to say. Nothing? No, lots and lots! Yet, he had difficulty articulating.
’�When’s ’�’� Mercy was talking in Malayalam. ’�Your’� was a simple English word, but not so easy to use, in this context, in Malayalam. Therefore, she hesitated, and then continued, ’�When’s MD examination?’�
’�This March.’�
’�Oh, only three more months!’�
’�Yes.’�
By that time, one by one, the relatives returned to the room. George was disappointed and relieved at the same time. Talk was awkward; but he had not had enough of time with her.
George had no difficulty saying yes to the proposal.
That evening Murali asked George, ’�You liked her?’�
’�Yes!’�
’�Look at his face! Excited? O Boy. Feeling shy?’�
’�Shut up.’�
’�Both, ah?’�
’�I’m scared.’�
’�Scared? Scared of marriage?’�
’�No silly! About exam.’�
’�You afraid?’�
’�I’m always frightened of exam.’�
’�You? If you’re afraid what about others? Me?’�
’�Don’t joke!’�
’�If you don’t pass who will?’�
’�If I fail now, look, how do I face Mercy?’�
’�Oh, that’s the point, ah?’�
’�No, not only that. Medicine is such a vast field. Who can be through with everything? Suppose I cannot answer some question?’�
’�You’ll be able to answer something, maybe not perfect, but something, no?’�
’�If I fail!’�
’�C’mon, you wouldn’t.’�
’�See, if I can’t answer a question, how’ll it look. That means I’m not a complete specialist. Much more than exams.’�
’�You think too much! Now shut up.’�
’�No, really ’�’�
’�Are you going to meet Mercy again?’�
’�Yes in the church!’�
’�Church?’�
’�Yes our wedding.’�
’�Oh, not before?’�
’�No chance?’�
’�None at all.’�
’�You write to her?’�
’�No. No contacts. Everything is taboo, prohibited.’�
’�What a pity!’�
Undulating between the abstract love, the romance of medicine and the horror of examination George spent his run up to the end of professional schooling in a daze. But, the examination was a walkover for George. None of his teachers and peers was surprised about it either.
Raj Mohan was pleasant. He was still fond of George, with no bad, offending memories.
’�What’re you going to do?’� asked Raj Mohan.
’�I’m trying to join Vellore, CMC. Most probably I’ll get a job.’�
’�Oh, I see. In Medicine?’�
’�Yes, sir.’�
’�Going to be a teacher, ha?’�
’�Yes, sir.’�
’�You start as?’�
’�Lecturer in Medicine.’�
’�Good. Starting immediately?’�
’�Yes, sir.’�
’�Good luck. Let me know if I can be of help.’�
’�Thank you sir. Ur ’� sir, one more thing. I’m getting married next month. Want to invite you.’�
’�Oh, good! When fortune comes it comes in bunches!’�
George just smiled.
’�Congrats and good wishes, once again.’�
’�Thank you sir,’�
Officially, the results came out on his wedding day. Thus, the family had two reasons to celebrate.
One of the first things George discussed with his wife was his career and future plans.
’�You know, I’ve completed MD.’�
’�Yes, I know. Great, isn’t it?’�
’�Yes, it’s a big relief.’�
’�I’m so glad, you know.’�
’�May be it’s your fortune!’�
’�You’re the one who studied!’�
’�Yet you brought the luck!’�
Mercy smiled shyly.
’�Now, for the future ’�’�
’�What about future?’�
’�I’ve certain plans.’�
’�Tell me.’�
’�I want to work at Vellore.’�
’�At CMC?’�
’�Yes. There’s nothing else at Vellore.’�
’�So, we start there? When?’�
’�I’ve to go there and find out.’�
’�You’ve a job there?’�
’�Sort of, yes. Medicine Professor assured that I would get a job. But, not yet official.’�
’�Is it difficult to get?’�
’�No.’�
’�So you’ve the job.’�
’�Yes. But, how do you feel about it?’�
’�How I feel? You’ll work. What do I know?’�
’�Yes, I’ll work.’�
George took her hands in his and pulled her towards him. Shyly she just turned her face.
’�But, the conditions there’re not good.’�
’�Then why do you want to work there?’�
’�No. The work’s good. Excellent!’�
’�Then?’�
’�Life there.’�
’�I wouldn’t be able to come with you? That’s hard, isn’t that?’�
’�No, no. You’ll come with me, of course. No question.’�
’�Good. But, then what’s bad?’�
’�Pay is poor. House will be small and shabby. Life outside work is nothing!’�
’�Oh. So, what you want?’�
’�No. Question’s what you want.’�
’�Me? Ha, I want to come with you, you know.’�
’�No, you don’t understand. Will you be able to live there? Life might be rather dull!’�
’�C’mon! You studied; now you work and you earn, you know. So you choose; I’ll go with you, wherever ’�’� She was not very articulate, but she made her views clear. ’�Wherever, life can’t be dull now!’�
The door was half open; but George did not care. He took her in his arms.

Chapter 58

Radha was happy they moved to Ernakulam. Jayaraj’s salary was good. They could indulge in certain comforts.
Soon after settling down, one evening she suggested, ’�Shall we go to a movie tonight?’�
’�No. See, I’ve a serious patient. I can’t leave!’�
’�But, you’re not going to stay in hospital all night!’�
’�No. But, I’ve to be available in case I’m needed.’�
’�But, actually it’s only three, maximum four hours!’�
’�But, if something happens during that time how’ll I know?’�
’�You mean you’ll have to be here all day and night?’�
’�Exactly!’�
’�You didn’t have to do this there, as a tutor.’�
’�There I was not alone. Others shared responsibilities.’�
’�There you’re waiting for patients to come home. Here you’re still waiting for patients in hospital. You’ve no consideration for others!’�
’�Look Radha, I’ve to ’�’�
’�Actually, you don’t bother about me. Patient, patient, patient! always patients! My fate’s terrible!’�
’�Try to understand.’�
’�This is worse than PG days!’�
’�I’m starting another career. I’ve to be careful.’�
’�Careful? About what?’�
’�If a patient becomes critical and if the doctor’s not available what’ll happen? You should know that.’�
’�You always have excuses!’�
’�It’s not an excuse. It’s my job.’�
Radha just swayed her head and left.
Meanwhile Jayaraj’s hospital life was not smooth either. But, that did not disturb Jayaraj much. He had anticipated that. In fact, the conflicts invigorated him.
Jayaraj and Paulose tried to find fault with each other, and made no secret of it. Each scrutinized the other’s work to find faults. The open criticism often went beyond ethical limits.
Animosity between doctors, leading to personal-ego clashes, was nothing unusual. But, overt quarrel, just for degrading the other, was not usual. The Paulose-Jayaraj conflict was noticeably high profile.
Soon Paulose got an opportunity he was looking for. Jayaraj admitted a patient with typhoid. The diagnosis was correct and the treatment with chloramphenicol was appropriate. Nevertheless, the patient developed a known, but uncommon and critical, reaction to the drug. The patient’s bone marrow ceased to function properly leading to the dreaded complication, agranulocytosis.
The bone marrow produced red blood cells, certain types of white blood cells and platelets. When the marrow failed, total number of these cells in blood came down. The patient became anemic and vulnerable to infections. Even minor infections would explode into dangerous ones, a life-threatening situation.
Jayaraj diagnosed the rare reaction to the drug a little late; the patient’s condition turned critical. In a small hospital the news spread fast. Everyone talked about it in hushed tones. To Paulose this was a godsend opportunity. He talked about it and not in hushed tone either. He made it appear a mistake Jayaraj committed. The treatment was terrible; instead of curing, it produced another lethal disease.
The patient’s relatives, fed on the myth of doctor’s mistake, made ruckus. They complained loudly and refused to pay the expenses. They demanded compensation. That hurt the partners. Money was something they understood well. Those were not the days of medical litigation. There was no court case. Yet the reputation of the doctor took a heavy beating.
Colonel remained levelheaded.
’�See, this was really unfortunate,’� the Director told the relatives, ’�But, it’s not a mistake. The treatment was appropriate and correct. Don’t you know that Chloromycetin is the treatment for typhoid?’�
’�But, did our boy have typhoid? We’re told that the problem could be wrong diagnosis!’�
Colonel knew the facts well. However, he knew that a little showmanship would not hurt. Therefore, he called for the chart and pretended to study the details.
’�See, blood tests were done. See here! Really confirmed diagnosis. It’s typhoid alright.’�
No one questioned Colonel.
’�The diagnosis was correct. And the treatment was right too.’�
’�Then, why this terrible problem?’�
’�Unfortunate! Unfortunately, Chloromycetin produces side-effect. Rare but real.’�
’�Why can’t a safer drug be used?’�
’�Chloromycetin is a good medicine; that’s really the best medicine for typhoid. Very few patients develop this serious complication. Every medicine has side-effects, unfortunately.’�
’�Why our relative had that complication?’�
’�No one really knows!’�
’�You mean no special reason?’�
’�No reason at all. No one could ’�ve predicted or prevented it!’�
’�Will our boy recover? He’ll ’�’�
’�Chances are that he’ll recover, safely. Let’s hope for the best. We’re really doing everything possible. The best care, appropriate medicines, everything needed!’�
’�Should we take to medical college or to Vellore?’�
’�See the patient is likely to get serious infection, that’s the greatest danger. Traveling now will only increase the chance of infection. Nothing more can be done anywhere!’�
Colonel’s reputation helped to pacify the relatives. Further, Chloromycetin, trade name for chloramphenicol, was a well-known medicine.
Ultimately, the patient recovered.
But, Jayaraj bore the burden of scandal. There was no mistake, yet the verdict was guilty. He remained guilty in people’s mind, no argument, no investigation and no judgment.
Jayaraj knew that an incident like this could destroy a doctor’s future, especially during the early days of the career. The society explained this away by one word: destiny. If his colleagues were reasonable and honorable it would not have been such a great disaster. But, Paulose was neither.
Jayaraj paid a heavy price. He was suspicious when anyone looked at him. He suspected everyone looked at him with critical eyes. The tumult finally subsided. He knew he could not go through one more such misfortune without serious damage. Howsoever carefully he practiced, he might encounter similar catastrophe. Then he might as well consider changing his career, if not his profession. And Paulose would see that change was quick and unpleasant.
Jayaraj now missed his Medical College Hospital. There he was part of a team. It assured relative immunity from such trauma.
Radha knew that her husband was under fire.
’�You’ve problems in the hospital, no?’�
’�Yes.’�
’�What’s that? Actually what did you do?’�
’�It’s a problem, not really a mistake.’�
’�What went wrong?’�
’�Patient developed a drug reaction’�
’�Why?’�
’�Why? Why! How do I know why that patient developed reaction? It’s a side effect!’�
’�Why didn’t you use safe drug? Drug without reaction?’�
’�There’s no such drug.’�
’�Then why this commotion?’�
’�People talk about the unfortunate reaction, toxicity. It’s known to happen, but very rare. When it happened people were disturbed, angry.’�
’�You could’ve used another medicine? Use safer medicine!’�
’�No, not for typhoid. Treatment was proper. Every medicine has some toxicity.’�
When he needed consolation, support and compassionate solace, his wife was rebuking him.
’�Oh, I don’t know. Actually, it’s unfortunate. The Gods are against you.’�
He noticed that it was Gods against ’�you’� not ’�us.’�
’�Actually everyone home knows about it! Achan was asking me.’�
’�Shut up. Why the hell should your Achan and Amma interfere in my life? You don’t even understand me.’�
Radha was frightened. She found her husband changing.
Jayaraj found solace in discussing the episode with Colonel. Jayaraj was a daily visitor to Colonel’s room and often to his house.
’�Look, Colonel, how unfair! You know that. Tell me, who, which physician, doesn’t use Chloromycetin?’�
’�It’s really unfortunate. But, it’s happened. So, what could you do?’�
’�Frustrating! Can’t do anything. Even more frustrating.’�
’�That’s what I said. The unfortunate thing’s it happened.’�
’�My colleagues should’ve been fair. They know it’s not my fault. No one’s fault.’�
’�Yes. Now remember. That’s why I asked you to stop criticizing Paulose.’�
’�But, what’s that got to do with this? Different issues.’�
’�Maybe different issues. But, same basics. When you criticize, expect criticism back. You really get back what you give, and not necessarily in the same measure.’�
’�But, my criticism was fair.’�
’�That’s what you think. He may not! Do you really think he’ll accept your practice good and his bad?’�
’�But, the criticism must be sincere and just.’�
’�My friend, criticism always hurts. Only the magnanimous, real great, appreciate censure. In ethical practice criticism should be in camera, in closed doors. Criticism really shouldn’t be punishment, it should be creative.’�
’�I thought I was fair!’�
’�If you really hurt someone, expect equal reaction, wild, with no respect for rules or decency.’�
’�I understand.’�
’�Jaya, if you go about fighting the windmill, the windmill, given a chance, will turn around and fight you. And since the windmills ’�ve no brains the fight will be irrational.’�
’�Look. Paulose is not a windmill!’�
’�Oh yeah? You bet!’�
’�What?’�
’�He’s really an anachronism. But, he’s been here long, for decades! He was popular, with lot of patients. His patients may not go to him now; but they sympathize, they like him. Do you think he’s going to fade away overnight?’�
’�But, look at what he’s going about doing!’�
’�He belonged to an earlier age. Really did a lot of good, helped a lot of patients. He just didn’t graduate into this era.’�
’�I don’t know!’�
’�Now, you stop criticisms. Don’t even try to correct Paulose. Not for anything else, but your own good.’�
Jayaraj did not promise that.
Radha’s parents visited her house frequently. They had resolve to shape their daughter’s future. Initially they merely asked about work and offered advice. Gradually suggestions and later, commands followed.
Jayaraj was unhappy with the hospital and his job. He resented interference. Worse, he could do nothing about these problems. Therefore he was nonplussed when, one day, Karunakaran Nair asked, ’�Jaya, why don’t you start house practice?’�
’�House practice?’�
’�Yes. Practice at home, after hospital.’�
’�Yes, yes, it’s good,’� chirped in Radha. ’�Anyway you’re sitting at home, all the time!’�
’�All the time?’� asked Nair.
’�Actually, after the hospital.’�
’�Not going out? In the evenings?’� Kunjamma seemed bewildered, ’�Why aren’t you children going out? There’re so many places!’�
’�Oh, he’ll always have serious patients. Or he’ll wait for a new patient. We’re always at home!’�
’�That’s good!’� Nair said. ’�If you’re here all the time, just see some patients; it’s easy.’�
They looked at Jayaraj.
’�That’s against hospital rules! My job’s full-time; how’d I practice at home?’�
’�Ah, Ah, Ah ’� The rules! The hospital’s not serious about it.’�
’�If they’re not serious why do they’ve it?’�
’�They’ve it. Sreedharan told me that you should practice at home.’�
’�What?’�
’�Yes; the hospital will only benefit from private practice!’�
’�Strange! But, how?’�
’�See, many patients like to see doctors at home, not in hospital! Doctors will admit those patients in the hospital; send them there for tests. That’s big business. The partners’ relatives want to consult you at home, not in hospital!’�
’�Then they should cancel that rule!’�
’�Why do you worry?’� Radha said. ’�You just see patients here!’�
’�You shut up!’�
Radha again was perturbed. Her husband was becoming rude, uncivil.
’�Mone! Some doctors here make more money at home than from hospital!’�
Jayaraj kept quiet.
’�You should consider this.’�
Parents left by evening.
’�You don’t listen to me; you shout! You insult me in front of others!’�
’�You’re talking nonsense!’�
’�Yes, I’m always talking nonsense. Actually, you’re the only one with sense here. But, one thing, you can’t insult me in front of others. I wouldn’t tolerate that!’�
’�Why do I care what you tolerate? You should know when to talk and when not to.’�
’�Ah, you think I don’t know anything!’�
’�That’s a fact!’�
’�You expect me to keep mum? Remember I’m your wife. I too have voice in this house!’�
’�Oh, yes, you’ve. But, you should know what you’re talking!’�
’�I know! Actually you’re sitting here doing nothing! You don’t go out! You wouldn’t take me even for a movie! You keep on waiting for patients! If you’re sitting here why don’t you see patients here?’�
’�That’s against the rules; that’s why!’�
’�Ah, you’ve an answer to everything!’�
The argument ended there, but not the fight.
A few days later Karunakaran Nair came to Radha’s house in tearing hurry. He waited impatiently for Jayaraj. As a tired Jayaraj walked in, he heard Radha shout, ’�You’re late! Achan’s waiting for long!’�
’�That’s not my fault! I was busy; I’d patients!’�
’�Okay, okay,’� Nair intervened. ’�Doesn’t matter! Now, Jayarajan, mone, take coffee, eat something!’� Nair turned to Radha, ’�Why pester him? Now, give him something to eat. Can’t you see he’s tired?’�
’�No, no. It can wait,’� Jayaraj was weary. ’�You’ve something specific, Acha?’�
’�Hum, you know, our friend Radhakrishnan. He’s the Tahasildar’s brother. He’s not well and they want you to see him.’�
’�Oh, when’ll he come? Now?’�
’�No, no, no. Hum. You see, we’ve to go. You’ve to see him in his house.’�
’�What? His house?’�
’�Yes. He doesn’t like hospitals!’�
’�I can’t leave here. You know, I’ve serious patients in hospital!’�
’�But, it’ll take only one and a half or two hours! We’ll be back soon!’�
’�Two hours! No. I’ve to be here!’�
’�What can happen in two hours?’�
’�Anything! There’re serious patients, critical.’�
’�Can’t you come for just ’�’�
Jayaraj was pleased that he could disobey Nair, with adequate reason. Therefore, he took pleasure in saying, ’�Acha, I can’t. How can I?’�
’�So, you refuse! I’d promised them.’�
’�But, sorry! It’s my duty.’�
’�So you do your duty! I thought you’re an obedient boy, obliging son! It’s my mistake.’�
Jayaraj found that except Colonel no one understood him. He often unburdened his woes in front of his elder colleague.
’�You know these people are difficult to understand. Hospital bans private practice; yet they want the doctors to practice at home. Strange!’�
’�You know, they really want the cake and eat it too!’�
’�Why don’t you do something about it? You’re the boss!’�
’�What? Boss? I? Really, I’m the menial, the foot solder.’� He sighed. ’�I’m trying. But, it’s not easy. For many, this is pure business!’�
’�Yes, but obvious contradictions have no place even in business.’�
’�You really expect such finesse only from sophisticated people.’�
’�But, can’t you do something?’�
’�My position’s not really very strong. I’m here to carry out their instructions. I’m not to question them.’�
’�But, banning private practice’s hospital rule.’�
’�But, the rules can be bent, really, management’s prerogative. There’re exceptions.’�
’�So this ambiguity will continue.’�
’�Jaya, be patient. Let’s work together and see if we can bring about some changes.’�
’�When I was in medical college, the talk was, ’�you’ve to compromise for people who matter.’� Here it’s ’�concessions to money!’�’�
’�Rally, I understand your point. You’re young, spirited! You’ll mellow down. Then you’ll understand, as I do now!’� He laughed his usual short bursts.
’�The same words I’ve been hearing all through!’�
’�What?’�
’�’�Cool down, you’ll understand when you’re older. Be practical!’� That sort of thing! In short, be prepared to compromise to succeed in life!’�
’�Maybe! I’m an old hog.’�
Jayaraj understood Colonel. He had his allegiance to the partners. But, within that framework, he was trying his best for the hospital, patients, doctors and medical practice. That was Raj Mohan trying to do too. What was the difference between the two? Jayaraj was kind towards Colonel; and harsh on the Professor. Raj Mohan was his superior. Jayaraj coveted to reach that position. His psyche was in competition with that image. Colonel on the other hand was in no way part of his dreams. And Jayaraj had a good personal rapport with Colonel; they talked in equal terms.
Jayaraj’s family life was in shambles. He accepted that as fate. But, his career was sliding down too. That was serious. He regretted his decision to move from his alma mater. Yet, happily for Jayaraj, the slide stopped soon, abruptly.

Chapter 59

What a drab place, thought George, as he traveled from the Kadpady rail station to Vellore Town, home to the Christian Medical College and Hospital. He had long admired the founder of the institution. Ida Scudder was the daughter of an American missionary stationed in India. While visiting her father, young Ida was requested to help women struggling in complicated childbirth. Neither trained nor experienced, she was helpless. The prevailing social custom did not allow a male, even doctor, to help in childbirth. Subsequently Ida learned about the suffering and death of these women. That incident transformed her life and with that, lives of thousands of people, forever.
Ida could have ignored the episode, as most would do. Alternately, she could have embarked on a mission to educate and reform the people. She took yet another path. She studied medicine in her country came back and not only served the people but also established a medical school for women to meet the scarcity of women doctors. George found it attractive that she studied medicine with a single-minded intension of serving women in India. Albert Schweitzer took the same course, and went on to serve Equatorial Africa. Fascinating.
However, the captivating history did not percolate into the ambiance of the place. The town was hot and dusty. Roads were rugged, crowded and muddy. Buildings were dilapidated. George found even the hospital buildings unattractive. If the building came without a name, he doubted if he would step into it. He came to love the place, but not at first sight. It was not unlike a parent’s love for the offspring, despite the looks.
On a warm, sultry day, George started his work as Lecturer in Medicine. He was given all of one entire morning to get used to the new place! Then it was full steam. Work pressure was intense.
George liked the atmosphere, work culture and his colleagues, senior and junior. He was surprised how a good place could bring out the best in him.
In the whirlwind of work, somehow, George set up home in the hospital campus. For Mercy, it was a strange world, a bizarre experience. For a girl just out of college, pampered by parents and brothers, she was remarkably simple, unspoiled and diffident. With wide-eyed innocence and childlike simplicity, she started her family life. Everything she saw and encountered was a novelty, a curiosity. She faced life with exuberance and vivacity. From sex to cooking, she turned everything at home pleasant and colorful. George thought that if all the hardship he underwent so far were part of the price for this life it was worth it.
The place had a culture of its own; it was a closed community. Generations grew up there, starting first-year medical studies. They taught there, worked there, lived their entire life there. George did not belong. He was an outsider. However, in discussions, seminars and in routine patient care George made his mark. The hospital recognized George as an astute, hardworking young physician. Senior doctors took note of him. One such senior doctor was the Chief of Cardiology, Prof. Gurdeep Singh.
After a few months, in a medicine seminar George reviewed the report of an obscure heart disease published in an important journal. The problem, a congenital structural malformation of the heart, was so rare and complex that no one in the hospital knew anything about it. George spent hours and hours in the library searching for background information and reading up anything that came his way. He had to conceptualize the problem, made difficult by the unique anatomy. It was totally different from the prevailing concepts. He visited the anatomy dissection hall and the pathology laboratory; he examined normal and diseased hearts. Then he presented the article in simple language, precisely and lucidly.
By a twist of destiny an American cardiologist, one of a handful in the world with some personal experience of the condition, was visiting the hospital. He had accompanied Singh to the presentation. At the end, Singh complimented George and then invited the American to comment. Matter of fact, he said none in the world could add anything to what George said. He however went on to give his personal experience. His extempore talk was more elegant than George’s presentation. George again had his usual sense of deprivation.
Yet George was pleased, a rare occasion when he had difficulty faulting his performance. His self confidence looked up.
’�That’s a marvelous presentation,’� Singh complimented.
’�I don’t know if I made it understandable. It’s so complex.’�
’�No one can make it more understandable!’� Singh turned to the American, ’�What do you think?’�
’�Absolutely. Yeah, very clear,’� he looked at George, ’�yeah, now, if you come across such a heart you can diagnose!’�
’�But, it’s so rare!’�
’�Yeah, it’s. But, part of the reason’s that the condition might go unrecognized.’�
’�You mean it’s more common?’�
’�No, no, I don’t know. I wouldn’t say, common. But today it may go undiagnosed even if a doctor comes across one. Do you see that?’�
’�Yes,’� said Singh, ’�I can see that.’�
’�Now George will diagnose!’�
’�Now, that makes you a cardiologist, George! You should be in our department.’�
It was not really a joke. George felt good to be wooed. For the first time he noticed the effort successful chiefs of great departments made to bring in good staff.
’�How did you get interested in this?’� asked Singh.
’�Yeah, it’s not household topic even among pediatric cardiology buffs!’� said the American.
’�Oh, I was just going through the British Heart Journal,’� George was self conscious, ’�This paper was a challenge. So, I tried to understand. I’d to read quite a bit. Frankly I don’t understand the whole of it.’�
’�You should be in touch with Van Praagh, in Boston. Heard of them?’� asked the American.
’�Impossible not to know when studying congenital heart disease.’�
’�Yeah, indeed! Marvelous couple, absolutely brilliant! I know Stella and Dick personally. You might want to contact Dick, I mean, Richard Van Praagh at Boston Children’s Hospital; you may quote me. He’d clarify anything you want clarified! And remember you can even send heart specimens for diagnosis.’�
It was an out-of-the world experience. In one moment George was elevated to a plane he never thought attainable. Recognition by sheer quality was a good experience.
That evening George entered his house in high spirits. He took Mercy in a bear hug and carried her from the door.
’�Hay. what’s happened to you! The door’s open.’�
’�Right, right. Yeah, the presentation was a grand success. Now, Singh virtually asked me to join cardiology.’�
’�Oh, good! But is that good?’�
’�Yeah, it’s.’�
’�When’re you changing?’�
’�No, no. Not so fast. He said it as a joke. But, I think he means it. Let’s see.’�
Singh met George after a few days.
’�How’s everything going? Well?’�
’�Yes, sir.’�
’�Tell me. What’re your plans? Continue in medicine?’�
’�I’ve not thought about it!’�
’�You should. Cardiology’s an up and coming specialty. I can see the field is soon going to explode with new ideas, technology, information, what not!’�
’�Yeah! Yes sir.’�
’�Future belongs to subspecialties.’�
’�Yes.’�
’�Now tell me, how come you looked in British Heart Journal?’�
’�Oh, in the past, we hardly got to see journals. It’s wonderful to read.’�
’�Ha, like to read?’�
’�Yeah! Yes, of course.’�
’�Only medical literature?’�
’�Everything, sir.’�
’�Great; here, half the staff wouldn’t even see newspapers.’�
’�I read two every day.’�
’�Anything more serious than newspapers?’�
’�Yeah, anything, if time allows. Even serious literature.’�
’�You interested in literature?’�
’�Yes, sir.’�
’�We must get together sometime!’�
Singh was an absorbing character, interested in arts, music and literature. He looked forward to discussing his interests with anyone who would listen. George was a good listener.
’�Who’s your favorite author?’�
’�Oh, actually, my favorite’s a German.’�
’�Oh, Not Friedberg?’�
Textbook by Friedberg was then the Bible of cardiology.
’�No, ha, ha. Not really.’�
’�Thomas Mann?’�
’�Hum, actually, Magic Mountain’s an all-time favorite. But, my favorite’s Günter Grass.’�
’�Ha, Grass, intriguing character; your favorite, eh? Interesting.’�
’�Little known now. But, books are going to become classics.’�
’�Hum, my favorite’s Dostoevsky, always has been.’�
’�Good, very good, I like his books too.’�
’�You know, he once wrote that, ’�Man’s a mystery that must be solved. If you spent all your life trying to solve it, your life was not wasted.’� In a way, we do just that, don’t we? He looked at one facet of man, and we at another. Do you agree?’�
’�Yes, absolutely.’�
The elderly cardiologist entranced George. Probably both of them belonged to a rare breed with interests that mixed cardiology with classical literature. As months went on, the bonhomie slowly deepened.
Singh finally invited George explicitly.
’�You know George. Cardiology’s growing. Do you realize the potentials of catheterization, open-heart surgery, valve replacement and what not? We’re pioneers in our country, one of the few to introduce the real cardiology in India. We’ve started a training program, doctorate, DM. Why don’t you consider joining our department, do DM and work here?’�
There it was. George got the invitation. But, he hesitated; not easy to be a student again. He had to discus with Mercy.
’�You’ll study,’� said Mercy, ’�But, you’ll still be a lecturer.’�
’�Yeah. Lecturer in Cardiology. I’ll get paid. But, I’ll be a student, study for exam.’�
’�Nothing new. You study even now!’�
’�Not for exam.’�
’�Anyway, you decide what you want. I think it’s a big opportunity, you know. How many DMs are there in the country?’�
’�Yeah, it’s a big chance.’�
They considered the switch over to cardiology for some time. Finally, they decided.
Singh asked George to the cafeteria for a cup of coffee.
’�I was thinking about DM; do I get a chance this year?’�
’�I think you’ve an excellent chance.’�
’�Thank you.’�
’�Involves a bond; serve CMC for two years. Agree?’�
’�With pleasure, sir.’�
’�Good. You read Ulysses?’� Singh changed the topic.
’�No, but I’ll, one of these days. James Joyce’s masterpiece has to be read.’�
’�Yes, superb. You know I walked through Dublin, years ago. I was in Oxford, Rhodes, you know. I visited Dublin just to walk through Joyce’s trail. He meticulously described his town.’�
Under Singh’s guidance, George migrated to cardiology and became a student once again.
’�This is interesting, you know,’� lullabied Mercy ’�You’re a lecturer; at the same time you’re a student. How’s it possible?’�
’�It’s nothing strange. University allows teachers to study.’�
’�Oh, that’s different.’�
’�What deference?’�
’�They live like students, you know.’�
’�I don’t know!’�
’�Teacher and student at same time!’�
’�Yeah. Lecturer is only a title. Every graduate student has a hospital appointment, registrar, lecturer or ’�’�
’�I don’t understand.’�
George laughed.

Chapter 60

Jayaraj was surprised to see Colonel in his room that morning. He was annoyed. But, Jayaraj hid his irritation.
’�Hello Colonel, unexpected! What brings you here?’�
’�Jaya, it’s really a very sensitive matter.’�
Jayaraj panicked. Another scandal!
’�You can count on me. What’s it?’�
’�A patient under Paulose. Apparently sinking. Relatives now want you to see.’�
’�Paulose will have to ask me. Proper thing, isn’t it?’�
’�Yes, really, but ’�’�
’�Yes?’�
’�Paulose really wouldn’t ask you. You know that. Wouldn’t write a reference. But, he assured me, he wouldn’t object!’�
’�That’s irregular, don’t you think?’�
’�Yes and no. This is really an extraordinary situation.’�
’�How so?’�
’�Number one, paramount concern’s patient’s life. A life’s at stake; if you can really help don’t stand on formalities.’�
’�But, as you’ve told several times, everything should be done properly. Propriety counts.’�
’�I’m asking you to overlook that. Try to save a life. It’s really up to you. Even if you can’t save, satisfy the relatives.’�
’�I see.’�
’�Other reason. Relatives are restive. You could really save the hospital from some embarrassment.’�
’�But, if I don’t save him?’�
’�It’s a she.’�
’�What?’�
’�Patient’s female.’�
’�Oh! Okay, okay. But if I fail to save her, then I’ll be blamed. The relatives will continue to be agitated.’�
’�No. They’ll believe you; if even you can’t save her they’ll accept it as fate. Really, they just want the best.’�
’�If you say so.’�
Jayaraj knew miracles rarely happened. The main effort was to satisfy the family. Nevertheless this was recognition. They sought him out in a desperate situation. If, just in case, he could save her! That was exciting. He agreed.
’�Thank you.’�
’�What does she have?’�
’�That’s really what you’ve to find out!’�
’�But working diagnosis?’�
’�Congestive heart failure. She’s fever too.’�
’�Endocarditis?’�
’�I don’t really know.’�
Jayaraj’s heart sank; if heart failure had not improved so far with treatment, it must be intractable. He might not be able to do much. Then there was fever; that was not a feature of heart failure. Infection. Difficult to prove and still more difficult to treat.
’�Come.’�
Hoping against hope, Jayaraj went. A small crowd of relatives, with a flicker of hope on their face, watched him enter the ICU.
’�Doctorsar,’� the patient pointed to her right upper abdomen, ’�I’ve pain here. Can’t breath, I’m breathless. And fever, no relief! Ten days. I’m deteriorating.’�
Jayaraj examined her carefully. Obviously ill, looking toxic, she was restless and breathless. Her liver was enlarged and painful on pressure. But, this liver was too big for heart failure. Then it struck him, liver abscess. Yes, very likely, amoebic infection. That would not respond to ordinary antibiotics. If the doctor failed to think about it, he would miss the diagnosis.
Liver abscess might kill the patient, unless treated appropriately and immediately. It should be drained. But attempt to drain the pus out was risky, especially if it was heart failure. Death, during or soon after the procedure, would be a catastrophe. If he did not draw pus, his diagnosis would be wrong; he did a dangerous procedure unnecessarily, by mistake.
But, Jayaraj was confident enough to take the chance. Quickly he wore facemask, cap and sterile glows. With shaking hands that he had difficulty steadying, he quickly anesthetized the lower chest, right flank. With a prayer, he pressed the needle into the liver. He felt it entering the lever and pushed in hesitently, finding the way throgh the soft tissue. He closed his eyes, and calling all the Gods he knew, pulled on the plunger of the syringe from time to time. Then as Jayaraj heard a gasp around the bed he opened his eyes. Hesitantly he stole a look. Pus! The syringe was full of brownish pus; it was pure gold, 24 carets! At that moment, to Jayaraj, nothing else was as precious as that pus.
Slowly with steady hands, he drew out pus, again and again. Jayaraj thought the patient was already better. He was witnessing a miracle! He felt grandiose in front of the small crowd of nurses and doctors. Proudly Jayaraj thought that if his performance were in visual arts it would command applause, a standing ovation!
As Jayaraj walked past the small group of relatives, he felt like a maestro. Any moment he anticipated the demand for an encore. Colonel made sure that Jayaraj got the full credit. He told the relatives how Jayaraj made a brilliant diagnosis and saved the patient.
Eventually that patient made a full recovery. Her relatives saw a miracle, a divine intervention. God chose Jayaraj to perform that celestial prodigy. Later, they came to pay worship to the savior. One of them articulated the family’s sensibility, ’�In you we see the living God!’�
In his subconscious mind, Jayaraj wanted to, and therefore did, accept it as a probability. He was no fool. Nevertheless, the bigoted, inflated ego did pure magic. He also knew that such a reputation was an important ingredient for successful practice. Popular belief held that a good doctor had not only professional skill but also the healing touch bestowed by heavenly blessing. The public now credited Jayaraj with that benediction.
Jayaraj’s professional life changed forever.
Radha did not seem to notice his success. Jayaraj waited for a couple of days and then lost patience.
’�Did you hear about ’� that patient I treated day before?’�
’�Patient? How do I know about patient?’�
’�One of Paulose’s patients turned critical. I treated her.’�
’�Oh. Actually, what’s that, abscess?’�
’�So you knew!’�
’�How come you treated Paulose’s patient?
’�I was asked to. He couldn’t diagnose.’�
’�Paulose asked?’�
’�No Colonel.’�
’�Oh.’�
’�It’s serious; might’ve died. She was saved!’�
’�Abscess’s that serious.’�
’�It’s liver abscess! Pus in the lever!’�
’�Oh, I see.’�
’�You knew about it?’�
’�I heard.’�
’�Did you tell Achan?’�
’�No. Actually I didn’t think it’s ’�’�
’�Not important? When one of my patients developed a complication you thought it’s important enough!’�
’�Why are you angry? If you want, you tell everyone, whosoever ’�’�
’�You don’t think you should!’�
’�Actually, you’re always finding fault with me. My fate, oh God!’�
’�You should be grateful for your fate.’�
’�Ha.’�
’�You don’t think my success’s important?’�
’�Why are you questioning me like this?’�
’�Just wanted to know.’�
’�You know now?’�
’�Yes. I know. It’s not important for you.’�
’�Actually it’s impossible to satisfy you.’�
’�Yes. You’re not capable of satisfying me! You know that!’�
’�I know, I know, finally it’ll come to that.’�
’�Come to what?’�
’�What you said!’�
’�What did I say?’�
’�You don’t know what you said!’�
’�I said you don’t satisfy me. You’re never home when I come back.’�
’�Never?’�
’�No hot coffee. No news. Nothing. That’s what I meant.’�
’�You’re good at argument.’�
’�This house’s like an inn for you. Not home!’�
’�If it’s, you made it so.’�
’�I made! You’re never home.’�
’�Why should I sit here all the time?’�
’�Because it’s your home!’�
’�Actually, I don’t have to sit at home always.’�
’�Not always, but at least some time.’�
’�You don’t value what I do.’�
’�You value what I do? If you did you would’ve talked about this liver abscess.’�
’�You always blame me!’�
’�You should know how good I’m. How well I treat! My patients and public consider I’m a great doctor.’�
’�Not all your patients!’�
’�Have you taken a count?’�
’�Maybe.’�
’�Maybe, maybe! If you loved me you would’ve known.’�
’�Love. Don’t talk about love.’�
’�You wouldn’t understand.’�
’�I don’t understand! Actually, you blame me to hide your neglect. You neglect me and home.’�
Jayaraj was mature, past the early character-formative age. Yet, he changed. He became morose, authoritarian and dogmatic, morose because of his failure in family life, dogmatic because of professional success.
If Jayaraj had great expectations from married life, he would be a very disillusioned and depressed man. But, his expectations were not great. Nevertheless, it was a failure; failures distressed him.
Radha had become self-centered. She enjoyed her frequent visits to Tharavad. Proudly she flaunted, in front of her cousins, old classmates and friends, what she thought was her eminent social status. She showed off her wealth by sartorial and aurous extravagance.
Absence of a child was a serious void in their life. Jayaraj did not like to think that deprived sex was an issue. Nevertheless, suppressed concupiscent emotions provided additional burden in their all-but-falling married life.
Jayaraj was quite adept at devising ways to overcome handicaps. He did not suffer deprivation easily. He had fallen into a habit of mentally playing sensual acts with women he would not dare even to look at lewdly. That was a mental game, purely imaginary. But, it was an emotional outlet for him. The habit became pleasant past time. No one would guess the fantasies that passed frequently through his mind. But occasionally it bothered him.
One day waiting to cross the road Jayaraj saw a car pulled up. The rear door opened and a woman with gracious, fluid movements stepped out, head first. The sari had fallen off. He saw two perfectly shaped, partly covered, breasts. Beautiful, he thought, perfect. At that moment, the natural thing he thought was to go and gently embrace her.
Suddenly Jayaraj realized that he was staring. For a moment, he had forgotten everything else; that woman was the whole world. He was frightened that he might forget the reality and do something foolish.
Minds that indulge in lascivious fancies usually were sensually stimulated; body was provoked. Paradoxically, Jayaraj experienced the reverse. He found orgasmic redress by that pure mental exercise. He thus resigned to a life of abstract emotional fulfillment.
However, physical rapport was not just an outlet of emotional needs. It helped to cement the physical, mental and emotional relationship. Radha and Jayaraj did not find fulfillment in any sphere of married life.


Chapter 61

Late one evening Karunakaran Nair came running to Jayaraj’s house. He was panting and sobbing; in between, he shouted, ’�Jaya ’� Jaya ’� mone’�’�
A startled Jayaraj ran to the front door.
’�Mone, your father’s not well. Very serious! He’s in hospital. Doctor says no hope! Come immediately, C’mon!’�
Jayaraj did not waste time. With emotions crowding his mind and tears flooding up the eyes, Jayaraj pulled up a pair of trousers, grabbed a shirt and ran to the hospital. He saw his father there, after several years. Profusely sweating, severely breathless and fretfully frightened, Kesavan Nair was still perturbed to see his son. It was an intense emotional moment for both. They saw imminent death.
Kesavan Nair raised his frail hand and tried to say something. But, Jayaraj caught hold of the hand firmly. He said softly, ’�Don’t say anything now ’� Acha, rest now, relax. You’re going to be alright! Then we’ll talk.’�
Jayaraj briefly reflected how this profession trained him to tell absolute lies without batting an eyelid! It was immaterial if it was one’s father or a total stranger.
Within minutes, Nair’s condition worsened. He again tried to tell something. Jayaraj did not stop him. But, Nair was beyond talking. His eyes bulged. Blood-tinged froth oozed out of his mouth. For a brief moment, his palm tightened around his son’s. Then it loosened and remained limp there. Jayaraj held that hand tight for several minutes. Then, gently he released it free and walked out.
A doctor’s function ended right there. Others took over. But, here Jayaraj was much more than a doctor, the son. A decadent son! He wondered what his father was trying to tell him. He should think of his father at his best. But, he could not avoid bitter memories. He expected forgiveness though he did not accept he did anything wrong. He was their son. Nothing would change that.
But, this was not the time for vendetta. Slowly Jayaraj walked towards his mother, who was standing nearby. To his utter shock, even at that moment, she remained stoic. Yet, he tried to put his arms around her. She did not shrug away. Nevertheless, she did not respond. Then Jayaraj realized that nothing changed. Not even death would change life.
Jayaraj accompanied his father’s body to his Tharavad. For the first time after his wedding, he entered the compound. It had changed. The pond that gave years of simple pleasure to his generation was neglected, full of weeds. The house was dilapidated. The land reforms that the elected communist-dominated government introduced took land from landowners. Many families with nothing but land as their source of income had decayed. Jayaraj’s family was amongst them. Many among the younger generation had left for employment elsewhere. Several elders were long dead and gone.
The heroes of Jayaraj’s generation were the professionals. As a specialist doctor, Jayaraj stood out in the crowed. Even Radha had that clout; she was more poised, with natural ease, in that crowed.
Some youngsters came near and talked to Jayaraj; some tried to befriend. Everyone was watching him; he was visiting after a long interval. His mother’s bitter animosity was quite open and obvious; it attracted attention. But, Jayaraj was oblivious of these subtle forces at play. He enjoyed his status as a celebrity. To him this visit, despite the tragic circumstances, was a tremendous ego booster.
Jayaraj tried again to talk to his mother. But she remained indifferent. Jayaraj’s sisters, weeping, stayed close to their mother. Even they kept a distance from Jayaraj. But he could not blame them. After his wedding he made no effort to contact them.
Jayaraj was a sad man. The total rejection by his mother shook him. He knew that his roots were rotten. He could do nothing about it. He concentrated more and more in the hospital.

Chapter 62

Change from medicine to cardiology was seamless. Since George was already working in the hospital, he did not rate an orientation tour or introductions. No welcome party. Only work to be done; just start. Cardiology was understaffed. The DM students bore the brunt of work. George enjoyed the work and relished the added responsibility.
The catheterization laboratory, affectionately abbreviated as ’�cath lab’� in the lingua franca, was the heart of cardiology. It was the major method of investigating heart disease. The DM students rotated through the lab. George approached with trepidation. He had no aptitude for work involving fine, coordinated hand movements, the reasons he shied away from surgery. Manual dexterity was not his forte. But, without cath, cardiology had no existence. George had to be acquainted with, if not master, the technique to become a cardiologist.
The chief of the laboratory was Dr. Rajaram Reddy, a brilliant though temperamental cardiologist with an outstanding track record. He pioneered catheterization in the country.
His first day in the cath lab, George, properly scrubbed, gowned and glowed, entered the sanctum sanctorum. Rao, the chief technician tried to instruct him the pre-cath procedures. But, before George could do anything Reddy walked in.
’�Everything okay, Rao?’�
’�sir.’�
’�Okay, let’s kick off.’�
Reddy looked at the patient and grumbled, ’�Not prepared! What’s happening?’�
’�Dr. George Thomas, here ’� he was trying to ’� he’s new.’�
’�Oh. You know what to do?’�
’�Sir, yes, I was going to prepare.’� A senior student had told him what to do.
’�Going to? Should’ve done it by now.’�
George moved.
’�You’re new. Haven’t done before?’�
’�Uh, no, sir. First time.’�
’�Okay, Okay. Let me do it. No time to waste.’�
A disappointed George watched Reddy systematically preparing the patient, performing the test and winding up the procedure all by himself. He made no effort to involve George.
Each of the senior staff had a fixed day in the lab. The most pleasant to work with was the most junior. Dr. Seeta Devi was on to her second year after DM. With an innate dexterity for finely coordinated hand movements, she was a natural for the cath lab. However, her problem was laziness; she simply was not cut out for cardiology with its round-the-clock work schedule. Therefore, she was not popular with senior staff. They just tolerated her; replacement was hard to come by.
Devi was enthusiastic to teach. She explained the procedures step by step. She taught George how to manipulate the catheter. After a few sessions, he picked up the basics. But, Devi extorted a price.
’�George,’� after work, Devi called, ’�I’ve some patients to see, references; but I’m ’� busy. Just see them, write your advice and ’� let me know, okay?’�
A staff cardiologist, Devi could ask George to do that. Yet she was not all that senior. It was her work; she did not have much to do. George saw the patients without grouse. The demands went on increasing. Later she asked him to prepare presentations for her, search out information, type it and get 35 mm transparencies made.
This was a tremendous burden. George went home late at night, increasingly tired.
’�Georgee, you come back later and later everyday, you know,’� complained Mercy. ’�At this rate soon you’ll come back in the morning.’�
’�Quite possible.’�
’�You know, I can’t bear this.’�
’�Bear what?’�
’�You’re so tired, completely drained! No energy left.’�
’�It’s nothing. I’ve my duty.’�
’�C’mon,’� retorted she, ’�You know, Thankaraj comes home by 7.30. After dinner, he might go back or he might not. How’s that?’�
Thankaraj was another first year DM student.
’�He’s much more senior, an associate professor in his place, before he came for DM!’�
’�So what? Here, he’s just like you.’�
’�Because of his seniority no one demands much. Everything comes to me.’�
’�That’s because you do everything everyone asks! You know!’�
’�No! That’s not true!’�
’�C’mon. You know, his wife told me, promise, she told me; Devi asked him to do some work. He refused, point blank.’�
’�He could. He’s very senior.’�
’�C’mon Georgee. Why do you allow others to take advantage of you?’�
’�Advantage of me? Only you take advantage of me! Anyway, enough of talk. We’ve plenty to do and so little time.’�
He pulled her.
’�Now,’� Mercy giggled, ’�You’ve plenty of energy!’�
They thought that made up for every thing else.
As Devi kept relegating work, senior staff got inkling. But, no one did anything; possibly no one could. Then almost simultaneously two incidents happened.
In a seminar, Devi presented data provided by George; and then she waited for comments.
’�Your third slide,’� Reddy responded. ’�It says the number of acute rheumatic fever as 68. Next slide says 42 patients had no rheumatic fever. That adds up to 110. But, you present data on 98 patients. How does that add up? How do you explain that?’�
Devi noted, what everyone thought was a discrepancy, for the first time. Everyone but George. Devi made frantic calculations. Nothing. She was pale; she started sweating. If what Reddy said were right, it would suggest that the data was defective, even spurious. That was a very serious insinuation. Falsifying data was an unpardonable crime in scientific community.
Devi was angry. She thought George give her false data. She glared at George. Yet, she could not blame him; that would indicate that George did the work. Using someone else’s data was not sacrilege. Getting a junior to collect data was not wrong, either. But, presenting someone’s data without analyzing or understanding it was disgraceful.
George, sitting in the backbench, kept a calm face. He was in a fix. When it was clear that Devi could not explain, he stood up.
’�Sir, it’s like this, simple.’�
Everyone turned back with surprise.
’�Some patients had recurrent rheumatic fever, more than one attack. That’s why the total is more than the number of patients.’�
The explanation was perfect. But, the damage was done. It made clear that Devi presented George’s data without proper understanding.
George should have felt smug. But, he did not. He noticed that Reddy stared at him and not with friendly eyes. The agility with which George explained away Reddy’s question was perhaps derogatory. That might have made Reddy look a bit silly. It bruised his ego.
’�Why didn’t you tell me about it before?’� Devi demanded after the seminar.
’�You didn’t ask me!’�
’�How could I ask if I didn’t know?’�
’�How do I know if you didn’t know?’�
’�You should’ve told me everything.’�
’�I’m sorry.’�
’�You made me look like a fool!’�
George knew he had made an antagonist.
Within a few days Dr. Sumita Sen, professor of gynecology met Singh.
’�We don’t refer cases to you or Rajaram, except complex cases. We know how busy you’re, we don’t trouble you.’�
’�But, Sumita, why tell me now?’�
Then he smiled mischievously.
’�Are you trying to get something from my department? Return for favors? Pressure tactics, ah?’�
Sen laughed too.
’�No, not really. We send most of our consults to your junior consultant; but she keeps sending students, that too the most junior ones, to see. Okay, that’s okay when she happens to be busy. But, she should follow it up. She never does.’�
’�Oh, I’m sorry. It’s most improper; I shall take care of it.’�
After some pleasantries, they parted.
Next day Devi met George in seething anger.
’�You went and complaint about my consults?’�
’�Complaint? About consults? Ma’am, I don’t understand.’�
’�You told Dr. Singh that you see all my consults. Didn’t you?’�
’�Me? No, certainly not.’�
’�Oh, I see. Are you sure?’�
’�Of course I’m’�
’�After seeing patients ’� do you ’� write that I saw the patient?’�
’�No, I couldn’t possibly ’�’�
’�Okay, Okay, do you write that you discussed with me?’�
’�Mostly I get to see them at night. You wouldn’t be available even on phone.’�
’�But, somehow, you should’ve managed.’�
’�I did the best I can.’�
George did not say sorry.
’�It’s part of your duty, you see?’�
’�I’m doing my duty as best as I can.’�
Devi walked away without saying a word. But, George did not get any more references. He was in fact sorry. He did relish seeing patients; even at night, when dead tired, he enjoyed that work.
But, catheterization was another matter.

Chapter 63

Evolution of a physician’s career depended on several factors; her professional skill was only one among them. Jayaraj was fortunate during his formative years. It was difficult to predict how patients would respond to treatment, or to explain why two different patients with the same syndrome receiving the same treatment reacted differently. Doctor was at mercy of the patient’s fate.
Jayaraj worked hard. He was available whenever patients were serious. Whatever happened was despite, and not because of, lack of effort.
As time went by, little miracles and minor failures punctuated Jayaraj’s work. His luck was that the miracles were more visible and failures less noticeable. Arguably, he was the leader in the profession in his town. His boisterous tenacity came to his help. The hospital became a battlefield. And, the battles were not always against diseases.
’�Colonel, why’s so much delay in getting things done?’� Jayaraj implored frequently.
’�You know the real reason. No administrative machinery.’�
’�Then get machinery.’�
’�Ha! Not so easy. It’s to start from top.’�
’�Then start!’�
’�Patience, patience, Jaya!’�
’�But we’ve only one life to live.’�
’�True. That’s why you should really learn to relax.’�
’�You set this hospital right! Then I’ll relax.’�
’�What do you want to set right?’�
’�Hospital.’�
’�What in the hospital?’�
’�First let’s give the buildings a facelift.’�
’�Okay, done.’�
Everyone appreciated the beautified edifice.
’�See Colonel, we’ve to streamline administration!’�
’�Administration?’�
’�I mean, daily running of the hospital.’�
’�What about it?’�
’�Patient registration, medical records ’� so many small, small things. Delay everywhere! Patients or relatives ’�ve to run around a lot. Shouldn’t we take better care?’�
’�Okay we’ll do it, but slowly!’�
’�Why not fast?’�
’�What?’�
’�Why don’t we do it fast?’�
’�Okay, okay. We’ll do!’�
’�And clean up wards. Some are dirty.’�
’�You’re really impatient, aren’t you?’�
’�Yes, only one life to live.’�
Gradually efficiency improved. The changes were not only in esthetics. They led to financial gains. The partners understood that better.
’�Jaya, do you know the hospital’s profit’s really increased?’� Colonel confided one day.
’�Really?’�
’�Yes.’�
’�How? More patients?’�

’�Yes, you know you’ve more patients, really more than you can manage. But, there’re other reasons.’�
’�What?’�
’�Expenses came down. Lots of waste eliminated.’�
’�I see. Efficiency pays.’�
’�Yes. Partners are really happy.’�
’�They should.’�
’�Now you also should,’� Colonel smiled. ’�You’ve reason to be really happy.’�
’�Yes, I pestered you.’�
’�Not that. They’re increasing your pay!’�
’�Oh.’�
’�Yes. They’re really generous.’�
’�I should now think of building a house.’�
’�Yes, you can think now.’�
’�Radha had been pestering for some time.’�
’�It’s time.’�
’�But frankly I see no reason.’�
’�What?’�
’�The house we’ve rented is quite adequate.’�
’�No, no. A house’s not just a dwelling. It’s security, social status and fulfillment of personal pride, all rolled into one.’�
’�Middle class fantasy!’�
’�Maybe. Really it’s every family’s dream.’�
The new house, Jayaraj and Radha built, was a little away from the hospital. Jayaraj, to Radha’s chagrin, used his old bicycle to go to the hospital.
Paulose watched Jayaraj’s rise with grudge and envy. By tradition and by professional custom, doctors rarely retired. As they grew older, many of them were ill informed and ignorant of newer developments. Paulose was one among them. He felt betrayed by the partners, by colonel and by his patients. The gush of time surged past him. Frustrated, he quit the hospital.
There was nothing to stop Jayaraj. Professional supremacy affected his behavior. Increasingly he became eccentric and dogmatic, whimsical and idiosyncratic, an unconventional character.
Some of his colleagues admired Jayaraj for his guts. A few grudgingly envied him for the total lack of self-consciousness while doing things considered grotesque by the society. Yet others were not so generous.
Jayaraj was knowledgeable. He supported his decisions by referring to published work. He had a canny ability of verbally twisting the interpretation to make it appear just the opposite of what it actually meant. In the process, he would confuse everyone. Contradicting him was a frustrating experience. Doctors avoided him or avoided discussions with him.
Jayaraj felt that he was conquering the world. His way of treatment was the best available. Everything else was sham.

Chapter 64

Seeta Devi stopped teaching George altogether. Vendetta, and that hurt.
Reddy was always tense in the lab. Being an established expert, he did the most serious and difficult cases. The lab then had that atmosphere of impending disaster. Teaching took the back seat.
George felt Reddy was hostile. But, he conceded that it might be Reddy’s mien and idiosyncrasies that made him look so. A small mistake and he lost his cool. George was scared of the tantrums. Outside the lab, Reddy was reasonably friendly. However, George knew that Reddy was interested only in students good at, and, enthusiastic about, cath-lab work. George did not qualify. The result was a mental barrier that interfered with his learning.
George recognized his handicap quite early; uncharacteristically, he accepted it as his destiny. Later in life, it surprised him that he did nothing to overcome his handicap. To his regret, he later realized this barrier was more of attitude than of ability.
George did not take note of the basic problem: He was a perfectionist. If he were skeptical about the quality of performance he would rather not attempt it. Perfectionism in its positive role could be prolific and creative. Yet, it was an obstacle when combined with fear of failure. He was always worried about the outcome.
George liked clinical work. He examined each patient in detail, planned out appropriate investigations and diagnosed accurately. But, when George saw a patient, he was scared about the mistakes he might make. He could affect an air of confidence. But, it was not easy. Yet, by sheer mental travail, he acquired a reputation for coolness at adversity. But, this reputation did not quite reach the cath lab, where George was still a poor-cath-savvy boy. However, Singh indirectly acknowledged his clinical skills when he delegated some of his patient-related responsibilities to George, a rare recognition for a student.
When George started his cardiology training, interventional treatment did not exit. Perhaps it was a gleam in the vision of a thimbleful of pioneers. George did not anticipate the explosive growth of interventional cardiology.
In friendly banter with friends, George pooh-poohed his disability.
’�I’m an intellectual. Adapt at using my brain rather than hands.’�
’�Sour grapes, eh?’�
’�Not at all. Do you think I’m a manual laborer? I intend to work with my brain, not hands.’�
’�C’mon, George. Not everyone’s cut out for precision jobs.’�
’�Precision job! It’s just hand movements; I don’t care. Why do you think I didn’t become a goddamn surgeon?’�
One day, Singh’s secretary summoned George. Worried, George went to the chief’s den immediately. It was a routine matter, solved promptly. Yet, the chief kept on talking. George felt that the actual purpose of this summons was something else, probably more important. He was right.
’�You’re keen on literature, George. Do you like music?’�
The sudden change of topic was typical Singh, but perturbed George. They were in the midst of work, no time for banter.
’�Oh, yes, I like to listen to Malayalam and Hindi film music.’�
’�Classics?’�
’�I’m afraid not.’�
’�Pity.’�
George kept quiet.
’�You know Beethoven? Symphony?’�
’�Heard about Beethoven, but never listened.’�
’�Carnatic music? Indian classical? Not even Subbualakshmy?’�
’�No sir.’�
’�A pity. Music has a lot to do with voice, pitch, tenor and such stuff. But, it actually has more to do with brain.’� Singh pointed his finger to his head.
’�The catheterization’s something like that.’�
There it was. George got the point. His face paled.
’�You work with hand; but you’ve to have it here,’� Again Singh pointed to his head, ’�’� to perform. It’s a combination of brain and hand movements.’�
George, crest fallen, kept quiet.
’�Take ballet dancers, the gracious movements, brilliant! That too takes these faculties, body and mind. That’s why I consider visual art much more difficult to master than literature.’�
’�Yes sir.’�
’�Do you know one thing? Many of the famous cardiologists are great showmen. I’m not saying a good cardiologist has to be a showman. No, no, ha, ha! But, I suppose it helps. Maybe it’s part of the character that makes a cardiologist!’�
George got the message.
’�This place’s pioneering catheterization in our country. That’s very important to us. Try your best, in the lab.’�
A worried George slowly walked back to his room.
George unburdened in front of Mercy that night.
’�Merse, I’m mucking up my training.’�
’�What?’�
’�Cath is not for me.’�
’�Why?’�
’�I can’t do it properly.’�
’�Why?’�
’�Why? Why! That’s how I’m.’�
’�Okay then. Don’t do cath. Simple, you know.’�
’�Don’t be silly. There’s no cardiology without it.’�
’�I see. But, there must be cardiologists doing other things.’�
’�Yeah, there’re. But, not here.’�
’�But, you can learn, you know, enough to pass this course. I mean exam.’�
’�Yeah. Exam’s alright, but to work here?’�
George looked at Mercy. That was the first time he hinted at continuing here after the required years, to make a career in CMC.
’�Oh, if you don’t like cath, why work here?’�
’�I, sort of, like it here.’�
’�Like it here? Other than work what’s there to like in this place? And you don’t like work, you don’t like cath!’�
’�But, I like the work culture, the atmosphere. Cath is not whole of cardiology!’�
’�That’s what I said! Now you say the same thing. Avoid cath, you know, do some other cardiology.’�
’�They wouldn’t have a cardiologist here just to do other cardiology!’�
’�So you wouldn’t get work you like.’�
’�I could do cath just minimum necessary. But I like to work here.’�
’�If you like it here, why not?’�
’�I’m not sure they’ll give me a job.’�
’�What? There’re vacancies always, aren’t there? You know, very few stick to this place for long. You’ll definitely get a job.’�
’�But, cath lab’s important. They may not have me.’�
’�Of course they’ll. I hear everyone think you’re good.’�
’�What do you think?’�
She hugged him, ’�You’re superb!’�
’�So you’ll give me a job.’�
’�You already have, you know.’�
’�What do you think of living here?’�
’�Lousy place. But you’re working, not me.’�
’�But you’ve to live here.’�
’�You know, I’m with you, wherever you’re.’�
He wanted to hug her. But, at that very important moment in life, he avoided dramatics.
George recognized the emotional ruffle. A sense of inadequacy slowly grew up, taking a toll of his shaky confidence. A self-propagating vicious circle set in.
In the lab, George was always an assistant, not performer. He often ruminated over the deprivation and the damage, caused by his inaptitude.
One moment he would discern cath as just one among several investigations; the next moment he would change his outlook; cath lab was glamorous. To abandon that, accepting secondary role in cardiology practice, was unthinkable. That was not true; there was nothing charismatic about it. Cardiology was much more than pushing a tube into the heart. But then, the bewitching charm of the darkened room with gowned and masked figures, beeping monitors and the blazing alarms, was alluring. Rubbish! There was nothing dreamy about a room, which houses diagnostic equipment.
One day George, as he came out of the cath lab, met Singh in the corridor.
’�George, how’s everything come out there?’� Singh pointed to the lab. George had assisted Reddy to perform a study on a sick blue baby. He was a witness and a minor participant in groundbreaking work in the country.
’�Went on without a problem. The morphology, I think, it’s Tetralogy. But, we’ll have to confirm.’�
’�Good. I hope our surgeons will accept the child for surgery.’�
Reddy joined them.
’�So, Jai,’� Singh addressed him. ’�Tough study, yah?’�
’�Yap, very sick child.’�
’�Tetralogy?’�
’�Yeah, I think so. We’ll have to review the angio.’�
’�Okay, When? When shall we three meet again?’�
That was too much of a temptation for George. By reflex, he added, ’�’� in thunder, lightning or in rain, when the hurlyburly’s done ’�’�
The two literature buffs indulged in their vagary even during professional discussions. That was one reason for the bond between them. At the same time that often annoyed others; they did not often understand. Shakespeare was not exactly leisure-time reading.
Reddy looked at George, as if observing someone gone suddenly insane. But, Singh laughed.
’�I hope, not,’� Singh then completed the quote ’�’� when the battle was lost and won.’�
Reddy grimaced.
’�Whatever you’re saying,’� Reddy glared at George, ’�It’s not helping you in the lab. You should’ve more ’� dexterity with your hands; not your silly quotes.’�
Stunned silence. That type of open indictment was not usual in that place. Cultured work ethics demanded decorum even when reprimanding and rebuking. George, though technically a student, was a post-doctoral scholar, not just an undergraduate. Moreover, Singh was part of the scene that Reddy rebuked. Probably, Reddy realized he went too far. He tried to amend, ’�Ha, did you notice how blue the child became after angio?’�
George did not answer. But Singh saved the scene, ’�Was the child sent to ward? George, why don’t you go and see if she’s okay?’�
George grabbed the opportunity and bolted.
Despite the troubles he faced, as expected, George did well at the examination. Lucky, performing cath was not part of the examination.

Chapter 65

Jayaraj remained at top for some time. But, as time passed, he started slipping. He was clever enough to realize the changes. Medical science was surging forwards. Even in his small town, changes were inevitable.
Jayaraj saw subspecialties slowly snatching away parts of his practice. The complex and exhaustive new technology made narrower specialization imperative. At the time he qualified, the training he received and the degree he earned were the ultimate. Now he was one step behind. An erudite physician could treat a heart patient well; but the public wanted a cardiologist, one with a degree in cardiology.
Jayaraj was in the same predicament as Paulose was in, earlier. Then, Jayaraj was at the cutting edge. The edge was getting blunt now. To be a cardiologist, he had to get a degree in cardiology. He had no intension of going back to school. He did not accept he still had to learn something.
But Jayaraj was anxious whenever he admitted a patient with heart disease. The patient or the relatives might quistion his competence. A few years ago, people accepted even deaths despite Dr. Jayaraj treated. Now it was because of Dr. Jayaraj treated. Death was not the problem. Doctor was.
Colonel had grown old. His rim of hair around the bald scalp and thick mustache was snow-white. But, he was still active and sharp. He tried to guide Jayaraj and let Jayaraj guide him.
One day Colonel brought the matter up. ’�You know, Jaya, heart attacks are really becoming a problem, don’t you think?’�
’�They always were!’�
’�Yes, yes. But, now patients and public are really demanding!’�
’�Patients! When dead, they can’t be demanding! Ha, ha, ha.’�
Colonel did not join that laughter.
’�Ah, the dead! Can be big nuisance, to say the least. Especially, when the relatives think death could’ve been avoided.’�
’�Prevented! Indeed, show me how!’�
’�I’m not really saying that. I’m not ’� I’m only stating public reaction.’�
’�Public opinion ’� public! What do they know?’�
’�That’s not the real question. It’s their satisfaction. Isn’t it important?’�
’�Er, yes, they should be satisfied.’�
’�How do we satisfy them?’�
’�How?’�
’�It’s the age of specialization ’� super-specialization.’�
’�Yes. They all look at degrees!’�
’�Even for a simple headache they want a neurologist!’�
’�New trends, yes.’�
’�No, not new. People here always wanted specialists.’�
’�Did they?’�
’�Of course they did. You’re really a specialist, remember?’�
’�Yes, general medicine’s a specialty. But now ’�’�
’�Now it’s one step ahead. Really the same specialization.’�
’�Narrow, now it’s too narrow.’�
’�Ask Dr. Paulose!’�
Jayaraj flinched. Colonel hit at the sore spot.
Jayaraj had several options. He could specialize in cardiology. But, he abhorred that. Alternative was to bring in specialists. That would affect his ego. More qualified specialists might command more authority, more importance. He could still ignore all subspecialties and continue as it was. Jayaraj preferred the last option. Still he felt insecure, a nagging fear. Paulose at one time must have felt invincible.
Jayaraj tried to discuss it with Radha.
’�See, practice’s changing.’�
’�Practice? Changing? Actually ’�’�
’�More specialties are coming up.’�
’�More specialties? More MDs will come here?’�
’�Not MDs. Super-specialists.’�
’�Super?’�
’�I don’t know what’s super about it.’�
’�Then? Actually, I don’t understand!’�
’�There’ll be more specialists, cardiologists for heart disease ’� nephrologists for kidney disease.’�
’�Who’re they?’�
’�Anyone with MD can specialize in a narrower branch.’�
’�Specialists above MD? Actually, I thought MD’s the highest.’�
’�It was. Not now. There’re specialization even after MD.’�
’�I see. They’re coming here?’�
’�Coming here? What?’�
’�Cardiologist and others. They’ll be in Kayemmam?’�
’�No. They wouldn’t be here tomorrow. But, eventually, yes.’�
’�So?’�
’�I could be a super specialist!’�
’�How?’�
’�We ’� I could go for specialization.’�
’�Go? Where? How?’�
’�Just as I did MD, I could do DM.’�
’�More studies? Now? You’ll leave here, this job, and go to study?’�
’�What else?’�
’�What do I do?’�
’�Come with me, of course!’�
’�Student, again? Oh God! Live in a dingy room!’�
’�It’s only for two years.’�
’�Only for two years!’�
’�What else will you do?’�
’�Actually, we could continue here, that’s what!’�
’�But I’ll ’� what’ll ’� my position in hospital? Think about it.’�
’�What about your position? No one will send you out.’�
’�But my position!’�
’�Actually, you’re physician now, you’ll be physician.’�
’�But another cardiologist here ’�’�
’�So what? What do you loose?’�
’�Doctors competing ’� bossing over me!’�
’�Why competing? There’ll be another specialist! Not boss!’�
’�You don’t understand. Cardiology’s ’�’�
’�I don’t understand! I don’t understand anything! Only you understand. Actually, there’re other specialists here even now! Why not one more?’�
’�But it’ll be part of medicine, my own specialty.’�
’�How? It has become separate because it’s not part of it.’�
’�No, no. There’s a difference.’�
’�What difference? I don’t understand. Actually, you think only about you and your life. No consideration for me.’�
’�That’s not right.’�
’�No? Then why you’re planning to leave?’�
’�It’s for you also! My study, my work it’s all for you ’� us.’�
’�But I’m satisfied with what we’ve now!’�
’�Let us see!’�
Jayaraj did not tell Radha that he too hated to go.
Days went by with Jayaraj getting restless.
’�If I leave now, Colonel, and come back as ’� let us say, cardiologist, will I’ve a job here?’�
’�What’re you talking? If you’re a cardiologist in three years, I bet, you’ll not come back here. You’ll ’�ve really better opportunities. Top of the world!’�
’�I’m not so sure! In a narrow specialty, opportunities will be much less.’�
’�What? Medical facilities are really expanding. There’ll be real demand for cardiologists or any specialist for that matter.’�
’�Maybe. I’m not sure.’�
’�I’ve no doubt. Every other man has heart disease. They’ll seek cardiologist.’�
’�Physicians can treat most of these problems.’�
’�Yes and no. The point’s patients really want cardiologist!’�
’�True.’�
’�Er ’� but, I know it’s not really easy at your age.’�
’�What?’�
’�Getting back to classroom, learn cardiology. It’s no joke.’�
’�There’s nothing to learn! We’ve learned cardiology, enough and more!’�
’�Hum, that’s not the real point!’�
’�What else?’�
’�Change of lifestyle. My misses told me the other day, Radha’s dead against. Understandable.’�
After a brief silence, Jayaraj asked, ’�Will I get a job here when I’ll be back?’�
’�Who can really predict? You know these private hospitals. No job guarantee. No security. There’s no surety even as we work. I’m really sure you’ll be in great demand, that’s all.’�
’�I’m not sure. Leave a job and comforts, for something uncertain. Risk. No?’�
’�You’ve to judge.’�
’�What I get after two to three years of student life may not be better than what I’ve now.’�
’�It’s really your decision.’�
’�Then, of course, problem of admission. It’s not easy. There’re very few seats, very, very few.’�
’�True. But, you’ll really know only if you try.’�
Jayaraj could resist the appointment of a cardiologist in Kayemmemm for some time. Ultimately, he would have to give in. He schemed. He could have a cardiologist to take the responsibility a cardiologist working under him. Jayaraj will be the de facto cardiologist.
He started planning.


Chapter 66

When George completed his cardiology training, he had to complete a bond. He continued to work as a junior faculty. No examination. Just work. It was bliss.
By the time his bond was over, Gurdeep Singh had a short but serious talk with him.
’�George, you know we all like you.’�
George instantly realized that he was being escorted to the door, kid gloves instead of boots. No job here.
’�With all my faults, you love me still?’�
’�Now, don’t misquote!’� Very briefly, Singh smiled. ’�All of us ’� we would’ve loved to have you here.’�
George knew that ’�all-of-us’� stuff was sham. He felt an overwhelming disappointment. Not for the first time, he recalled how much he loved this place; and he realized how much he would miss it.
’�We all ’�’� Singh started.
’�Ha, first person plural,’� George made sure a smile was on his face. Carefully creating an impression of bonhomie, cautiously taking the sting off, and as pleasantly as required, he continued, ’�Is that ’�we’� a royal first person? Or does it represent others too?’�
Singh smiled mirthlessly. ’�Let me put it this way. The department wants you here, to join this team. But, we couldn’t pull it through.’�
’�Oh ’� er ’�’�
’�We tried hard to accommodate you. But, the administration wouldn’t approve another staff position.’�
’�But, there’s a vacancy, sir!’�
’�Yes, but we can’t fill it. The post’s scrapped. In fact, they want one more staff position dropped. Of course, they’ll not sack anyone now; we shall see to that. But, if one leaves, that position almost certainly will not be filled. No new appointments.’�
Sadly, George remembered his mediocre cath-lab performance. He could have had a staff position, if the department unanimously recommended, budget or no budget. Cardiology department had that clout. If he were good in catheterization such of his mentors as Singh could have easily pulled his appointment through. Now someone could easily, and appearing genuinely impartial, blackball him.
’�All right, sir. Thank you for everything.’�
’�Of course you continue in your temporary post for some more time ’� till you find a job. Try to get something good. Don’t hesitate to ask any help, letters, recommendation, introduction, anything! I’ll also look for openings.’�
’�Thank you, sir!’�
George was more desolate than normal. That evening he told Mercy the new developments.
’�In a way it’s good!’�
’�How could you say such a thing?’�
’�Now, be honest! You know, how can anyone live with the pittance you get here? We’ve to have food, cloths ’� and our other needs.’�
’�We’ve been living here, decently. Now what ’�’�
’�Okay, we scrape through as long as we live here. Don’t forget the support we get from Appa and my Daddy, you know.’�
’�Not much.’�
’�C’mon Georgee!’�
’�We meet our needs. We don’t starve.’�
’�You know, the moment we step out, anywhere outside, how we’ll be? We’ll always be the poor cousins.’�
’�Simple living and high thinking!’�
’�Easily said, you know.’�
’�There’re people, hundreds of them, who do it here.’�
’�Why do we’ve to do it?’�
’�Why not? Work’s good.’�
’�Okay, if you’re here I’m with you. You know, I’ll gladly go along, no complaints.’�
’�Thank you! But I don’t get it here.’�
’�That’s good! If you get a job here, you’ll stay back. You’ll never quit; I know it. Now that you’re not getting, you’ve no choice, you know. So go, get a job, earn money and let’s live decently.’�
’�So you like it! Like the way I’m thrown out?’�
’�No. I don’t like it. But it’s a fact, what I said, isn’t it?’�
’�But, think of me. The job I liked. I loved this place. Rejection’s terrible. Never thought they would veto my appointment.’�
’�Oh, darling, I understand; but my baby, what can we do? Believe me, this is the best that’s happened to us in a long time!’�
He was now lying, his head in her lap, her soft hands caressing him. He relaxed.
’�That’s the worst part. We can’t do anything. We’re so helpless. Our fate lies in unfriendly hands.’�
’�Right now you’re in very friendly hands!’� She bent down, brushed her lips on his cheeks and then lightly kissed him on his lips. ’�It’s not the end of the world. You know, we’ve our full life ahead.’�
’�But how much I wanted!’�
’�Yes, but we’ve to accept.’�
’�I like a teaching hospital.’�
’�This is not the only teaching hospital. There’re others.’�
’�But, this is one of the best.’�
’�So, you join another one and make it the best.’�
’�Occasionally you have flashes of genius!’�
’�Only occasionally?’�
Instinctively he pulled her face down.
George thought about the possibilities for days. Decision was difficult. He did not want to discuss with anyone. It had to be his decision. Mercy made her choice clear.
’�You know Merse,’� started George one day, ’�I was thinking. I don’t want to join another teaching hospital. The pay of course will be bad anywhere. I’m not interested in private practice. So our income will remain low.’�
’�So?’�
’�I could put up with that hardship in exchange for a job here. In a new place I’ll be unknown. How’ll that place accept me? I don’t know. Yeah, I wouldn’t know the work atmosphere, type of people. There’s a whale of unknown factors. I start from the bottom. It could be nasty. No, I’ll not be happy. I prefer a smallish private hospital. The pay will be good. Let’s make some money!’�
’�You know, this hospital is a second mother to you. Even you’ve to have some emotional support. I mean other than me.’�
George smiled, but said nothing.
’�After your mother’s death, this hospital took that place. You’ll always want to come back.’�
The silence prolonged; she wondered if she hurt him.
George marveled how very close she was to the truth. Even he was unaware of this.
’�But, I’ve you now.’�
’�No, no, not as your mother.’� said she in a serious tone. Then she burst out laughing, ’�Of course, I don’t want to be your mother.’�
’�Okay, mother.’�
’�Shh ’�’�
’�Now seriously, I’ll try a small hospital.’�
’�As you wish. Remember, it’s not easy to come back, you know. I’m ready to go with you anywhere, anytime, anyway, all the way.’�
’�So you come with me now!’� He pulled her down into his hand. And, the night stretched on and on.
That night George slept well with the satisfaction of one, who had reached a decision, howsoever difficult and unpleasant it was. He thus ended hours of agonizing uncertainty. That helped him to endure the pain of rejection. He was pleased that, for once, an unpleasant experience did not lead to depression.
Then again, his main problem was not about handling disappointments or containing frustrations around lost paradise. It was embarrassment over his past indiscretions, faux pas, and blunders, real or more often, imaginary.
Yet this was a small victory.
As soon as he announced his decision, Singh asked him, ’�Are you mad, George? What’re you going to do in a place like that?’�
’�Well sir, practice cardiology.’� That would have sounded impertinent, had it come from anyone else. His unimpeachable reputation for good behavior, his bond with Singh, his demureness and the tone in which he made the cryptic statement allayed any such impression.
Singh smiled. ’�We’ve done better than that, haven’t we? We trained you in investigative cardiology.’�
’�But I’m not good enough, am I?’�
Singh ignored the defiance. ’�Cath lab may not be your forte. But you should still go to a place with invasive work going on. There you can use what you have learnt. That’s what we tried to do for you!’�
’�Sir, you’ve done much more for me. You’ve changed my whole approach to heart disease. I’m a different, hope better cardiologist!’�
’�I’m glad you’ve confidence.’�
’�In a place like that it’s immaterial whether I’m good at cath. What matters is patient care.’�
Singh smiled; that smile did not quite reach his eyes.
George gave the mandatory notice to quit. After a customary, uninteresting sendoff party, he was off to start in his new hospital.


Chapter 67

Jayaraj finally realized that he could no longer stall the cardiologist’s appointment. Unknown to him, the management also had reached that conclusion. Interest of the hospital demanded that. They were not concerned with medical progress. It was a matter of existence.
The partners had another, more selfish, reason. They had a niece who had just completed her training in cardiology. The family was proud of her, a highly qualified woman in a family not noted for academic achievements. Naturally they wanted her in their hospital. But, they were afraid of antagonizing Jayaraj; he had a large number of loyal patients, including VIPs. A new cardiologist would need his active support and help. They were not comfortable asking Jayaraj.
Eventually, the partners sought Colonel’s help. He was in a difficult spot. He did not want to offend Jayaraj, a close friend and his family physician. Yet, he wanted to help the partners.
But, Jayaraj surprised them. One day, over drinks, he told Colonel, ’�We’ve discussed this before. Medical practice’s changing. Especially cardiology.’�
’�Yes, I know, really.’�
Then Colonel waited, looking for the opportunity to introduce the partners’ relative.
’�New techniques. They catheterize even the coronary arteries! But, I don’t see what good it’ll do.’�
’�True. Really, true for other branches too. Look at good old kidney. Nephrology’s progressing, what with artificial kidney and what not.’�
’�Hum. Mind you, I’m not sure if all that’s good for patients. It’s certainly good for cardiologists. Medical treatment’s still the best for heart disease. We’ve wonderful drugs. No need to cut up. When the drugs don’t work nothing will. But, no doubt, cardiology’s arrived. Common people ’�ve started asking.’�
’�That’s true! Really no difference between a good physician and a cardiologist. But common man’s started asking. They look at qualifications.’�
’�I’m thinking, perhaps ’�’�
’�Yes?’�
’�Do you think we should’ve a cardiologist?’�
’�What ’� er.’� Colonel made no effort to disguise his surprise; but he suppressed his excitement.
’�No?’�
’�What?’�
’�Perhaps it’s time we’ve a cardiologist.’�
’�In this hospital?’�
’�Yes. Surprised?’�
’�Well, somewhat, really. Now, why?’�
’�We face criticism when heart patients die. We do everything cardiologist can. But, people wouldn’t be satisfied.’�
’�Occationally.’�
’�Increasingly now. People look for qualification, paper qualifications! Our people suffer from multiple diplomatosis!’�
’�Ha!’�
’�Public would accept anyone, but, only someone, mind you, with a degree in cardiology ’� as cardiologist.’�
’�Really! Cardiology was part of medicine in our good old times!’�
’�Yes, and it’s right. Cardiology’s part of medicine.’�
’�Times are changing.’�
’�All changes are not for good.’�
’�Good or bad in this business we’ve satisfy everyone. Anyway, you’re a cardiologist. Think about it, qualifications are necessary for a beginner. There’s no dearth of patients for you.’�
’�Look, be realistic. Sure, my old patients stick on; at least the majority of them. But, very few new heart patients. You know that! Even old ones leave, when they get worse or get into problems.’�
’�I don’t agree. Where else do they go? Who else? No other doctor’s really as popular as you’re.’�
’�They all want to go to cardiologists if possible. To hospitals with cardiologists.’�
’�So what do we do?’�
’�Look, we should’ve a cardiologist.’�
’�You planning to go to school now?’� laughed Colonel, ’�Get DM?’�
’�Don’t be funny. We’ve only one option. Get, recruit, a cardiologist.’�
’�Really! Another cardiologist!’�
’�Don’t get excited! I’m not giving up practice, not yet. I wouldn’t give up even my cardiology practice, you bet!’�
’�Really! So, you want to eat your cake and ’�ve it too! You’ll ’�ve a cardiologist and you’ll practice cardiology? Make some sense, damn it!’�
’�Look, I’m the chief cardiologist. I’ll continue. Another cardiologist will join as my associate. Does that make sense to you?’�
’�It really does. To me, that’s. Now, try to think as that cardiologist thinks. Would that make sense to him? Or for that matter her?’�
Jayaraj visibly relaxed and smiled.
’�No chance; it’s to be a he.’�
’�What?’�
’�It’s to be a male.’�
’�Really! But why?’�
’�A female? Cardiologist? With me? Certainly not.’�
’�Why not? Really, you’re not a misogynist.’�
’�No. Not that.’�
’�Then what? What’s really wrong with a female doctor? We’ve a long tradition of ’�ving female doctors. Why not now? I’m not willing to get branded as an MCP.’�
’�An MCP?’�
’�Male chauvinist pig.’�
’�Oh, Colonel, tell me if I say only women will bear babies, will I be MCP?’�
In a show of mock fright, Colonel looked around as if searching for anyone overhearing them. He added in a conspiratorial whisper, ’�Hush ’� but probably, yes.’�
’�Only because I tell the truth, right?’�
’�Okay, okay. Leave it. That’s really different. But, it’s not a good idea to look for only male cardiologist.’�
’�What’s not good?’�
’�There’re really excellent doctors who happen to be women.’�
’�It’s not just a question of excellence. It’s something to do with compatibility.’�
’�Compatibility? Tell me, who or what might be incompatible? Not really cardiology and feminine gender, I’m sure!’�
’�The department I head’s incompatible, that’s it.’� The smile had disappeared form Jayaraj’s face.
’�Doesn’t really make sense, not to me; and very likely to the large number of people, doctors out there.’�
Jayaraj did not respond.
Deliberately or unwittingly, Jayaraj blocked the appointment of the partners’ relative. Colonel thought about the many more clauses Jayaraj might stipulate later. Yet this was a break. Jayaraj probably knew about the partners’ relative. He was cleaver in preempting her appointment. Colonel could imagine the difficulties the partners’ relative might cause.
’�Okay,’� asked Colonel, ’�What’ll be the new cardiologist’s status? How’ll he - really it’ll ’�ve to be a he, wouldn’t it? - How’ll he work here? What conditions?’�
Jayaraj thought for some time. Then he started, ’�He ’� He’ll work as associate, my junior.’�
’�If that’s not really acceptable to a cardiologist?’�
Colonel had difficulty saying that, to hurt his friend’s sentiments. Yet, he had to; there should be no misunderstanding later when clash between qualification and experience surfaced.
’�Why not?’�
’�A cardiologist coming to a smallish community hospital may really insist that he’ll work independently.’�
’�A junior working under a senior’s nothing extraordinary, even for a cardiologist! Why does it look so unreasonable?’�
’�That may not make sense to the cardiologist! He doesn’t ’�ve to come and work here unless the conditions are right. There aren’t really a lot of ’�em, unemployed cardiologists, in search of jobs.’�
’�Then we’ve to find someone who can make sense out of it.’�
’�Ok Jaya, we’ll try. Someone who’ll really accept your ’� er, our terms!’�
’�Terms ’� what terms? A junior working under a senior? That’s usual practice.’�
’�I understand that. But, really, you know these youngsters. They’re so independent!’�
’�So, find someone not precociously independent!’�
’�Right! We’ll see.’�
Colonel reported the conversation to the partners. They were disappointed. Colonel strongly advised against appointing their relative. They knew they could not take Colonel and Jayaraj together.
Jayaraj was pleased. He was aware of the woman cardiologist. If she came in, she might create problems for him. Now he blocked her appointment
The search for the cardiologist went on right in earnest. But without success; it was not altogether unexpected. For long, no one responded. The hospital had little to offer to a cardiologist. The partners offered good remuneration. And they waited.

Chapter 68

Jayaraj did not brood over past events. He accepted that he probably committed a few mistakes, but far less than the ordinary mortals did. He did not recall many. He could not retract what he did; loosing sleep over that was foolish.
But, future was never far from his thoughts. Now getting a cardiologist was prominent among them. The initial adjustments would be stressful and tricky.
Jayaraj was aware of his power. Now the management treated him like royalty. But, that would not last for ever. In his job, privileges came and went with the patients. Jayaraj wanted the cardiologist appointed and the arrangements finalized before his power regressed.
No cardiologist came to Kayemmem. Jayaraj wondered if the management was intentionally stalling. He had difficulty accepting that he could be responsible for the lack of response.
Jayaraj shuddered at the memory of the sole applicant. The youngster refused to work anyway other than independently. ’�Of course, I’ll happily work under a cardiologist!’� he said stressing the word, ’�cardiologist.’� Luckily, the young brat did not say he refused to work under a pseudo-cardiologist!
Jayaraj frequently met Colonel. ’�What’re partners doing about cardiologist?’�
’�They’ve really done whatever they could. They’re still trying.’�
’�Doesn’t seem to achieve much.’�
’�Look, situation’s really difficult. There aren’t many of them, unemployed cardiologists. Our hospital’s not really top-notch. Very many doctors don’t really chase this hospital. The partners tried to persuade their niece to come over. But, you ’� well, that didn’t work. Now all of us are trying.’�
’�Colonel, did you try some of your contacts? Someone might be interested. After all we offer very good salary.’�
’�That’s true. Really, salary’s good.’�
’�Try outside our state.’�
’�Believe me. I’m really trying every possibility. Be optimistic.’�
Uncharacteristically, Jayaraj took it as a personal failure. He considered further. He would not change his way of practice. The hospital was unlikely to improve overnight. The only adaptable variable was the working relationship. He was disturbed that no young cardiologist liked to work under him. Painfully, he accepted. Cardiologist will have to be independent.
’�Look Colonel, we’re nowhere near getting a cardiologist. What do we do?’�
’�You sound depressed! Really! Don’t get worked up. We’ll ’�ve someone very soon. Believe me. You shouldn’t worry. We knew it’s not easy.’�
’�But, I was thinking. I’m thinking ’� if I’m the stumbling block! I should do something to remove that.’�
’�Look, really, no one’s saying that. You’re a fact in this hospital. Any solution will ’�ve to recognize that.’�
’�Okay, Colonel, thank you.’�
’�No, no, really!’�
Jayaraj raised his hand to stop Colonel. ’�But, I’ll give in, a little bit.’�
’�Really?’�
’�Cardiologist will have internal freedom; he’ll manage his patients independently. I assure that.’�
’�May I quote you? Can we let it be known outside?’�
’�Yes, you can. Promise.’�
’�Okay, good.’�
Jayaraj felt degraded.
Within a month, Colonel called Jayaraj.
’�There’s a doctor, a cardiologist with some experience, now working at Vellore, interested in joining ’� under our terms.’�
He handed over a buff envelope to Jayaraj.
’�His résumé. Looks fine, really impressive. I hear he’s really good. And he’s keen to join our hospital.’�
’�He cannot be that good, if he wants to join this hospital!’�
Colonel laughed in short bursts. Jayaraj opened the envelope, took out two neatly typed bond papers and started reading. At the top of the first page was the name, underlined: Dr. George Thomas, MD, DM.
Jayaraj read the document carefully.

Chapter 69

The car turned, entered the rusted and scruffy gate and came to stop at the door of a long, low building. A man jumped out of the front seat and rushed to open the rear door. But, George had already got down and was looking at the building. Physical appearance did not matter. He remembered the CMC buildings. He had not overcome the shock of rejection. The loss appeared much more profound and painful when he stood there looking at the alternative.
George did not know it, but he was about to enter the building he would spend his remaining working life in. If he were told that now, he would not believe. And, if he believed, he would fall into a deep and long spell of depression. His solace now was that he was just trying for a temporary respite.
Gingerly George entered the South Wing of Kayemmem and reached the conference room.
George was surprised. The room was cool and stylish. Not everything was, after all, bad. The contrast was stark. Later he would wonder if the room was impressive because the exterior was not.
A group of people carefully scrutinized him. An elderly man extended his hand and said pleasantly, ’�C’mon, Dr. Thomas. Welcome!’�
They shook hands.
’�I’m Colonel Iyer, the Medical Director. Meet ’�’� he swept his hands towards the partners. ’�They’re the owners of the hospital, really. Meet Dr. Jayaraj, our chief physician. Must ’�ve heard about him?’�
Colonel waited for a response. However, George was silent.
’�He’s the senior physician, probably the senior most in town! Really the most popular!’�
’�Glad you came,’� said Jayaraj, shaking hands.
George had heard about the work environment. The main object of discontent was the man talking to him now. Obstinate, crazy and eccentric, his treatment was unorthodox and unscientific. To make the matters worse he was popular.
George sat down. Both the Director and Govindan started talking. Colonel immediately differed to the partner.
’�We’ve only one thing to ask you ’� you join our hospital. We promise all cooperation. We’ll buy any equipment you want. We’ll give anything you ask. Please join.’�
Govindan detailed the remuneration.
’�That’s what we had in mind. Doctorsar can demand anything extra. We’ll give a blank check.’�
George was overwhelmed. For a brief moment, he thought about the comforts this could bring in. Then he remembered the price.
There were other sensitive issues, Jayaraj top among them. ’�Okay, cardiology here, now ’�’�
’�The work here’s really informal,’� intervened Colonel. ’�No hard division.’�
He looked at Jayaraj, who kept quiet.
’�Of course, you’ll be the cardiologist,’� continued Colonel. ’�Really! You’ll be responsible for all heart patients. No one will interfere.’�
Suddenly Jayaraj spoke up, ’�Cardiology’s part of medicine; it should be. But, as he said, you’ll have complete freedom to treat heart patients who come to you. There’ll be no interference. You wouldn’t have any problem.’�
’�Don’t worry,’� Colonel added, ’�You ask anyone here! When you start you’ll also realize.’�
’�That’s a fact,’� agreed Jayaraj.
’�Let us ’�ve coffee,’� said the Director. ’�Then I’ll show you around the hospital.’�
’�You’re at Regional Medical College. MBBS and MD, sixties?’� Jayaraj asked George.
’�Oh, yes.’�
’�You’re my house surgeon, remember?’�
’�I was Dr. Roy’s house surgeon!’�
’�Same thing!’�
How could George forget Dr. Jayaraj? The same Jayaraj, a conceited buffoon. Jayaraj, in Roy’s unit!
George was worried. He wondered what attracted him to this hospital. Absence of cath lab was appealing. Was he afraid to work in a good institution and face intense competition, especially in the cath lab? Here, in this hospital, no competition and no fear of contest.


Chapter 70

His first day in Kayemmam, George met Jayaraj in the ICU. It was an uneasy meeting. Nevertheless, though morose, the physician introduced the staff. Then they took the rounds together.
’�This is coronary thrombosis ’� infarction, you see.’�
George flinched at the old, outdated terminology.
’�Received glucose-potassium-insulin solution, GIK you see, on admission.’�
George did not say a word.
’�This here, angina. Chelation therapy!’�
’�Chelation? What’s that?’�
’�Chelation, EDTA, you see ’� don’t you know?’�
’�Oh, lead poisoning, eh?’�
’�No, no. EDTA for atherosclerosis!’�
’�What? What’s it? Oh, yeah, I see.’�
George saw why Jayaraj acquired the mantle of a crackpot.
A small number of cardiologists, years ago, at different circumstances, tried EDTA; even smaller number recommended its use.
’�Do you routinely give this?’�
’�Indeed, we do.’�
’�Dangerous stuff, toxicity?’�
’�None in my hands, you see.’�
’�But, I thought it’s given up probably as useless.’�
’�Useless? Who says so?’�
’�Hardly anyone recommend it!’�
’�I recommend it.’�
’�Oh, yeah?’�
’�We give GIK and EDTA, routinely. And with excellent results, I might add.’�
’�Yeah?’�
’�Don’t you use them?’�
’�Not really!’�
’�Hum. They’re very useful. You say, not proved? That’s because no one looked for proof. If you don’t try, how do you know?’�
’�But, GIK was tried in sixties ’� and given up.’�
’�Why given up? If they continued, they would’ve found out. What do you use? How do you treat these patients?’�
’�We give aspirin, small doses ’�’�
’�Aspirin? You’ve evidence?’�
’�No, not really. But on theoretical grounds ’� there’s no evidence.’�
’�Yes, yes. Aspirin’s good. We too use it.’�
’�When pain persists, we try nitrates. Other than that, mostly, as usual, morphine and bed rest’�
’�Nitrates? Dangerous stuff! Maybe. Do you give heparin?’�
’�No.’�
’�Good. We too don’t. Useless, you see. But, you must take up EDTA and GIK.’�
For many diseases more than one right method of treatment was available. But, Jayaraj’s pharmacopoeia had only two methods, his method and the wrong method.

Chapter 71

Not long after, George was summoned urgently to the ICU. He saw the nurses and doctors around one bed. George to his astonishment found Colonel on the bed. He looked ill, sweating profusely. George panicked. The hospital Director was very much a VIP. The panic was short lived. The self-control and the mental discipline automatically took over. He assumed charge.
The Director had suffered a heart attack. Though ill, he remained calm. The pain had almost disappeared.
’�Yes, George. What do I have? Coronary?’�
’�Sir, There’s a small problem.’�
’�I know, really it must be coronary.’�
’�Well, a minor problem. Yeah, you should be okay in a jiffy!’�
’�Really?’�
’�Yeah.’�
’�What do we do now?’�
’�We know, yeah, beta-blockers are very useful in this condition. I’m going to give you propranolol and if you tolerate it, we’ll continue. Is that okay?’�
The question was unusual. Doctors just prescribed, what they thought was appropriate. But, here the patient was a doctor and a senior colleague. That made all the difference.
At that moment, a visibly upset Jayaraj rushed in. He had just heard about his friend’s illness. He assumed that he was in charge. In a way, he was justified; he was Colonel’s personal physician. He fussed over his friend. The duty doctor and the nurses were perplexed and embarrassed. George could not believe what was happening. Colonel clearly was helpless. He looked at them pathetically, probably implying to get on with the treatment. He did not indicate his preference for either doctor. But, Jayaraj needed no approval. He gave the orders, his usual medicines. It did not include propranolol.
Doubtfully the nurse looked at Jayaraj and then at George. ’�Propranolol, sir?’�
’�What?’� shouted Jayaraj.
’�Er, yeah,’� George explained, ’�Beta-blocker, they’re useful. Standard treatment now.’�
’�No!’�
George turned crimson. He did not know who decided to summon him. He felt like an unwanted guest. He considered asking Jayaraj who authorized him. But if Colonel indicated that he preferred Jayaraj, George would look silly, utterly foolish. He cursed himself for not ascertaining before ordering who the treating physician was.
Initially, George thought that Jayaraj did not know of George’s involvement and, once realized, he would default to him, the cardiologist. That did not happen. Another rude surprise was stopping propranolol. If Jayaraj regularly updated his knowledge he was unlikely to have overlooked this development. He would not have barred it purposely to slight George. No, no doctor would do that. So, Jayaraj was not well informed. The impression he created as knowledgeable was a façade.
George sheepishly left the ICU.
Later he discreetly asked the ICU nurse why she called him.
’�No one asked me. You’re the cardiologist! So when he came in, I called you. I thought ’�’�
’�Yeah. Did duty doctor ask you to call me?’�
’�No.’�
’�Colonel?’�
’�No.’�
’�What’s the usual practice?’�
’�Usually treating doctor admits patients. Admission is made under a doctor, usually Jayarajsar. No confusion. But, Colonelsar came here directly. Duty doctor said MI ’� I called you. I’m sorry.’�
It was a comedy of errors; George was the joker.
Later George visited Jayaraj, with pounding heart, but a brave face. The senior physician reflexively got up and looked with apprehension. For some time both of them did not speak.
’�Well ’� Colonel settled down,’� started Jayaraj. ’�Hope he’s stabilized.’�
George kept staring at Jayaraj, who just looked down. ’�Why did you do that?’�
’�What?’�
’�You know! In the ICU. I had ordered treatment. Yeah. Why did you interfere?’�
’�Look, Colonel was my patient.’�
’�I went there because I was summoned. He gave no indication that he didn’t want me to treat him. In fact I asked him about propranalol. He was your patient, yeah, was. But, in that ICU I was treating him.’�
’�Oh, did he sign a new contract with you?’�
’�What?’�
’�How can you object to my treating him?’�
’�When I joined, you promised you wouldn’t interfere.’�
’�True, I agree. I’ll honor that. But, this was different. Can’t you see?’�
’�See what?’�
’�How do you know he wanted you to treat? He didn’t ask you. Did his family ask? I was his doctor.’�
’�Okay, tell me, why did you cancel my order? Propranolol? I’d already ordered.’�
’�Oh, propranolol ’� I’m not sure ’� I’m not convinced that ’� they’re useful or entirely safe!’�
’�What? Surely you know ’�’�
Jayaraj raised both hands. ’�Look, let me treat my patient my way. Why do you interfere? I thought you dislike interference!’�
George had no answer. Jayaraj, in a voice oozing artificial kindness towards a loosing junior, assured him, ’�I’ll not interfere in your work. I’ll expect that curtsy from you?’�
With a triumphant smile, he extended his hand. George had no choice but to shake. He could not have won that fight.
That evening Mercy found George temperamental and depressed. That distressed her. She had been seeing him increasingly moody those days. She understood his predicament. But she had started enjoying the comforts money brought in. She wanted her husband too to savor the luxuries. She was exasperated when he did not.
For a while, Mercy hovered around George; he was sitting with a fixed gaze. He did not appear to notice her. After some time she went near him, sat on the armrest and asked in a voice that she carefully modulated as casual, ’�What went wrong today?’�
’�Everything’s wrong everyday. Today it went a bit more than the usual everything.’�
’�This is one thing I like, you know. Your wonderful sense of humor.’�
’�Yeah? Humor? It’s nothing humorous. I’m serious.’�
’�Here you go again. Okay, now tell me what’s that extra everything?’�
’�Yeah. Director had an MI; he’s in the ICU now.’�
’�Oh, my God! Is he bad? Complication?’�
’�No, he’s progressing well.’�
’�You worried about him?’�
’�Hum ’� he’s stable.’�
’�So why worry!’�
’�There’s always worry; concern’s routine. Anxiety’s part of our job.’�
’�Don’t I know that!’�
’�Then?’�
’�This worry’s more than usual!’�
George felt bad to admit that his worry was not about Colonel. He felt guilty that, instead, he was engrossed on his humiliation.
’�It’s routine for us, this anxiety,’� George continued. ’�But, for the patient and family it’s a life-and-death affair!’�
’�Ha, now you’re worried that Colonel’s family’s worried! Limit, you know!’�
’�No, no. That’s not the thing!’�
’�Then what! What’s your new worry?’�
’�There’s another development.’�
He described what had happened.
’�You should’ve stopped him. You’d every right, you know. He promised not to interfere.’�
’�Yeah, but I was not sure ’�’�
’�Trouble’s you don’t assert, don’t use your authority. You’re too timid!’�
’�Think of circumstances. Jayaraj might’ve thought Colonel was his patient.’�
’�Was he?’�
’�I said he might’ve thought so. If he did, I couldn’t blame him.’�
’�You know something? Your main problem’s this. You understand views, thoughts and rights of everyone else, probably better than they. You think like them. You justify their actions. Now, you know, I love you for that. But, if you’re in war, you’ll let the other side win. You’ll think they deserve it!’�
Once again, George marveled how accurately she understood him! Even when George faced rude behavior, he first considered if he had done something to deserve it. Yet, he was not a saint who forgave everyone. He would seethe, loose his temper and shout. But, later he demurred and repented. That made him unhappy and unsure.


Chapter 72

After the heart attack, Colonel retired. With unusual efficiency, the partners found a replacement immediately. Dr. Rama Murthy, a general surgeon, who retired after climbing up the administrative ladder in the government service, found the Kayemmam directorship a convenient job. He was a slimy medical politician with very little administrative talent. Murthy practiced surgery in addition to his administrative job. However, his practice was negligible.
Murthy, with the beginner’s enthusiasm, started interacting with the staff.
’�Thomassaare, how’s practice, your work?’�
’�Good.’�
’�You like the place, no?’�
’�Yeah, that’s why I’m here.’�
’�Any problems?’�
’�Work goes on, but ’�’�
’�Yes?’�
’�See, doctor, this place needs tuning, lot of tuning up!’�
’�What, doctor? Kayemmem’s doing very well!’�
’�Yeah, yeah. It’s!’�
’�Then?’�
’�Of course, Kayemmem’s great! But certain things need ’� could be improved.’�
’�Improved? What can be improved? Your practice?’�
’�My practice?’�
’�Yes, that needs be improved?’�
’�Not my practice.’�
’�That’s the problem. Everyone has ideas about other’s work. We should all look after our work!’�
’�I’m talking about the working conditions. It should be good.’�
’�It’s good now.’�
’�Maybe good; but it could be better. We could organize better.’�
’�It’s not organized now?’�
’�Yeah, not, well ’� it could be improved.’�
’�Everything in this world could be improved.’�
’�I’m not interested in philosophy!’�
’�What! Don’t be arrogant!’�
’�Problem’s no one wants to hear about mistakes. How cold we improve?’�
’�If everyone looks after their interest everything will work out well!’�
’�Yeah, okay!’�
’�See you then.’�
George did not discuss the hospital with Murthy again. Instead, he started interacting with the partners. They were quite naïve, ignorant of the requirements of modern cardiology practice. George advised them and guided them to improve the hospital.
Despite the drawbacks, George overcame the obstacles slowly. The available facilities in the town were primitive. Therefore the society accepted, with gratitude, whatever he could marshal. The progress of the hospital’s reputation, workload and prestige was steady, though slow. An enthralled management committed substantial resources to support his work.
George’s reputation grew a great deal more and substantially faster than those of the hospital did.
One night, some years after he moved to Kayemmam, his phone rang.
’�Hello,’� a harsh male voice said aloud.
’�Hello?’�
’�Get me Georgesar; let me talk to him.’�
’�Yeah, this is Dr. George Thomas. Who’s that?’�
’�Ha, saar, this is Raman Master, we’ve met before, you remember?’�
’�Hum, Ha! What ’�’�
’�I’m Surendran’s brother-in-law, you know Surendran, our MP?’�
’�Hum, why this call?’�
’�I’m coming to that. You know Kumara Menon? He’s my cousin; and Surendransaar’s cousin also. A little while ago, he came to our hospital, in your ICU. He has had a massive heart attack, we’re told. Did you see him?’�
’�Doctor informed me. Your cousin’s getting proper treatment, good attention. I shall follow. He’s had no complication.’�
’�No, no! I request doctorsar to see him now. Did Surendran contact you? No? Oh ’� he’ll call any time. We’ll be satisfied ’� will be grateful if you see your patient now.’�
’�If I’m required there, whenever I’m needed, the duty doctor would call me. I’ll be available all the time. There’s nothing that I can do now.’�
’�But we’ll be reassured, and patient also, if you visit.’�
’�You can be sure that he’ll get the best treatment. Don’t worry.’�
The family had political influence; they were shamelessly using it to pressurize him. He recalled how Raj Mohan used to adapt to demands.
George was resolute to provide equal attention to all his critically ill patients. In the ICU, all patients were equal, and should receive identical care. He was not an ivory-tower tenant. He knew all were not equal. The society had and will always have privileged, under privileged, and unprivileged. People changed, but not the class.
That class distinction unquestionably reflected in medical practice, even in his practice. Every patient did not receive the same reception. Influential people, who were not averse to misuse that influence, could easily receive preferential treatment. It was built into the system. But he made sure that every patient received appropriate prescription.
George tried to incorporate the Schweitzerian reverence to life into his practice. However, during his frequent escapades into introspection, his mind considered the more fundamental aspects of his personality. He then empathized with Schopenhauer’s pessimism, asceticism that annihilated the will to live. World had no rational structure or purpose. Life was a purposeless, obnoxious disturbance in the pleasant barren void. The opposing ideologies created intense mental conflict. Yet, in practice, he was determined to uphold reverence to life, all human life, as his working philosophy. Emergency-care should be the basic right of everyone.
If George visited one newly admitted patient outside regular working hours, he should see every newly admitted patient. It was impossible. He decided to visit only if the duty doctor asked.
When diagnosis was straightforward and treatment standard, a personal visit was superfluous. But to patients and their relatives it was reassuring. George’s attitude created resentment. But he stuck to his decision.
George could not forget the phone call. That worked in his mind with disastrous consequences. Yet he was prepared to pay that price. He did not have much time to brood; the telephone rang.
’�Halloo’�’�
’�Hallo! Dr. Thomas here.’�
’�Hellooo, Thomassare, what news?’�
George instantly recognized the Director’s voice. Murthy, his senior, was calling him, ’�sarae,’� one of the local versions of sir. That was a local custom. The pronunciation changed depending on the person involved and the degree of respect or even disdain intended. Though George grew up in that culture, he did not practice it. Now he was not sure if Murthy was sarcastic or it was just habit.
’�Getting along. Now, what do I owe this pleasure to?’�
’�I was just thinking ’�’�
’�Yeah?’�
’�Ha, you see ’�’�
’�Yeah?’�
’�That Raman Master - you know him? - called me. You see, he wants you to see his cousin. I know you told him ’� Now, I also feel the same. But, you see, he’s a relative of our MP. Also partners’ relative. Govindansaar actually called me. MP has not. But, he’ll. Why don’t you ’� just?’�
’�Eh ’�’�
’�You see, just visit ICU. That’s all you’ve to do. They’ll send a car. Don’t even examine patient. Ha, ha! That’s the advantage of ICU, ha, ha. Secrecy, privacy, ha? None will see what you do or don’t.’�
’�But ’�’�
’�No, no. You’ve nothing to do there, no? Treatment’s going on. So? Just talk to everyone. Just pacify them.’�
’�Ah, Yeah! It’s difficult for me.’�
’�Uh ’� But we’ve our responsibility! Seeing patients even at odd hours ’� bit uncomfortable, real nuisance. But, that’s a professional responsibility, part of the job, isn’t it?’�
The devil was ’�pedanting’� moral values, thought George. He smiled at the abuse of the noun, pedant. That helped him to contain his anger.
’�That’s not the point,’� countered George. ’�I’ll go if I was needed there, day or night, rain or shine; but not just to hold hands. I’ll do even that, if I can do that for every patient. There’re other patients admitted this night. I can’t visit every time a patient’s admitted. That’s why we’ve duty doctors. They contact me when necessary. I believe in the system.’�
’�No one will ask you. No one’s bothered!’�
’�Don’t believe that! Maybe no one might ask. But, everyone, patients, relatives, staff, doctors, all of them will notice! They’ll know.’�
’�Know what?’�
’�Know that I saw one patient, but not several others. Yeah, that’s what.’�
’�You’re too sensitive. Everyone does these things.’�
’�But I don’t follow that tradition. You just think. One of your relatives goes to hospital, and the consultant doesn’t see. Later the consultant sees another patient admitted in similar condition. How’ll you take it? How’ll you feel?’�
’�See, Thomassar, don’t go that deep. I tell you, you’re too sincere, too sensitive. That’s not how this world works. You’ve to compromise; it’s part of life.’�
’�Not me. Tomorrow I’ll face my patients, staff and colleagues.’�
’�If your relative admitted, what’ll you do?’�
’�I’ll certainly see that relative, day or night, as any relative does. I’m going as a relative, not as doctor.’�
’�Be practical, doctor. There’re doctors here, even top consultants, who’ll go to patient’s house, if requested.’�
’�Maybe. But what’s the purpose? What’ll they do at the patient’s house in an emergency?’�
’�Why not? You may give first aide.’�
’�At home? A GP in the prehistoric times may ’�’�

’�Prehistoric times?’�
’�Anytime before the eighties is prehistoric in cardiology! Today treatment’s too complex.’�
’�Complex for what?’�
’�To practice at home.’�
’�So don’t practice; you advice them to shift to hospital.’�
’�I see. Why go there to say that.’�
’�Because you’re asked!’�
’�I see. If they don’t shift?’�
’�That’s their look out, not your responsibility.’�
’�You can do the same thing over phone!’�
’�But you’ve to satisfy them.’�
’�Compromise, yeah. We should educate them. Yeah, that’s what we should do! We only loose time by calling doctor home.’�
’�So you educate them. If they don’t learn what do we do?’�
’�We could refuse.’�
’�Be serious. We’re moving away from what I asked. You’re not requested to patient’s house, only to ICU.’�
’�I’ve told you my difficulties. Also, it’ll not improve treatment.’�
’�So you’re refusing to see patient now!’�
’�Yeah! I gave the reason.’�
’�Have you thought about consequences?’�
George was rattled. He was concerned about the consequences.
’�I’ve thought about it. I’ve already contacted the ICU. Diagnosis is no problem. Treatment’s stabdard. No complications so far. In case of a complication I’ll know; I shall do every thing possible. Don’t worry. We shall take care.’�
’�Do as you like! But, remember one thing. If anything happens it may lead to problems. They’ll interpret it as your neglect. I’m not saying it’s negligence; I’ll understand, but, not everyone. They don’t know these fine points. Nor will they appreciate your philosophy. For them it’s, you didn’t see despite their request. You didn’t treat him and that lead to complications.’�
’�But I don’t have to go to treat.’�
’�Please ’� I’m not saying that. I’m only saying what they might say. You convince them.’�
’�So if something happened after I see him, it’ll be okay? Look, we’re not treating simple appendicitis or sinusitis. In acute MI patient’s condition may change from minute to minute, whether I visit or not. The best I can do is to train a team to constantly monitor patient every minute and act when complication strikes without loosing time. Damn it, that’s precisely what I’ve done for your VIP patient.’�
’�It’s like this,’� Murthy was calm. ’�If complication occurs after you visit, then, it happened despite your treatment. Otherwise, because you didn’t see him and treat. Well, you decide what you want.’�
Without waiting for an answer, Murthy cut off the phone. Not only the patient’s relatives but the Director too would pronounce him guilty if it reached the stage of trial.
Diabolical! Everything would be fine, if only he visited. No point in getting annoyed with Murthy. He had to please people, just as Raj Mohan had to. But, then George corrected. The Director had a responsibility to be just and fair. He had a responsibility to his profession. He must convince those relatives that the patient was treated properly.
Public did not know. Many doctors had a stake in keeping the system work that way. It was easy and lucrative. The doctor would visit the hospital and please people. After that, they were safe.
As usual, George could recognize the other patients’ perspective. What would they, those who did not earn his visit, feel? He could understand the anguish, anger and sorrow of discrimination. George did not like to be so sensitive. He should forget about it. But no, he was different. This will go on and on in his mind.
George prayed that nothing happened to the VIP patient. Every time the phone rang he jumped up, heart racing. By morning his nerves were so bad, he was moody and irritated. He disturbed Mercy sleeping by his side.
’�You didn’t sleep well. What’s the matter?’�
’�There’s an admission in the ICU.’�
’�Serious?’�
’�Acute MI. No complications.’�
’�Routine, isn’t it? Why restless?’�
’�Pressure to visit him. Director and some others called.’�
’�Complications?’�
’�No. It’s a VIP.’�
’�Oh, you didn’t go.’�
’�No.’�
’�Why restless?’�
’�Pressure. They insist, or else!’�
’�That’s natural, you know.’�
’�But not fair.’�
’�Oh, there you go again! You’re hurting yourself, you know. You can’t control other’s behavior.’�
’�Not that. If something goes wrong with patient they’ll blame me. Yeah, they’ll crucify me.’�
’�Don’t do that Messiah act.’�
’�No, no! Problem’s real. I’ll be held responsible.’�
’�You’re treating, so, sure, you’re responsible, you know. But, are you the reason for complications? Can you prevent them?’�
’�Certainly not.’�
’�Then forget it; sleep well. And let me sleep.’�
Mercy was practical and focused. But George could not sleep.
Early during her married life, when her husband described his work, Mercy was proud. Like an army commander planning war strategy, George kept his ICU ready for the battles. She knew that he spent sleepless nights thinking about the battle ahead.
Next morning George entered the ICU with trepidation. He was comfortable only when he saw the patient. The relief was phenomenal. At that moment, he was happy about his decision.

Chapter 73

The MP’s relative had an uneventful recovery. George had forgotten the incident, when driving into the hospital one morning, he found his usual parking space occupied. The watchman was apologetic but he could do nothing. A partner came early and his car occupied George’s usual parking space. George parked elsewhere. It was a small matter. But, it hurt. Parking was a privilege. So far, he had used the same place, though he did not have it officially allotted. Now clearly he could not take it for granted.
After two days, he still found the space occupied. In addition, the entire parking lot was full. George was livid. He shouted at the helpless watchman. In his rage, George did not realize that later he would regret this rudeness to someone who was so defenseless.
George parked outside, on the road. Then he headed to the medical superintendent.
’�Look, I was parking my car in that lot ever since I came here. Yeah! I even had the same spot, always. Today I had to park outside. You know, road’s not a safe place. The way it’s going, tomorrow I may not find a place even on the road. What’s happening?’�
’�Sure doctor, I’ll look into that. I’ll try my best to help you.’�
But, when it happened again and again, George was worried. Even after his substantial contributions to the hospital, he could be pushed around.
When George entered the MS’s office he was invited to sit down. Instantly he knew; there was no easy solution.
Raghavan, the medical superintendent, was uneasy.
’�I talked to the Director and management. Their position is they didn’t promise a parking space for anyone. You take one when available. First come first served.’�
’�But, so far, I’d one every day, the same place. Why this sudden change?’�
’�Please don’t take personally. Parking is limited. More difficult to get than us, doctors!’�
George frowned.
’�There’re complaints from staff and patients. You’d been lucky so far. You’re put to inconvenience only for a few days. You know a partners’ relative is admitted. His family takes up one, sometimes two parking spaces.’�
’�Yeah. I know. But, in the past, that didn’t create problem.’�
’�You see, Thomassar, that partners’ relation, Hariharan’S uncle actually, was admitted at night. Immediately, Doctor Mukundansaar came and saw him, midnight. The relatives are grateful. Mukundansaar’s getting some privileges as a pay back.’�
There it was! George understood. Be a good boy, then you get the chocolate. Come and see the patient when asked, be a good boy, and you get the parking space. His look must have betrayed his thoughts. Raghavan smiled ever so lightly; and nodded, just a flicker.
’�I see.’�
’�I’ll try my best. It’s not my decision.’�
’�So someone did decide!’�
’�I didn’t say that.’�
’�No?’�
’�No. I’ll help you whenever I can.’�
’�I know you’ll and thanks,’� said George. Bitterly he thought that the cagey fox was polite and helpful because he didn’t know when he will need George.
The battle lines were drawn. The standoff was real. In a range, he considered resignation. But, lack of parking space was not a credible reason for resignation. There was no principle involved, no work ethics. Surely, he might face similar problems in other hospitals too. In an altruistic sense, this was an opportunity to demonstrate the strength of his character. He should resign only when it was impossible to do his job the way he wanted. He was not unaware of the problems of changing jobs. The advantages of an established department, fruits of his toil, will be lost. He was embarrassed that pragmatism, and not idealism, was his major deciding factor.
To George this was not a minor problem. He could not reconcile to the deprivation at such a small provocation. Provocation? He acted in the hospital’s interest. The hospital’s reputation depended upon incorruptible staff. Until now, he blustered himself indispensable. How expendable he was! That scared him.
George was sore at no one in particular, but at everyone in general. If his ire was pointing at anyone, it was at the hospital management. But, management was an abstract concept. Like almighty the God, it was omnipresent, yet cannot be seen or dealt with on a personal basis.
However, those who bore the brunt were not the hospital administration, but his family. Mercy as usual left him alone for a few days and then interfered.
’�Georgee, what now?’�
’�What?’�
’�What’re you thinking now?’�
’�Nothing. I don’t know why you ask.’�
’�You! You’re restless. That’s bothering me. I know you’re always on the lookout for anything to get sore and blue. That’s usual. We’re all used to it, me and children. But this is more than the usual, you know. There’s something.’�
’�That night-visit thing, mounting pressure. It’s so unpleasant.’�
’�Pressure? Who?’�
’�Administration.’�
’�Who in the administration? Director? Med sup?’� Med sup had nothing to do with gastronomic fare. It represented the MS.
’�Right from top, partners, I think!’�
’�Hum. But, what pressure? What they ’� did?’�
’�For one, I’m not getting parking space.’�
’�You aren’t serious, are you? That’s silly, you know. They aren’t that mean? Must’ve been full ’� parking lot, you know. You’re too sensitive. Tomorrow you’ll get it.’�
’�No, no, I talked to MS. He told me clearly. It’s the real thing.’�
’�You’re sure?’�
’�Yeah, I’m.’�
’�Unbelievable; very crude, mean.’�
’�Yeah. First time such a thing happened!’�
’�But nothing to loose your sleep. Find another parking place, you know.’�
’�You don’t understand; it’s not the parking, but the attitude!’�
’�Ha, there you go again.’�
’�Merse, you don’t understand. Now, sleep baby, sleep.’�
George faced no more problems for some time. A few weeks later a junior doctor in cardiology resigned. That was usual; turnover of junior staff was very high in hospitals. George immediately asked for a substitute. Usually the replacement arrived even before the incumbent left. This time no one turned up.
Again, George made a trip to the MS.
’�We’re short of staff. No replacement yet.’�
’�I know. But can’t do anything.’�
’�Why?’�
’�You should check with Director. I think no one applied.’�
’�Yeah? Strange.’�
’�Please ask Doctor Murthy.’�
Murthy was cold.
’�Doctorsar, come in, sit down.’�
’�Good morning. I came to ask about the junior doctor. Roy left already. No one yet!’�
’�I know, I know. You see we’re short of doctors. You know that? Good. Look at surgery; we’ve only one. That’s short of two. Boys don’t want this type of jobs, duty, responsibilities, serious patients, what not. They don’t work hard. Times are changing. In our days we worked and learned, we enjoyed it. Today they read and learn. They’re miserable and they don’t learn much.’�
George did not go there to discuss the sociology of medical practice.
’�But, we always got doctors. We deal with serious emergencies. Can’t slacken pace. It’ll affect efficiency.’�
’�Yes, of course. But, we’re all working under pressure. All departments are understaffed ’� had been for some time. You’d been lucky. Now your staff will have to work a bit harder. That should do it.’�
’�Yeah, of course. But, when’ll we get the replacement?’�
’�Well, I don’t know. The fact’s, management thinking of reducing staff. No definite decision. We’ll try to give you your full compliment. But, I’m giving an inside information: staff reduction’s very likely.’�
’�I can’t believe it!’�
’�I’m telling what I know.’�
’�Actually we need an additional doctor. Work and surely, income have gone up in cardiology.’�
’�I don’t know that. It’s not my decision.’�
’�But why?’�
’�Hospital’s not making enough money. It’s loosing. Unless income increases how can we improve our facilities? Some belt-tightening. Management’s decision.’�
’�Hospital loosing money? Cardiology isn’t, surely. You can’t reduce our staff.’�
’�I’m not, doctorsar, I’m not doing it; it’s the management. They don’t discriminate against any department. All are equal, right?’�
’�Wrong! Some work more. Work’s not same everywhere. There’re departments without emergencies; and critical night admissions.’�
’�Ha, night admissions and ’� night ’� visit!’� Murthy smiled sarcastically. ’�Okay, you talk to management. For the time being I’ll give you someone when available.’�
’�When’ll that be?’�
’�I don’t know. How can I predict when anyone will join? I can’t withdraw anyone from anywhere. Someone’s to join.’�
George had to know. It was against his character to chase a matter doggedly. But he had to find out.
’�This too is connected with the night-visit issue?’�
’�What? What did you say?’�
’�Yeah, I was asking ’�’�
’�Oh no! Okay, okay. You see, by refusing the request for night visit, you’ve created problems for us. You’ve raffled some feathers. Those feathers belonged to powerful people, powerful from hospital’s point of view.’�
’�I see.’�
But, he did not.
’�Yes.’�
’�So the message’s if I don’t obey, my department will not get what it should, right?’�
’�No Doctorsar, no, no, it’s not that way. You misunderstand. That’s not how it’s.’�
’�No?’�
’�Just think. Someone asks a favor, okay, not just a favor, an unreasonable favor. They’re used to getting what they fancy. So when you refuse they’re hurt, disappointed, an unusual sensation for them. They think their demand was simple, genuine and justifiable. They’re not refined either; they’re not used to turning the other cheek ’� they’re more like two-teeth-for-a-tooth type, as your Bible says. So, they refuse a favor you or I ask. It’s simple.’�
’�I didn’t request a personal favor; I ask what’s due. Yeah, for my department, for their hospital. You people are actually hurting your own hospital!’�
’�Not me, they. Yes, possibly. But, you’re hurt too; that’s what they want. They think hospital can absorb that kind of damage, but not you or me. In this business, who’s hurt more, the hospital or you? Aren’t you hurt? Even if the hospital got hurt simultaneously, your bruise is no less painful. They don’t worry a bit about hospital. It’ll keep going. Whether we’re here, or someone else, hospital will go on. It’s used to ups and downs. It’s more in your interest you keep your department healthy. You choose what you want, decide how much you’ll give in, to keep it healthy.’�
’�So I’ve to give something to keep it healthy?’�
’�Believe me, there’s to be give-and-take. You do something, give something and then take back ten times what you gave.’�
’�But, there’re certain things you can’t do, no matter what. Certain things are not negotiable.’�
’�C’mon, doctorsar. Nothing extraordinary was asked from you. It happens every day.’�
’�Maybe, but ’�’�
’�I know, I know you’re fair, all patients are equal ’� I know the whole thing.’� Then, with a sly smile, as if struck by a fresh, cleaver idea he asked, ’�Now, just imagine if one of our ministers, say chief minister, ring you up ’� Not that there is a chance for CM to call you ’�’�
’�Yeah, no chance; so why talk about it?’�
’�No, no. Just imagine. If the CM asks you to see a patient at mid-night, wouldn’t you see that patient immediately?’�
The reflex answer that came up in mind was, ’�But, you’re no CM. Neither is your Raman Master nor Surendran MP!’� But, he did not say that.
’�Doctorsar,’� said George, ’�The CM wouldn’t call such lowly mortals as I. He would call top administrators like you and make them order us to go see anyone anywhere! But, a minister once called me. Do you recall that?’�
’�Uh ’� a minister, aha?’�
’�Yeah. Health Minister. Actually, his secretary called. Wanted me to see a patient in another hospital. That was a political thing ’� patient was a politician. Do you know what I did? I called the minister and politely told him that I’ll be breaking a code of ethics if I go and see a patient without his treating doctor asking me to. The minister understood.’�
No one spoke for some time.
’�Of course,’� continued George, ’�If a Mafia Don made a demand, I couldn’t have refused!’�
’�You’re going away from what we’re discussing.’�
’�I don’t think so.’�
’�Okay, you want fairness, impartiality, that sort of thing, isn’t it?’�
’�What’s wrong with it? Being fair’s no fault.’�
’�No, doctorsar. We can’t change the world, can’t change society. You go the way society goes. Otherwise you’ll only get hurt.’�
’�If everyone does that, social order would never improve. How’ll it change? Someone’s to challenge the system.’�
’�So you’re challenging?’�
’�Behavior of a small band of people could change habits and customs.’�
’�Good number of people, responsible, intelligent, educated people, would do what you refused. Many will consider your attitude ’� rather silly.’�
’�That’s the tragedy.’�
’�Tragedy or comedy, we all follow norms of our times, don’t we?’�
George shrugged.
’�Let us see. By the way Doctor Murthy, we live in New Testament times. No tooth-for-tooth, now. That’s Old Testament. Now it’s like turning the other cheek.’�
’�What?’�
’�Nothing. Forget it.’�
That evening his wife asked George, ’�You still under pressure?’�
’�Hum, yeah. How do you know?’�
’�Georgee, I’ve known you for ’�’� she caressed his hair, and then continued, ’�How many years, now? All my life, I think! I know you inside out! Now, be a good boy, tell me.’�
He kept quiet.
’�What’s it, Georgee? I know it’s more than the usual,’� with a naughty smile on her face and twinkle in the eyes, that took away the sting from what she was about to say, she added, ’�You know how long you’ve been cold, absolutely icy? When was the last time? That’s always a sure sign. When you’re this quite, you’re depressed. Nothing else stops that. Now what’s it all about?’�
’�Oh, you miss it?’�
’�Of course! Starved, you know.’�
’�Sorry.’�
’�Ha, no. Just joking!’�
’�I don’t believe that.’�
’�You’re naughty! I’m not famished.’� She giggled.
He smiled, put his hands around and tried to pull her to him.
’�Well, hospital work’s a burden.’�
’�Burden? You know, first time I hear you say that.’�
’�Yeah. Too much pressure, terrible problems.’�
’�What’s it about this time?’�
’�Same night-visit.’�
’�Oh, I thought it’s over.’�
’�No, not at all.’�
’�No parking space?’�
’�Much more serious. We’re not getting doctor. Roy left last week. No replacement yet.’�
’�Maybe, no one came, you know.’�
’�Never happened before.’�
’�Can happen any time, you ’�’�
’�No. Murthy said as much.’�
’�Really? They’re not posting a doctor because you ’�’�
’�Yeah.’�
’�How could they?’�
’�They’re capable of that!’�
’�Who?’�
’�Partners, Murthy. Oh yeah, all of them. They’re out to get me. The length they go to settle a personal vendetta! Scary. Ego’s much more important to them than the hospital. No concern for justice and fair play. They wouldn’t stop until I’m house trained.’�
’�But, they’re spoiling their hospital. What you do helps the hospital as much as it helps you. Oh, no,’� Mercy laughed, ’�’� as it hurts you. You’ve done so much for this hospital.’�
’�I thought so. But, ego’s much more persuasive than hospital’s interests.’�
’�Don’t tell me!’�
’�Yeah, it’s. They’re trying to intimidate me.’�
’�Very successfully, I might add.’�
’�Hum, life’s tough. It’s miserable.’�
’�It’s your making isn’t it? You know, life can be beautiful.’�
’�How? Teach me!’�
’�Look, you don’t have parking? Park outside. Not getting doctor? Why worry? Management’s as much responsible to patients as you, even more. Patient care in their hospital’s their responsibility. Why you loose sleep?’�
’�Point’s, once doctor accepts a patient, that doctor’s committed to treat that patient. No matter what, patient should get proper treatment. No compromise. As chief I’m responsible. Staff or no staff, patient care should go on without flaw. Management probably understands this. That’s why they play this game. They could irritate doctors, yet get those same doctors do their work conscientiously. Ironic. Doctors’ employer’s management. But, their true masters are patients. There’s a conflict of interest.’�
’�I don’t think they’re smart enough to realize all this.’�
’�Maybe they don’t realize. But unknowingly they do it.’�
’�Then it’s a reflex reaction. Like all reflex this too will stop after the jerk.’�
’�Maybe, but ’�’�
’�Make them realize their stupidity.’�
’�Impossible!’�
’�Then don’t brood over it. Don’t make life more miserable than it’s.’�
’�You’re angry?’�
’�Yes I’m. With good reason. Shatters family harmony.’�
’�I’m sorry.’�
’�No, no. Don’t. You know, my anger’s towards them. They ill treat my husband.’�
’�Oh, I’m angry too. But it doesn’t help.’�
’�Yes it doesn’t; so why not relax?’�
’�I’ve another burden. I’ve to pacify and console my staff. I’m not good at holding hands.’�
’�Ha, don’t I know!’�
’�We can’t desert night shift. Junior doctors bear the brunt. I’ve to support them.’�
’�Are you planning to do night duties? To help junior doctors?’� She laughed.
’�Night duties?’�
’�Why not? You sleep there, instead of here. What do we loose?’�
He pulled her over him. She giggled.

Chapter 74

Weeks went off; nothing extraordinary happened in Kayemmam. Cardiology did not get a new doctor.
Then, one day George received a cryptic notice from the Director asking him, and two of his junior colleagues, to attend a conference. That was unusual. Such meetings were always informal, advantage of small private institutions. Matters were settled on a personal basis. Even that was changing.
With considerable trepidation, George went with two of his colleagues, Latheef and Sheshan. Raghavan had already arrived. Hariharan came with Murthy a little later. The atmosphere was serious and awkward, in contrast to the usual informal and friendly ambience.
Murthy came to the point immediately, ’�Management’s received a complaint from a patient’s relatives. We’ve to find out what really happened, dig out the truth.’�
He sounded very officious.
’�That patient died in our cardiology ICU.’�
There was a subtle but audible gasp. George understood now. The management was shrewd; they were out to humiliate him. More than humiliate, would this destroy him? He was scared.
’�Show me that letter.’� George demanded.
’�One moment Thomassar! We’ll be methodical.’�
Unexpectedly Hariharan spoke up, ’�Hospital shouldn’t have a bad mark. We’ll not allow Kayemmam’s name tarnished. We aren’t paying a single paisa; no compensation for any doctor’s foolishness.’�
An embarrassed silence.
’�One T. K. Ramunni was admitted in ICU,’� Murthy produced the letter and said, ’�On 24th of June. He had abdominal pain. They came for treatment from gastroenterology; but he was admitted in Cardiology ICU and cardiologists treated him. He died next morning. Now the relatives feel he died because proper specialists did not treat him. They demand compensation and action against erring doctors. Then there’re allegations against ICU, inhuman treatment, staff callousness, over-drugging and lack of medical attention.’�
Murthy extended the letter to George. But, Hariharan snatched it and read it aloud, relishing every sentence.
George regained his confidence. He remembered the patient and the details.
’�Let me explain. Yeah. This patient had abdominal pain and vomiting, alright. But, it’s upper abdominal pain, due to heart attack. Yeah, he’d myocardial infarction.’�
’�But, then why this confusion?’�
’�Yeah! Confusion was unnecessary. If Directorsaar read the chart carefully, this fuss could’ve been avoided. Everything possible was done, and nothing unnecessary. A gastroenterologist saw him, not because it was necessary, but because relatives wanted. Hum ’� perhaps that’s the only unnecessary thing done for that patient.’�
’�But, this complaint? Must be something more! Is it a clear cut MI?’�
’�It’s MI. One glance at ECGs confirms that. He died of its complications. Unfortunate, but unavoidable.’�
’�But relatives. Why they’re not told?’�
’�They’re told. They’re under emotional stress! Death, deprivation. Couldn’t accept sudden death. Misunderstandings and anger. You should know that.’�
’�Chart’s incomplete. Shoddy!’�
’�Our hospital charts are always incomplete. Every thing’s not recorded. Inevitable cost-cutting practice. Good record keeping takes time and time’s money. We’re short of staff. Remember? Incomplete charts are usual. Still this chart contains enough information. Just go through it.’�
’�I’m not sure ’�’�
’�I’m sure. Look at the ECG.’�
’�But records ’�’�
’�Agree, not complete. Yeah, usually, when complaints came up, doctors wrote in what had happened, to clear up the doubts and misunderstandings. Usually it’s not dishonesty. Just write, what they did, on a later date. Sure, yeah, there’s immense potential for fraud and misappropriation. I’m uncomfortable doing it. Still frankly, I did it in the past. If I didn’t do, some innocent people and the hospital would’ve suffered.’�
Clearly here, the end was justifying means, a principle George disapproved. But right now he did not feel guilty.
’�But, how could you rule out additional abdominal disease?’� asked Murthy gruffly, ’�MI didn’t give immunity from abdominal disease.’�
’�I told you doctersaar, a gastroenterologist saw him and ruled out abdominal disease.’�
’�But, there’s nothing in chart.’�
’�Because nothing wrong was found, nothing was written down. I told you the problem. Latheef, who was the gastroenterologist?’�
’�Dr. Thomas.’�
’�Yeah. Why don’t you pick up the phone and ask Dr. Thomas right now? I’m all for keeping charts complete, as I said before. But it’ll need more staff and more funds.’�
’�Come to the point; let’s not divulge.’�
’�This is very much the point. If we write everything down, we’ll have at least four times more work than we’ve now. That’s we’ll see one fourth of patients we see now. The expense will go up fourfold. Hospital income will suffer.’�
That was a language, the language of money, they understood well.
’�But then your plan’s to reduce staff, isn’t?’� George dug in, ’�At least in cardiology!’�
George relished his victory.
The Director was studying something intently on the floor. Hariharan was annoyed. He looked at Murthy accusingly. No one spoke.
’�Now let’s come to complaints against the ICU,’� continued George, ’�Yeah, it’s the hospital’s responsibility. I wanted more staff. Denied. As for the excessive bills, I don’t write the bill.’�
An uncomfortable silence followed.
’�Okay, okay,’� spoke Hariharan. ’�We can settle this here.’�
’�These things have happened before,’� continued George. ’�I was involved ’� to help the hospital and other doctors, to resolve problems, not to enhance.’�
’�If you all say everything was done properly why continue? Write to them,’� said Hariharan.
’�Yes, sir!’� answered Murthy.
’�But, let’s ’� have chart completed, in case they pursue. Get the gastro write his notes, okay?’� He looked at George.
’�I’m not getting anyone write anything.’�
Hariharan looked at Murthy, who reluctantly nodded.
George did not wait for the coffee. He took it as a personal triumph. Nevertheless, the situation could have been different. A minor mistake, and they would have pinned him down.
That evening Mercy was happy to see her husband in an unusually elated mood.
’�You’re in high spirits! Thank God. Great to see you this way!’�
’�My usual self. Nothing unusual.’�
’�Joking?’�
George explained what happened.
’�Honestly, darling, do you think this is the end of it? Will they stop with this?’�
’�Hey, trying to demoralize me?’�
’�Nooo. Really ’�’�
’�They may not stop. Might dream up something. But, right now, I don’t care. Tomorrow, yeah, perhaps. Now let me celebrate!’�
’�Okay let’s!’�
’�Let’s, till it lasts!’�
Though Mercy’s unusual pessimism was uncharacteristic, it was accurate. The basic problem remained unsolved.
But, that night they celebrated.

Chapter 75

Next morning George was eager to reach the ICU. He wondered if the staff knew what had happened. They might have heard. Still, he was elated. He was the hero of the legend.
George had lunch with Latheef and Sheshan.
’�That’s so bizarre, yesterday’s meeting and complaint,’� said Latheef. ’�Why on earth did they do it?’�
George looked at Latheef and smiled. ’�Who knows? They must have their own reasons. See, the partners are not doctors. For them this is business!’�
’�That’s bad even for business!’�
’�Bad businessmen!’�
’�But the change’s so sudden.’�
’�Yeah.’�
’�We’re not getting the junior doctor. Never happened in cardiology before. I wonder why!’�
’�No idea.’�
’�Now this; something must’ve happened.’�
’�Who can predict how big brains work?’�
’�Must’ve some reason!’�
’�Is it likely to ’� go on? This ’� disturbance?’� asked Sheshan.
’�Don’t know. Whatever, our work will go on.’�
George had no intension of divulging the reason. He was not sure how his colleagues would react to his refusal for night visits.
When it was clear that George had no interest in pursuing the matter, his colleagues changed the subject.
But George could not hide anything from Mercy.
’�You know Georgee, you want peace of mind?’�
’�Yeah.’�
’�Settle that call issue! Then only you’ll have peace.’�
’�Settle? But how?’�
’�One simple answer is, go and see the patients, when asked.’�
’�No, no! I’ll go only for a specific reason.’�
’�Why are you so worked up?’�
’�I suppose ’� it’s disturbing.’�
’�Maybe, but it needn’t be, you know. It’s nothing extraordinary.’�
’�To me it’s.’�
’�C’mon! You’re asked only rarely.’�
’�Ha, but if I start, every patient’s family might ask. What then?’�
’�Okay, granted.’�
’�Then?’�
’�Many doctors welcome the opportunity. They make money out of it.’�
’�I’m not one of them.’�
’�Quite obviously. So don’t go. But don’t weep!’�
’�I don’t like it.’�
’�There you go again. Don’t do if you don’t like. Stop fuming.’�
’�You don’t understand. I’ve to refuse. That ’� the consequences bother me.’�
’�Then don’t refuse. Go and see.’�
’�I don’t want to. I told you, I couldn’t possibly do that.’�
’�Great! You’re upset that someone called you. Then you get upset because you’ve to refuse. Once again, you’ll be upset if you go. The common point’s upset, you know. Whatever happens you’ll be upset!’�
’�Leave out that sarcasm, will you? You’ve to understand.’�
’�Now don’t loose temper! I understand you well, you know. Look at it. You’re unnecessarily getting upset and depressed. You can’t win! There’s nothing that’ll not upset you!’�
’�That’s not my fault!’�
’�No? Okay, we’re not fixing guilt. We’re trying to get you out of this spiraling depression.’�
’�For that, demand for this ICU visit should stop.’�
’�Who’ll stop it?’�
’�I don’t know.’�
’�So blame’s God’s, isn’t?’�
’�I didn’t say that.’�
’�No, you didn’t! But, what did you say? You’ve the freedom to do what you like. But whatever you do, you’re upset. Solution’s with others! They shouldn’t make any demand!’�
’�It doesn’t happen in ’� other ’� hospitals. When I was at ’�’�
’�C’mon, you know the difference.’�
’�That place brought up the best in me.’�
’�But that’s different. Patients don’t depend on one doctor there. It’s a different system. When you chose to come here, you knew that, didn’t you?’�
’�You sound so logical, brutally so.’�
’�You suffer from nostalgia, unfulfilled dreams.’�
’�Maybe.’�
’�C’mon, Georgee. I’m only trying to help. It’s your decision. You could choose anything. I was willing to go along whatever you wanted, wasn’t I?’�
’�Yeah; I’m not blaming ’�’�
’�No, no. But we’ve to live normally.’�
’�I don’t have a choice! Look at the pressure. I can’t go on like this.’�
’�Exactly. We can’t go on like this, you know. What do you do?’�
’�I don’t know. That’s the whole point. I don’t know what to do. I feel so helpless.’�
’�Can you withstand pressure? Pressure will be there. Either you go or resist.’�
’�This hospital visit, it’s a vestige of old GP. Poor guys had nothing more than aspirin, bedside manners, pep talks, disarming smile for the patient. It’s changed. I can’t treat heart attack at home. Even if I’m Sushruta and Hippocrates rolled into one!’�
’�Maybe. But, in modern world, if a consumer wants you to visit, you visit, period. That’s consumerism.’�
’�We’re not discussing business; we’re talking medical treatment.’�
’�Not much difference. Doctorsar, times are changing.’�
’�Even in the consumer heavens when demand exceeds supply, customer has to wait.’�
’�Okay, they wait. When their turn comes they get everything they want.’�
’�That’s the problem. Everyone wants everything.’�
’�Problem? That’s no problem. It’s an opportunity.’�
’�Opportunity! For whom?’�
’�There’re many ’�’�
’�Don’t count me.’�
’�Okay, what’s your solution?’�
’�I’ve no solution.’�
’�That’s the problem! You’ve no answers.’�
’�Answer’s to educate consumers, make them see realities.’�
’�You do that; until they’re educated, you better do what they want.’�
’�We’re in an age of micro-specialization. We depend so much on technology. Bedside manners has very little role.’�
’�Not always! I still want my doctor to show sympathy, to give me a special personal smile, to look kind, to demonstrate understanding ’� that sort of things.’�
’�Ah, when you want, sympathy and humanitarianism; at other times it’s consumerism.’�
’�Both are part of medical practice.’�
’�How can you’ve both?’�
’�Why not? Many doctors give that type of service.’�
’�Problem’s, only a few patients get it. Others don’t. They’re all in the same room. Spare a thought for those who don’t get.’�
’�Inequality’s ’� unavoidable! Part of life, you know.’�
’�You sound like Murthy.’�
’�What?’�
’�You say inequality is natural? Inequality between patients who come to the same place, demand the same type of service and pay the same amount?’�
’�Isn’t it reality?’�
’�Even in the ICU?’�
’�Yes, even there. If I happen to be there, I’ll be special, wouldn’t I?’� She smiled coyly. ’�I’m the cardiologist’s wife!’� She kissed him lightly.
’�Strange, Murthy had the same argument! If the chief minister asked wouldn’t I go? Now you ’�’�
’�Yes! What’s your reply?’�
’�CM’s not likely to call me.’�
’�That’s not ’�’�
’�I know, I know ’�’�
’�So?’�
’�He’s unreasonable ’� Murthy’s ’�’�
’�Whatever that’s, he’s hit where it hurt, didn’t he?’�
’�Er, er, yeah. There’s an ethical element there.’�
’�So?’�
’�I don’t know.’�
’�Could you say you would refuse whosoever demanded?’�
’�I ’� don’t know! What the hell ’� I don’t know!’�
’�Yes. Try to know. Try to figure that out.’�
Even in the mundane daily pursuit of an ordinary profession, how tumultuous and controversial could ethical dilemmas be!
’�Am I, tell me, am I inflexible?’�
’�You’ve your beliefs! Who am I to question?’�
’�Tell me, am I unreasonably stubborn?’�
’�Maybe you’re. But you’ve strong belief. Maybe you’re different from, you know, ordinary people like me!’�
’�Do you think I should be more adaptable?’�
’�You always follow your faith. But then you’re distressed. If your beliefs, values are not right, you unnecessarily go through distress.’�
’�You’re right. You’re so practical.’�
’�Most people are, you know!’�
’�Why I’m not in those most?’�
’�Answer’s you.’�
’�I should change?’�
’�Don’t know.’�
’�You don’t?’�
’�Only you can decide. I like the way you’re. But we should’ve peace in this house.’�
’�Am I that bad ’� spoiling your peace?’�
’�I didn’t say that. I’m always with you, you know.’�
’�I like to be reminded.’�
’�You’ve doubt?’�
’�No, absolutely no.’�
’�Oh, thank God. I’m glad.’�
’�Now come back! You say discrimination’s not wrong even in ICU.’�
’�I don’t know what’s right and what’s wrong. But, it’s practical. I’m a common ’� an ordinary ’� oh God, I’m no philosopher. I’m just an ordinary woman ’�’�
’�Wrong! You’re a cardiologist’s wife, remember?’�
She laughed.
’�You know, ordinary people think as me. They don’t go deep into right and wrong. We accept facts of life. A doctor goes and sees some patients. So what? That’s life.’�
’�Yeah. Facts of our life! People jump queues, part of life. Even in church! Going to confessional, we try to beat the line. Part of our life! No concern for decency, fair play. You accept. That’s life! No concern for others, on the roads drive as you please, overtake wrong, left or right, that’s life. What a society ’� ours!’�
’�Aren’t we part of it?’�
’�No! We don’t have to belong.’�
’�You’re a Westerner!’�
’�That’s it! When one demands justice, decency, one’s a foreigner! Good qualities are not part of our life. I’m ’�’�
’�You know, you’re like Englishmen. You think, behave like one!’�
’�So if you’re decent, you’re a European? That’s great!’�
’�Live as people here live.’�
’�If society’s rotten we don’t have to be rotten.’�
’�We’re part of society, we obey the rules.’�
’�That’s the problem. Follow the rotten conventions, jump queues, bribe! Or you don’t belong! You can’t survive. You’re a foreigner.’�
’�Take it easy. You’re so worked up.’�
’�Why aren’t we civilized?’�
’�Georgee, are you crusading or treating?’�
’�Both.’�
’�Continue! But crusaders should be prepared for sacrifices, sufferings.’�
’�Hum, er, I’m no crusader!’�
’�Georgee, listen! You either follow or ’�’�
’�Stop! Difficult!’�
’�Do you’ve a choice?’�
’�That’s what I hate, that I’ve no choice. This shouldn’t happen. Okay, I suppose my quarrel’s with God!’�
’�Once you take a decision you’ll feel better; even if you don’t like it. Be practical!’�
’�Fact, I’m afraid of that. I’ll be corrupted. Don’t you understand that? Let me see ’� Do you think I should change job?’�
’�Change ’� job!’�
’�I’m talking about getting another job ’� Not changing profession.’�
’�Oh ’� Will it help? Same problems will come up there, I’m sure. You’re just changing the job. But, our country, our people, our habits and our way of behavior ’� nothing will change!’�
’�You’re right. I don’t seriously consider changing career or job now. But, I can play with that option; let me see. I think it’s time to pay a visit to old man Colonel.’�

Chapter 76

’�What a pleasant surprise!’� Colonel beamed.
’�How’re you Colonel? You look great. What’re you doing these days?’�
’�Me? Nothing much.’�
’�How’s health?’�
’�I’m fine. How’s life treating you?’�
George was visiting the retired director.
’�Not too good,’� sighed George.
’�That’s sad.’�
’�Yeah. Do you know what’s going on?’�
’�Yes and no ’� Do you’ve something in mind?’�
Colonel patiently heard the full story.
’�I’ve heard. But, what can I say?’�
’�Hum.’�
’�I’m no one to advise you. You’ve your reasons. You’ve to do what you think right.’�
’�Thank you, sir!’�
’�Jaya’s told me. He thinks you’re right.’�
’�Really?’�
’�Yes, he approves your stand.’�
’�I don’t believe!’�
’�Both of you’re together at college, right? He’d left a job on a similar tiff. Something like this, principles! You supported him then.’�
’�I was just a ’� let me see, yes, I was a house surgeon then. I said he’s right. I can’t imagine he remembered that!’�
’�People tend to remember support at times of peril, even insignificant support. I just said what he told me.’�
’�Yeah. What does Dr. Jayaraj think now?’�
’�You’re right. But, difficult to win!’�
’�So?’�
’�So, nothing. It’s up to you.’�
’�I was thinking. Yeah. Should I follow my illustrious senior’s example?’�
’�What?’�
’�As he did then, leave this job, this hospital.’�
’�Are you serious?’�
’�What else can I do?’�
’�Have you decided?’�
’�I think I’ve no choice.’�
George was sure the news would reach the partners. He was taking a calculated chance. If the management made no effort to persuade him to stay back obviously they considered him dispensable. Then he had no choice but to leave. Nevertheless, he hoped that they would woo him. He would know his worth soon.
That weekend Sreedharan invited George for dinner. It was unusual. George was weary and intrigued.
’�I’m not invited,’� joked Mercy, ’�I’m not up to their standards.’�
’�You know these families. His wife wouldn’t come. How can he invite you?’�
’�But, why this meeting?’�
’�They might kidnap me!’�
’�Stupid!’�
Sreedharan came in a chauffeur driver Mercedes and took George to Malabar, a luxury hotel. They went straight to Rice Boat, the expensive restaurant. The staff fussed over them. Clearly, Sreedharan was a regular guest. The maitre d’ came to take their orders.
’�Doctorsar, what’ll you drink?’�
’�Orange juice.’�
’�What Doctorsar, only juice? Have something hot.’�
’�No thank you, I prefer a soft drink.’�
George wanted to have all his faculties intact.
’�Your wish. Can I’ve a drink? Yes?’� He turned to the waiter, ’�My usual double scotch.’�
The conversation was clumsy. But the Scotch loosened his tongue and Sreedharan eventually spoke up.
’�Doctorsar, let me say frankly. Some unfortunate things happened, totally unnecessary. I’m very displeased. I’ve already told Director. They should’ve handled it more carefully.’�
George kept quite.
’�We want to resolve immediately. We value your services. We don’t want to make you angry. We’re not against you. Don’t think otherwise.’�
George felt relief. Still he said nothing.
’�We’re prepared to do anything to overcome the ’� trouble. Please tell me openly if you’ve any difficulty. We’ll solve them. What can we do?’�
’�Yes, there’s something. Don’t interfere with my work. Let me do it my way. If I make a mistake, it’s different; point that out. If I do anything against the hospital’s interests, tell me. Otherwise, leave me alone! Is that too much to ask?’�
’�No, it’s not much. But, please understand our position. Running a hospital’s like running an industry. Do you know how difficult it’s? As the saying goes, without a wall we can’t draw picture?’�
George grunted. He now wished he had a drink, after all.
’�So we’ve to have wall. If wall’s broken, no drawing. The hospital’s wall. Wall we provide for you to draw.’�
The rustic logic was appealing.
’�We’ve to please a lot of people. Otherwise they create problems for us, for hospital. I’m sure you know labor problems. We depend on politicians and their parties. So, when some influentials ask us to get a specialist to see a patient, we’ve to oblige. There’re trade unions, very powerful. When their leaders ask us, can we say no?’�
George felt pity. Running an industry in his enlightened Kerala State was a burden. Yet George had his difficulties.
’�But, just understand my position. If I go and see one ’�’�
Uncharacteristically, Sreedharan cut George short.
’�Doctorsar, I know. Everyone’s equal. We appreciate that. But, can I humbly say, you’ve to be practical also. Rule has exceptions. So make some exceptions, rarely only. We can’t go on like this, fighting each other. We’ll not disturb you unnecessarily. We’ll be very careful. If my close relative’s ill, I’ll not trouble you. I know your ICU. Anyone and everyone get best treatment. So, I’m satisfied. But, there’re some others ’� only in very VVIP case ’� we’ll call you. I promise you that. Why do you think there’s demand for your treatment? Because all think that you’re a great cardiologist; the greatest in our state!’�
George saw where Sreedharan was leading him. The purpose of the shameless cajolery was entirely transparent. Yet, he was getting disarmed. Shameful, but he actually enjoyed the flattery.
’�Please don’t misunderstand; we’ll not trouble you unnecessary. Just oblige us,’� pleaded Sreedharan, ’�We’ll be grateful. We’ll not forget. We’ll treat you very well. Whatever, just anything, you want we’ll provide.’�
Sreedharan was begging him, crude, unrefined.
’�I’m sorry. So much trouble was created. Those fellows have no culture. As I told you, we’ll trouble you only when it’s unavoidable. We’ll send you a car wherever you’re. You just talk to the relatives. That’ll make them happy. You’ll have parking space, the full quorum of doctors for cardiology. You want one more? No problem! And no more trouble.’�
Sreedharan laughed aloud. He was getting drunk.
Even in his pleasantly drunken state, Sreedharan sensed that George did not relish his talk. He added, ’�No doctorsar, I’m not trying to bribe you. You’re our special doctor. We’ll do everything we can. But, please don’t disappoint us. We want to be friends.’�
The message was clear, voice was steady and menacing; this was no drunk talking. It was up to George to keep the friendship; but it was on their terms; the choice was his.
George felt weak. He did not have the stamina to continue the fight. Sadly, he had no stamina to resign and go, either.
’�Okay, I’ll keep it in mind; I’ll think about it.’�
Sreedharan had the grace to keep quiet.

Chapter 77

The very next morning George had his usual parking place. As he watched the watchman saluting, George realized how much he valued that space. He liked to think of himself as someone simple, unassuming and modest. That was what he wanted to be, not what he was. Everyone had ego. The measure of narcissistic satisfaction differed from individual to individual. That parking space was George’s fulfillment.
When Murthy met George he was affable.
’�Doctersaar, how’re you?’�
’�Good, how’re you?’�
’�How many doctors do you want?’� He had a sly smile.
’�Give us our replacement, at least. Now the staff restriction has gone?’�
’�I’m coming to that. Yes cardiology can have more doctors. Management decision. As it happens we’ve an application. He wants to work in cardiology.’�
’�Good. Rather sudden isn’t it?’�
’�Yes, yes. These applications come suddenly. One day you’ve no doctors and then there’s a waterfall! Ha, ha.’�
’�If you’ve more applicants we would like ’� one more. Work’s increased. I’d indicated before.’�
’�Yes, sure. Now we’ve doctors. But tomorrow we may not have any. Ha, ha.’�
’�No. You’ll produce doctors whenever there’s need!’�
’�C’mon. You joke.’�
Murthy had a sneer: this boy had now learnt.
Conscience was always a burden for George. Following the Malabar dinner, it was working overtime. The truce offered was the least traumatic way out. Survival needed some adjustments.
Mercy had no doubt.
’�You learn to live happily.’�
’�Yeah, I’ve a good teacher now!’�
’�Sreedharan?’�
’�No. You!’�
’�Oh, good! You know, I can teach you a thing or two.’�
’�Lesson one?’�
’�Happiness’s not just absence of grief.’�
’�Ho?’�
’�Two, it’s a positive attitude. You know, you develop the reflex.’�
’�Are you attending one of those self-improvement courses? Your club running one?’�
’�No Georgee, I’m serious.’�
’�Okay. But, we’re all created a certain way, aren’t we? I’m too old to change.’�
’�No, no. No one’s too old ’�’�
’�If everyone can change according to advice, world would be heaven.’�
’�I’m not talking about personality change. This is just an adjustment.’�
’�Adjustment? Do you think it’s easy?’�
’�Compromise’s the key to happiness.’�
’�Yeah. I’ve heard that before.’�
Soon enough his moment of trial came.
It came as a phone call from Sreedharan, a request to see a patient in the ICU. When can he send the car? George pondered over the request. He did not want to reopen the wound.
’�Don’t worry about the car. I’ve mine.’�
’�Much obliged.’�
As he put the phone down George cursed.
’�There you go. It’s a visit to the ICU, right?’�
’�Yes!’�
’�Who called?’�
’�Sreedharan.’�
’�Why’d you refuse car?’�
’�What? Oh, yeah, our car’s here.’�
’�When’ll you learn to live? Now you’ll refuse the fee they offer, I suppose!’�
’�You think I’ll take money for this visit?’�
’�Why not? You’re doing something extra for them! Charge for service!’�
’�Am I entitled to a tip?’�
’�Call it any name!’�
’�If I take money today, tomorrow, in the ICU, I’ll be miserable. How do I face other patients?’�
’�What’s it to do with others? How’re they concerned?’�
’�Everything! How many times I explained?’�
’�Why? Can’t you see this? You know, even if you don’t take money everyone will think you did!’�
’�What?’�
’�If you go, everyone will know. What’ll they think? Money, what else? Whether you accept is immaterial!’�
’�Hell, what the hell! You’re right.’�
’�For once, ignore what others think about you.’�
’�I can’t. It’s not what others think; it’s what I’ll think about me.’�
’�C’mon. You’re not ’�’�
’�You think it’s nothing to bother about? Sorry, that’s not my way.’�
’�You’ll have difficulty only in the beginning. You know, soon, you’ll feel normal.’�
’�That’s what frightens me. I might pick up that attitude!’�
’�You’re talking as if world’s coming to an end!’�
Slowly, he got up, dressed and went to the hospital.
Next day was a nightmare. He knew it was useless to discuss with anyone. Very few will understand the finer timbres of right and wrong. To the rest it was just squabbling.
As George moved from bed to bed, he was fazed. What were these patients thinking about him? They saw him last night. He did not see them when they were admitted. Money! Unless paid, he would not come.
His worst fear was about his image among colleagues. It did not occur to him that colleagues might not view this, the same way and with the same passion, as he did. This was one link in the long chain of compromises inevitable in life.
When George faced conflicts like these, he lost his faith in human nature. The irrationality of life disturbed him. If compromises were inevitable then, life was not worth living. The existence was meaningless and hollow, totally unnecessary and purposeless. There will be no pain or suffering, if life did not exist. Since it existed the only escape was the end of life. Therefore, he found a certain charm in death. He was ever conscious of the attractive end. What made death unattractive, almost repulsive, was the suffering it bought to the survivors. His commitment to his family and society was total. His concept of the society included everyone in contact with him, even remotely. Therefore, total absence of life was much better than the end of a life. Death left survivors.
The pleasures and happiness of life were inadequate compensations for the pain and sorrow and did not justify existence of life. Nevertheless, his negative outlook was offset by his commitment to alleviate pain and suffering. He consciously tried to cultivate a reverence for life. George, an introvert and an ivory-tower creature, chose to practice medicine, a populace intense occupation, because of his concern for the society. That distinguished his thoughts from the totally nihilistic philosophy.
George had set his standards so exacting, it created a burden often difficult to overcome. Fixing high standards was a romantic passion for him. How peaceful his life would be if he did not have the very fine distinction of right and wrong?
As George feared, the demands for personal visits increased. Cynically, he started thinking that his day, every day, started wrong.
’�You’ve now accepted?’� asked Mercy.
’�Sort of.’�
’�You’ll keep doing it, right?’�
’�I suppose so. No choice!’�
’�Aren’t you foolish?’�
’�What? What’d you say?’�
’�Now, you know, like it or not, you’ve to do this. Right?’�
George grunted.
’�Why don’t you charge? There’s nothing wrong. You do something you dislike. If they want it let them pay. Why free?’�
’�See, I don’t charge because I feel it’s ’� unclean. What’s it ’� blood money?’�
’�You’re reading Godfather?’�
’�No, really ’� I feel I take revenge by not accepting. They might feel guilty or insulted.’�
’�Fat big chance! Guilty? Embarrassed? My poor Georgee, you’re so simple! Grow up.’�
’�No. I’m serious. Can’t accept fee.’�
’�Look, you do it for rich and influential, you know. It’s not saving life.’�
’�You depress me!’�
’�You visit some and don’t visit others. But charge both same! Now think. Isn’t discrimination? How do you feel about that?’�
’�Oh! I didn’t think that way.’�
’�But it’s true, isn’t it?’�
’�Yeah ’� but no. I’m not available in different measures with different price tags!’�
’�You treat every patient well. But, you know, some want frills. So they pay for the frills!’�
’�So I’m the frill!’�
’�Think about it. In that role you’re just a frill, aren't you?’�
’�Even frills should be available to anyone who wants! In the ICU.’�
’�Increase fee! Demand’ will come down!’�
’�You sound like a salesman!’�
’�Maybe. But it’s fact. Proper treatment to everyone; extras cost more. It’s simple!’�
’�Doesn’t sound simple to me.’�
’�You’ve a complex mind.’�
’�You sound as if I’m on sale.’�
’�On sale? You? No, no! I’m not selling you ’� for any money in the world. No one, but me, will get you! Even in our next life!’�
But, as it turned out, the decision was virtually thrust on him. One evening George had a visitor, a young man. He looked uncomfortable and was sweating. George turned on the fan.
’�Are you okay?’�
’�Doctor, it’s my father. He’s in the ICU ’�’�
’�When?’�
’�Just now ’� chest pain, just a while ago.’�
’�Yeah, duty doctor must’ve seen him ’�’� His look asked, ’�Now, why are you here?’�
The man was embarrassed. ’�Doctor said he’s had a massive heart attack. That’s why I’m here!’�
’�But why?’�
’�Please come and see my father.’�
He kept an envelope on the coffee table.
’�He’s getting proper treatment. Yeah. We’ll take care of him properly.’�
’�No, doctor, we want you ’� please come and see him!’�
’�Hum.’�
’�I’ve brought a car. Will wait outside. If you come and see ’� Please! I shall drop you back immediately.’�
His first instinct was to refuse. But, he had already done, several times, what this poor man was begging him to do. He was pleading not ordering, not even demanding. George decided.
’�Right, I’ll be there. You may go now.’�
’�Doctor, car ’�’�
’�No. I’ll come there!’�
As George went, he remembered the earlier days. He tried not to think about the decline of his self imposed standards.
It became routine. George visited the ICU whenever the patients’ relatives demanded. Gradually he accepted this as normal. He had failed in his effort to become altruistic. He now accepted it as normal.

Chapter 78

It started as a routine consultation. The elderly couple walked into the room with trepidation.
’�Come Mr. Joseph! Have a seat.’� The sweep of his hand indicated that Mrs. Joseph was also included in that invitation. After the examination and review of investigation results, George said, ’�You see, you’ve a problem with your heart.’�
’�Yes, doctor?’�
’�Yeah, blood supply to the heart muscle’s not sufficient.’�
’�I’ve no blood? Anemia?’�
’�No, no. Nothing wrong with blood. But, blood doesn’t reach the heart sufficiently. There’s obstruction to flow in the arteries that supply the heart. Maybe it’s enough when you’re resting. When you walk or carry weight, heart has to pump more blood. Your heart’s work increases. It needs more blood. That, more blood, can’t get there because of obstruction in the arteries.’�
’�Pumping is the problem?’�
’�No. Pumping is okay. Obstruction to blood flow’s the problem.’�
’�Does he have a block?’� intervened Mrs. Joseph.
George was anticipating that question. It was a local vagary. The ’�block’� referred to the obstruction in the coronary artery. However, that word carried a menacing quality. Whether it was critical heart attack or a stable angina, if it was put across as a problem due to ’�block,’� the degree of seriousness increased several fold. George was amused that whenever he described the same disease using one of it synonyms, ’�obstruction,’� ’�barrier’� or ’�obstacle,’� the perception changed. The condition looked less lethal to the patient. That single word, more than anything else, conveyed a sense of ultimate urgency and gravity. Also attached with it was the simplistic misconception that if a block was present it should be removed; and that, when the block was removed everything was fine.
’�Yes, he’s.’�
’�Oh, God! How many blocks?’�
’�I don’t know; one or probably more. Can’t be sure now.’�
’�When’ll we know?’�
’�We can get that information only after an angiogram.’�
’�Oh angiogram? Then it’ll come to bypass operation!’�
’�Not necessarily. Some blocks can be removed by balloon ’� angioplasty. We can also try treating with medicines.’�
’�Can medicines remove block?’�
’�No they don’t remove, not immediately anyway. They can eliminate the pain and might prevent serious complications.’�
’�But blocks will remain.’�
’�Yeah.’�
’�Then?’�
’�Blocks are not the only important thing. Keeping that blocks stable is. Medicines might do it.’�
’�I see. Can I live with blocks?’�
’�Yes, but it’s better to remove the blocks, if possible; go for angiogram.’�
’�Do you recommend bypass?’�
’�I recommend angiogram. Only that’ll tell if you need bypass, balloon or medicines. If you don’t go for angiogram I’ll treat you with medicines.’�
’�Doctor, will you do the angiogram here?’�
George sat still. A pang of misery, a nostalgic ache scalded his breast.
’�No ’� no,’� in an unsteady, husky voice he said, ’�We don’t do it here. You’ll have to go to Trivandrum, Coimbatore or Madras.’�
He tried hard to keep the disappointment out.
’�Oh. No. It’s difficult,’� said Joseph.
’�But if it’s necessary we can,’� countered Mrs. Joseph.
’�No. Go to a strange place, new hospital, unknown doctors? Impossible.’�
’�But the block?’�
’�Doctor said he’d give drugs.’�
George was sad. He also felt guilty. He was failing his patients.
That afternoon George was more introspective than normal. The topic came up during lunch with his junior colleagues.
’�More and more people accept interventions now,’� said George.
’�Yes, a large number,’� said Sheshan
’�Yeah. Some even demand it!’� George agreed.
’�When’re we starting?’�
’�I’m thinking. There’re problems, you see.’�
’�But how long can we postpone?’�
’�I think it’s a matter of time,’� added Latheef.
’�Yeah.’�
’�I heard that some other hospitals are thinking ’�’�
’�Thinking what?’�
’�About starting cath lab.’�
’�It’s a big undertaking, you know,’� said George.
’�Still ’�’�
’�I know it’s to come.’�
’�Or we’ll be pushed back.’�
’�Yeah, There’s a wide gap between our cardiology practice and developments out in the world.’�
’�Sir, I think it’s the right time to start. People started accepting, no other hospital in town has it ’�’�
’�Maybe. I’m concerned. But then every hospital cannot be the best.’�
’�Since we offer treatment for heart disease, we should keep certain standards.’�
’�Yeah, if we’re not careful, we would slip; we’re in a crucial juncture.’�
’�Yes sir.’�
’�Cardiology ’� why, medical practice’s like running on a treadmill. If we don’t keep running we’ll fall back!’�
’�Exactly, sir!’�
’�But expense’s high. Big investment. If patients didn’t turn up and equipment remained underutilized, financial returns would be poor. Yeah, management would be restive. Pressure to increase the number of tests and interventions.’�
’�Do you think there’ll be any dearth of patients?’� Sheshan was confident.
’�No. There’ll be plenty,’� Latheef agreed.
’�Your confidence’s infective! Yet it’s a tightrope walk.’�
’�If we don’t start we’ll be like Jayarajansar.’�
’�Oh, no,’� shouted Latheef, ’�He’s the limit.’�
’�His reaction’s amusing. He outright rejects interventions. We can’t do that.’�
’�He’s becoming more and more dogmatic and obdurate,’� said Sheshan.
’�Very unreasonable and illogical,’� agreed Latheef.
’�He probably wants us to support his fight against the technology invasion!’� said George.
’�Probably because he doesn’t know it.’�
’�Jayaraj probably conceptualize issues as right or wrong, black or white, and with nothing in between.’�
’�But people are smart. They know and have their own opinion.’�
’�Yeah, true.’�
Gradually George realized he could not put off interventional treatment any longer. He met the director. Murthy was friendly.
’�Doctor,’� started George, ’�You see cardiology’s stagnating?’�
’�Stagnating? Not at all. You’re doing very well doctorsar!’�
’�I’m not talking about that! We’ve had no progress.’�
’�Progress? Be specific.’�
’�It’s time we start a cath lab; and cardiac surgery.’�
’�Hum. Surgery?’�
Murthy, a general surgeon, was not keen for another surgical specialty in the hospital. He worried that a new high-profile specialty would edge him out of the visual field of public gaze.
’�It’s a big undertaking. Will it work?’�
’�Yeah, it’ll. Up to us to make it work!’�
’�I’m not sure.’�
’�Our future depends on it.’�
’�How?’�
’�We’ll be obsolete in no time. Patient outlook’s changing.’�
’�They accept ’�’�
’�They demand!’�
’�They do?’�
’�Even those who don’t, believe their availability’s proof of hospital’s standards.’�
’�But the cost!’�
’�Doctorsar, can’t you see what an opportunity that’s? Another specialty, that too cardiac surgery, comes under your department. You’re the chief surgeon. There’ll be a cardiac surgeon under you!’�
’�Maybe you’re right. Cardiac surgery’s probably inevitable.’�
Murthy set up a meeting with the partners and George.
George was surprised to see Jayaraj at the meeting. Murthy introduced the subject.
’�Heart operation? Good! Open heart, no?’� asked Sreedharan, ’�But how much it’ll cost?’�
George knew that to win the war he had to win the financial battle. It should not only be viable, but also profitable, substantially lucrative.
’�The cath lab will cost about one and a half ’�’� George started.
’�Leave the details,’� Parameswaran cut in, ’�Give us the total amount.’�
George was annoyed.
’�Don’t interrupt Doctorsar. Let him say what he wants! We should listen,’� Govindan interfered.
’�Total investment will be to the tune of four to four and a quarter crores of rupees, including surgical set up.’�
That startled the group. The atmosphere changed dramatically.
’�Four crores?’� asked Sreedharan, ’�How ’�’�
’�Four crores for a useless and often dangerously harmful facility?’� shouted Jayaraj.
’�That’s not true,’� said George. ’�It’s life saving, sometimes.’�
’�It’s overrated, overpriced, impractical and a mutilating way of treating a disease eminently treatable with simple medication.’�
’�Many patients benefit from intervention.’�
’�Rubbish.’�
’�Ultimately some hospitals here will have it. Do we want to fall back?’�
’�No, no ’�’� Sreedharan hesitated.
’�If others are foolish, we don’t have to be,’� Jayaraj was adamant.
’�It’s useful. It’ll come. If we don’t have it we’ll loose out.’�
’�I think,’� Govindan said, ’�We should seriously consider.’�
’�But, who’ll do the catheterization?’� asked Jayaraj.
’�That’s no problem. We’ll have well trained invasive cardiologist. The important thing’s Keyammam having it,’� retorted George.
The partners promised to decide soon. They kept the promise. Within a week they approved the project. They asked Murthy to plan, in consultation with George. George was disappointed. He was sure that they would give him that responsibility.
Time went by. Nothing happened. George met Murthy daily. But Murthy did nothing. George assumed that the delay was due to the Director’s ignorance of specifications. He was too haughty to ask George. To save the situation George made a detailed plan and gave it to Murthy. Yet nothing happened.
’�Sreedharansaare,’� George at last phoned up the partner. ’�How’s the work going on? I mean cardiology cath lab and heart surgery!’�
’�You tell me. You should know!’�
’�I don’t know. Dr. Murthy ’�’�
’�Oh, he wouldn’t. He doesn’t know!’�
’�But he could ask me.’�
’�He’s busy I think. Why don’t you start?’�
’�Yeah. I’ll.’�
George wanted just that nudge.
’�We’ve that one floor, not properly utilized, on the west wing. We could house the whole thing there.’�
’�Okay.’�
’�I’ve the quotations for instruments.’�
As could be done only in an inefficient administration, George usurped the authority. The partners supported him. Murthy was not pleased. But, he was helpless.
During the next meeting, Murthy started reading from the first dossier George gave him.
’�Directorsar, you’re telling us old story ’� you tell us what’s done ’� not plan; we know that,’� Sreedharan cut him short.
’�Why are you impatient so much? Don’t interfere; let directorsar say what he wants,’� Govindan intervened. Looking at Murthy he continued, ’�Now tell us; what’ve you done.’�
The director said nothing.
’�Hum ’�’� George cleared his throat. ’�We’ve the space now, West Wing. The equipments selected. If you approve ’�’�
’�If director’s something to say, let’s hear,’� Jayaraj again interfered.
’�Oh, ha. I’ve ’� nothing more to add.’�
George realized that the turn of events was unfortunate. A simpleton who saw things straight without side vision, he inteceded without appreciating the finer sensibilities of people. He sensed the tension and hostility.
George briefly reported what he accomplished and what he planned. No one asked questions. Meeting was over. Murthy with a red face walked out. Quite unintentionally, George once again offended Murthy.
George quietly went ahead setting up invasive cardiology. When the equipments were in place, George recruited people to run the program. He also persuaded a young heart surgeon to join. The stage was set for the kickoff.
Murthy, so far an indifferent spectator, suddenly became active. Ignoring George entirely, he planned the ceremonial inauguration. The partners saw nothing unusual. Together they invited ministers, religious leaders and government officials for the function. George had no role. He was disappointed. At the same time, he was also relieved. He did not have to face an audience; he abhorred public performance. At the meeting, the director introduced the interventional cardiologist, Dr. Rama Iyer and the heart surgeon, Dr. Jacob. They in turn presented the plans. As the meeting progressed, Govindan noticed George’s absence on the dais. But it was too late. Murthy had his revenge.
George supported the invasive program. He had no choice. His future depended on its success. It worked. He was satisfied that hospital was not loosing money. He could face the partners with assurance and dignity. He could even confront Murthy with arrogance. Success had its rewards.
Murthy tried to avoid George. So did Jayaraj. The invasive work went on smoothly; yet good number of patients flocked to Jayaraj to avoid surgery.
The young invasive team stole the limelight. Interventional work was more dynamic, dramatic and newsworthy. George accepted it without envy or resentment. If he appeared jealous, he would be admitting his failure.
One day George found Jayaraj talking animatedly in the ICU. George instantly knew his colleague had something to gloat about. Anything that excited Jayaraj could be nothing good.
’�Do you know?’� shouted Jayaraj as he saw George, ’�I knew it throughout; don’t I use it? Now it’s official! Only when Americans say, it becomes official!’�
’�Hallo, Jayarajsar, what’s the excitement?’�
’�Ah, C’mon now; have you heard the new verdict about GIK in MI?’�
’�Yes, I’ve heard. I accept; it’s proved its worth.’�
George was embarrassed. Jayaraj enjoyed it.
’�No one listened to me. Who am I? When the Americans say, everyone runs after it.’�
It was an interesting story. Several cardiologists in the sixties led by the Mexican Cardiologist Sodi Pallaris, used and believed in GIK solution; but small trials did not show any unequivocal benefit. Eventually everyone, except a few diehards like Jayaraj, discarded it as useless. In 1997, a respected cardiology journal published the results of a through reexamination of the old GIK studies concluding that the GIK might be useful. This led to a new, elaborate and well-planned study in South America. The results, published in the same journal, proved the efficacy of GIK.
This was a big personal victory for Jayaraj. Cardiologists accepted the new scientific evidence and incorporated it in their practice.
’�Now, Americans will vouch for EDTA too. You just wait and see.’�
’�Okay. If EDTA proves to be useful as GIK, we’ll use it. But we need evidence.’�
George walked away. The animated discussion continued.



yesterday

Chapter 79

As was his habit, George reached the hospital early that day. He would have liked to walk from home. The morning walk would have been good. But, after the long walk, he needed a shower and change of cloths. That was not practical in a hospital on shoestring budget.
Radhakrishnan came to the hospital emergency room with chest pain midmorning. Because of his age, no one took him seriously. However, his pain increased and Radhakrishnan became restless. That, along with the profuse sweating, attracted the doctor’s attention. He ordered an ECG. After a cursory look, the stunned physician rushed Radhakrishnan to the ICU.
The ICU informed George about the unusually young patient immediately.
’�It’s very unusual, strange,’� pointed out George. ’�But, not unknown. Very infrequently, even youngsters do get MI. We should check if there’s a cause ’� complete work up. Now treatment’s same, standard. You’ve already started thrombolysis?’�
’�Sir, can’t we send him for angioplasty?’�
’�No. Not at this stage. Start thrombolysis, now.’� He emphasized that ’�now’� and looked at the nurses. One of them scurried to carry out his order.
’�But, isn’t intervention better? Considering his age?’� Latheef persisted.
’�Consider several factors. Weigh possible risks and cost against likely advantages. But most important is time factor. Earlier, the better.’�
’�But, sir, hopefully ’�’�
’�Hum. Hope ’� fully!’�
’�Sir?’�
’�No, nothing. What did you say?’�
’�Sir, shouldn’t we keep his heart as healthy, and undamaged, as possible? Isn’t that more important, here, because of his age? Intervention reestablishes blood supply more efficiently, salvage more myocardium ’�’�
’�To achieve that it should be done immediately. How fast can we do it? By that standard, right now, he should be in the cath lab. Do you think that’s possible?’�
’�But sir, we’ve to decide!’�
’�Exactly! Takes time to decide. We’ve to get family consent. How long will it take? That delay takes away the advantages. On the other hand, we can start drugs immediately. Yeah, you should’ve started it already! Why wasn’t it started? Delay’s unreasonable.’�
’�But, sir, we thought we might send him for angioplasty.’�
’�It’s done for AMI at some centers. Rarely, even bypass surgery,’� said Sheshan.
’�Don’t you realize that in AMI it should be done fast, to be effective?’�
’�We’ve to start the program ’� then, we could streamline.’�
’�There’re inherent restrains. Risk, expense, delay ’� whichever way we streamline it may not be acceptable.’�
With that, George hoped to stop that discussion. He was not comfortable defending.
But, Latheef spoke up again, ’�Studies have started showing superiority of angioplasty. So ’�’�
’�Problem with those studies is that procedures were invariably done in first rate institutions with unrestricted resources, in other countries. They’ve different ethos. That’s not our world. We don’t take informed consent from patient; we get from immediate family. Yeah, we need our own experience to judge.’�
’�Some in our country also are doing it,’� persisted Latheef.
’�And what’re their mortality and morbidity rates?’�
There was an uneasy silence. They were clearly hurt; it showed on their faces. George was perturbed and distressed. He should keep the morale of his team high. What just happened was not likely to help. George cursed in his mind, not anyone in particular, but the fate that placed him in that position of ambivalence.
Radhakrishnan’s relatives were not in the hospital yet. What George said about the delay was proving to be prophetic. The family, Radhakrishnan’s parents, wife and her parents, came later.
’�Radhakrishnan has had a heart attack. He’s very young. Unusual age for heart attacks. But, he did ’�ve it.’�
’�Are you sure?’� Radhakrishnan’s father asked. ’�I mean, is’t beyond doubt? Is’t a suspicion or ’�’�
’�Yeah, it’s beyond doubt. ECGs and blood tests are clear. No question.’�
There was silence.
’�Radhakrishnan came immediately after his pain started. We could give him medicines early. That should help.’�
George watched their faces. They were completely lost, dazed; they were grappling to grasp the significance of what they heard.
Radhakrishnan’s father asked, ’�How serious is’t? He’ll ’� recover with treatment?’�
’�Heart attack patients could develop serious complications. Chances are small. Only a very small number develop such ’� But there’s a chance. Complications could be ’� very serious. But, as I said, chances are very small. As time ’� minutes, hours and days goby chances of complications come down.’�
’�Does he’ve a block?’� asked Radhakrishnan’s father-in-law.
’�Yes, he most probably has. Usually it’s a block that causes heart attack.’�
Radhakrishnan’s wife was sobbing uncontrollably. Her mother, weeping silently, held her tight. The presence of block confirmed the seriousness.
’�How many blocks my son ’�ve?’�
’�I don’t know. Only an angiogram ’� that’s a test done by pushing a tube into his heart. It’ll tell us how many blocks he has and how best to treat them. I don’t think it’s necessary now. Better to treat with medicines. But, in case drugs prove ineffective, angiogram may become necessary.’�
’�Doctorsar, will you do it yourself?’�
George smiled mirthlessly. He heard this question repeatedly. It demonstrated their faith in him. But it also brought out the painful memory that he was incompetent to do it. Now, after all these years, however, he had reconciled.
’�No, I wouldn’t. Dr. Iyer will do it. He’s very good. And I’ll personally see that Radhakrishnan gets the best care.’�
’�Angiogram will take care of his block?’�
’�No, it’s only a test.’�
’�Then?’�
’�We could do balloon dilatation.’�
’�If it’s not removed, what’ll happen to the block? Would he be able to live normally with a block?’� Radhakrishnan’s wife spoke up.
’�That’ll depend on the type, condition and site of the blocks. With many types of block, normal life’s possible and safe. But, some types are dangerous.’�
’�So what we do now?’�
’�Nothing. Treatment goes on. But, you’ve to decide if you want. Or rather, if you’re willing to get Radhakrishnan treated that way. Not now ’� in future, if need arises. You should think and take a decision.’�
’�Now?’�
’�Yeah, now. Could you?’�
All of them looked stunned. Obviously they were weighed down by the implications, financial, therapeutic, and emotional. Then the question of survival loomed big. People usually took a long time to decide. At the end, they may leave it undecided!
George was afraid that, perhaps, the way he put it across might not carry the emphasis of his conviction about the need for intervention. They might think that he was neither supporting nor recommending it. Involuntary body language and spontaneous, unintentional voice modulation could carry such suggestions. He was sincere and wanted to appear so. Yet, he felt guilty that the effect might be negative. That he was a non-interventional cardiologist weighed heavily in his mind.
This was a very weird thought process. It was as if he was incapable of advising any of his patients properly and sincerely.
Next moment he would have the reassuring thought that perhaps the guilt complex was his negative imagination. The skepticism was unfounded. He was, in reality, explicit and his recommendations unequivocal and decisive. The human mind envisages mirages as realities.
’�Doctorsar, will it come to bypass operation?’�
’�What? Oh!’�
’�Yes?’�
’�Right now, no ’� Anyway it’s, I mean operation now, too dangerous. Later, if necessary, we’ll see.’�
Mind was funny; its ways were myriad. These people intensely wanted to hear that an operation was unnecessary now or later. They would interpret any hesitation as a flat no. Later if operation would become necessary, these same simple and helpless people might turn around and indict that they did not receive advice about surgery at appropriate time.
’�Later means?’�
’�Any time, if he develops complications. We’ll do angioram. That’ll tell us if operation’s necessary. If it becomes necessary we’ll tell you.’�
Then George explained the financial implications.
’�Doctorsar,’� said Radhakrishnan’s father, ’�We’re not rich. We struggle to make a living. That kind of money’s hard to rise. But we don’t want to deny good treatment to my son. We trust you. You decide what to do and when to do it.’�
George found their faith touching. It was a covenant of trust the family had in him. At the same time, it was an imposition. The present day consumerism demanded informed consent. The patient and the family should share, or take the entire responsibility. What he experienced now was the old world physician-patient relationship in action.
After hearing them, George thought a great deal. The family was not affluent. Radhakrishnan seemed to settle down with medical treatment. He decided to continue drug treatment. He then got immersed in work and forgot about Radhakrishnan.

Chapter 80

That evening George walked home from the hospital; he did it most evenings. A driver took the car back in the morning. After the day’s onerous work he might do anything to avoid the long hike. But he had no choice when the car was unavailable. It would be desperate madness even to think of traveling in the city bus, not taken as normal in this part of the world.
In any case, George thought the evenings were just as good for a walk as the mornings. However, his walk through the crowded thoroughfares, during the peak hours of vehicular and pedestrian traffic, was not pleasant. The roads were always filthy. At the time he walked, they were congested; and the air was thick with smoke and dust. After starting the habit his perception changed. This walk was not pleasant. But it was too late to change.
Some of his friends advised George to change, either the time or route so that the roads he traversed were less crowded. The crowded streets were polluted, unhealthy and accident-prone. The dangerously careless driving accentuated the hazard. However, George joked that if accident happened, it would better be in a crowded street. In the forlorn secondary roads the drivers were equally careless and perhaps more rash. From such streets, his chances of reaching a hospital were low. He did not believe what he said. In his mind, he conceded that his friends had a valid point.
Some folks, including Mercy, thought that it was demeaning to walk the crowded streets. The established local custom counseled that if he must walk, he should go down to the public gardens. That provided a pedestrian track in a park setting. There was an additional, in their view crucial, advantage. It will state the purpose as the bliss of walk and not transportation. A walk for the purpose of walk was a la mode. Yet as a means of transport, it was in poor taste, just common. They did not appreciate his point that he could combine both. Snobbish? Perhaps; but that was what the local elite did. What he did was unrefined. The glitterati did not do that.
’�You’ve chosen the worst way to walk, you know,’� Mercy told him, ’�That’s unhealthy. Is it a vow?’�
’�Yeah, you might say that; a vow! A promise to walk every day.’�
’�Ha! A promise? Do you keep all promises?’�
’�Yeah, of course.’�
’�Okay, you know, I’m not nagging; but some promises get priority! Others, like a vacation during summer, were neglected.’�
’�No, no ’� that’s not a promise; I said, if possible.’�
’�How very convenient!’�
’�Every promise has to ’�ve a safety valve!’�
’�Oh! So, what’s the safety valve in your vow to walk?’�
’�Hum.’�
’�If you’ve a safety valve, use it. Don’t walk like this.’�
’�But why? It works.’�
’�It’s unhealthy. It’s dangerous. It’s undignified.’�
’�Why undignified?’�

’�Ha, you took up just one point! Do you agree it’s unhealthy and dangerous?’�
’�See, I’m doing it because I want to walk and that’s the only way I can walk.’�
’�It’s shabby, you know. No one does it!’�
’�It’s shabby because no one does it?’�
’�No. No one does it because it’s shabby!’�
’�But, it’s easy. It’s working.’�
’�Your simplicity’s very complex.’�
After a while, George did not try to reason; he grudgingly admitted to himself, the reason was weak. For, he knew, they had a valid point. No question, the walk in the shaded park would be much more comfortable. Gradually he recognized his antipathy to egotism, his obsessive aversion to elitism. Maybe he had his own brand of elitism.
George considered himself a reasonable man. True, but that was in his private world. After all, he conceded that his walk was not very pleasant. Paradoxically, he was not willing to change it. He thought he was resisting ritualistic snobbishness. He had an uneasy feeling that he was as snobbish as the worst of the egotists, but with just one difference. The trajectory of his narcissism was diagonally opposite to that of the usual variety.
What took George by surprise was the kind of attention his walk attracted. He always opted to hide in the midst of the crowed. An introvert, who did extravagant and unconventional things only in fantasy, he disliked limelight. Yet even as he contemplated the impropriety of exhibitionism, his mind would waver. His well-developed cynicism would come out. Did he frown upon self-propagating publicity drive, because he had no such talents? Touché! He knew that showmanship was not his forte. Did his mind trick to transform that flaw into a virtue, a virtue such as simplicity, savoir faire? Nevertheless, he was happy when his actions and achievements were under the bushel. Yet he surprised himself by taking a step, which became a subject of gossip.
George did such things rarely. Had he anticipated the attention it attracted, he probably would not have started it. He had assumed that the crowded streets would keep him incognito. However, it invited and engaged attention out of proportion to the simple act. First, he panicked. Then, gradually, he accepted it as inevitable. Later, to his utter amazement, he started enjoying the attention, more than he thought he would, much more than the walk.
It was one thing getting noticed and recognized; but getting critically evaluated was another. The advantage of being an insignificant part of a crowed was to escape the constant scrutiny. At this point, his ego showed up. He did not accept that he was insignificant! Who knows, he might be under gaze. He was extraordinary, important. He loved the anonymity of being part of a crowd; but he was never part of the crowd. He could not identify with the proletariat, hoi polloi.
Dangerous thoughts; menacing ideas; prejudices, that drove men into megalomaniacs. Winston Churchill abused his butler, David Inches, and justified it by his status as a great man. Inches had no such privilege because he was a commoner. Richard Nixon claimed impunity for criminal acts because he was the president. Deep held beliefs of supremacy led Hitler and Mussolini to heinous crimes. The king cannot be wrong, a dogma, propagated in self-interest.
Nevertheless, George did not want to, or at least did not want to appear to, manipulate to attain special privileges. He might not demand recognition and respect. He can only deserve them.
Finding a logical reason, a rational basis to justify his actions, was important to George. He tried to convince himself that he had reasons for continuing the walk. But it was difficult to get convinced.
George was afraid of torture and pain; yet the magnitude of discomfort he was capable of enduring and surviving, for a cause, was phenomenal. Very often, the causes were flimsy and trivial. To sustain them, he would dream up some positive and salubrious aspects of the issues. His walk through the crowded streets was such a cause. On a critical self-analysis, he had concluded that he championed small causes because he was not capable of taking up big challenges.
Very often, his suffering for the causes went unnoticed, but not this time. Knowing that more and more people were watching, George doggedly kept the itinerary unchanged. For a person who perpetually sought to remain unknown, this was quite a feat.



today, again

Chapter 81

After coffee and newspapers, George was ready to face the day.
It was an unusually cool December morning, year 1998. It was a beautiful day. The tropical sun was normally sedate and placid during the winter months; today it was magnanimously subdued. The air was crisp and fresh.
As he drove to the hospital, George kept thinking about his patient. The more he thought, the more indignant he became. Logically, there was no reason to feel guilty about the treatment he recommended. It was the textbook standard. George was apologetic, repentant one moment, and by turn righteously incensed the next.
The victims of heart attack developed complications, even fatal ones. At the time of admission, Radhakrishnan gave no indication about the future crisis. To prevent it by intervention, every patient should be treated that way. It was not feasible, because of sheer volume and staggering expenses.
Yet, that was not the point. Here only one problem existed: Radhakrishnan, one patient. And only, one question: Should Radhakrishnan have had angioplasty at admission? George recognized that physicians like him might understand the basic concerns. Still some physicians will deliberately choose not to accept the issues. The patient and his family were unlikely to have that perception, either. In their eyes, the treatment was a failure, period.
George was sure that no hospital staff would question or criticize him directly or openly. Openly no, but, covertly? He could visualize the criticism, barely concealed, lurching in their eyes. They will question the decision, reason out and draw conclusions in their mind. The simplistic inference, with the advantage of hindsight, would be that an early intervention would have prevented the complication. This would be yet another day of trial and judgment. In the minds of many he will be in the dock.
Intervention for Radhakrishnan at admission would have been heavy financial burden. After an uneventful recovery, it might appear unnecessary. The intervention could fail; result in complications. George would have owned up the blame. Jayaraj would make sure that everyone heard that. The disease could recur, a waste of effort and resources. The coin had two sides and when flipped came down with either side up. It so happened that this time George called the wrong side.
The financial, egoistic and egotistic implications were formidable. George now accepted that money was substantial and controlling force in many facets of life. As a medical student, and later as a novice physician, he was full of idealism. It was the type of lofty, unselfish meliorism, combined with a dash of romanticism that made him proud that he belonged to the same profession that such diverse, remarkable women and men as Ida Scudder and Albert Schweitzer practiced. Anton Chekhov, the prolific Russian author had declared that medicine was his lawful wife and literature his mistress. Why, even Che Guevara, a genuine revolutionary hero to his generation, was a physician. If George was told during those heady days that, on a later day, money would influence his decisions, he would have laughed it off.
That had changed. Now, when matured, he had no difficulty believing that money was a powerful force, if not the most powerful force, in life. It was a controlling drive modulating human behavior. He had trouble accepting that change in his outlook, though. Nevertheless, the starry-eyed idealism of his younger days had given way to the hard headed pragmatism.
With nostalgic ache, George remembered the tumultuous sixties. He was young, his mind was young and his world was young. The planet was reborn sometime during his youth. The oppressed peoples all over the world were waking up; they demanded freedom and justice.
In recent years the conflict between, what was left over from the virtuous youth and the newfangled pragmatism, had become a source of mental strife. George could still assert, quite honestly, that financial considerations never guided his therapeutic decisions. Not yet, he would hasten to add, with growing cynicism.
For years, George had a favorite quotation on his desk: ’�The best specialist is one who recognizes in his clientele the greatest percentage of patients who do not belong to him.’� It was from a book a Mayo Clinic physician, Walter Alvarez, wrote in 1951. It reflected young George’s pride in being a highly trained specialist. Perversely, with satisfaction amounting to arrogance, he send his patients with even minor non-cardiac problems to the respective specialists. He had no reason to doubt his integrity.
But George could not forget that he referred after unsuccessful treatment. But it was the limitation of medical treatment. Then he wondered if he referred too many patients if only to prove that he was unbiased. That added an altogether different dimension to his confusion.
Irrationally, George’s inability to perform interventions compromised his self-esteem. His preference for medical treatment was linked to this handicap. It was a bias based on personal prejudice arising from professional incompetence. When taking difficult therapeutic decisions, the question, ’�What if George was an interventional cardiologist,’� loomed high in his mind. It was one of the ’�ifs’� that troubled him.
Soon, his outlook and his mood changed. These were immature and irrational thinking. He was balanced. He had the right equilibrium between medical and interventional treatment. He was not ’�catheter happy.’�
When treating serious patients, physicians were anxious about the outcome. Part of the anxiety, the major part, was the concern for the patient. However, the outcome influenced the physician’s career. That was a source of anxiety too. The commanding generals would not forget that the outcome of wars would affect their reputation and destiny.
As he woke up suddenly to reality, George saw that he was entering the hospital. With an unpleasant startle, he realized that his mind had wandered.
George realized that he had completely forgotten his critically ill patient. What a fortunate break! Earlier in his career, he would have thought about such a patient constantly. If ever he managed to forget, he would feel guilty, as if, by forgetting, he neglected the patient. Now he was grateful for the respite, total oblivion.
George now found solace in doing the pleasant, not to please anyone. He remembered Muhammad Ali, ’�I don't have to be what you want me to be; I am free to be what I want.’� It made sense. He had a newfound respect for the former heavy-weight-boxing champion. In a lighthearted reverie, George wondered whenever he recalled the quote right. Was it, ’�’� what I want to be’� or just, ’�’� what I want.’� To be, or not to be?
The hospital was awaking into daytime activity. George carried his old bag, which he could not throw away. It carried memories. He could not give them up.
Even small objects, an old bag here, a pair of shoes there, crowded George’s memory with phenomenal panorama of the past. It was like Einstein’s theory: Every thing that surrounded him was a four-dimensional space time continuum. He often felt if he traveled in time.
George entered his small room. He remembered Radhakrishnan. He should salvage his young patient’s heart. He also had to satisfy his colleagues, reassure and convince them, that he took the correct decision.

Chapter 82

The intensive care room had a surrealistic air about it. The life and death problems tackled there every day created hectic tempo of activity, incessant shift in pace and an air of alertness. Together they created an image, an experience, at once scary and fascinating.
Throughout the major part of his working life, George was a member of the ICU team. Yet, to this day, he did not cease to feel an accelerating excitement mixed with anticipation, concern and trepidation, as he opened those doors. When fighting for a life or pondering over the diagnosis of a perplexing problem the anxiety was overwhelming. Yet, after a brilliant diagnosis or an ingenious therapeutic action that saved a life, excitement, even haughty pride, was the dominant emotion. After decades of emotional endurance, it became second nature.
However, now the nighttime visits changed George’s attitude. The ICU had become a source of conflict, an ethical dilemma. He blamed the circumstances that a corrupt society created, but with little conviction.
By reflex, George looked towards Radhakrishnan. A posse of nurses and doctors was around that bed, busy and efficient. George George took Radhakrishnan’s hand and gently squeezed it. ’�How’re you feeling?’�
’�I’m better now; but it was horrible. I thought I was dying; it’s not like first time.’�
’�Don’t worry; you’re going to be fine. It’s only temporary. You’ll be absolutely normal.’�
’�Yes doctor, if you say so.’�
Unlike the Western norms, Eastern medical etiquette dictated that the doctor did not tell the patient the gravity of his condition. Occasionally the lie was so very transparent that, George felt, the patients knowingly partook in the charade. He had become an effective liar, a first rate deceiver, that qualified him as a compassionate physician.
’�Sir, what do we do, now?’� asked Latheef.
’�He’s not a typical problem,’� said Sheshan.
’�Yeah, it’s unusual. What do we do now?’�
’�Age’s one thing; medical treatment has failed.’�
’�But treatment’s stepped up now. These medicines might stabilize ’�’�
’�But can we wait?’� intervened Sheshan, ’�He should’ve angiogram. Another setback and it’ll be too late.’�
’�Yeah, agree. But the question’s when? Right now, he’s unstable and risk’s considerable.’�
’�We’re not sure if he’ll be stable at all.’�
’�We hope he’ll be!’�
’�He’s already had two problems. One more may be ’� fatal. So ’�’�
’�We don’t have much experience in intervention in acute MI. If we wait, he’ll be in a better shape.’�
’�He may or may not. We’ve postponed angiography once.’�
’�I’m worried about complications.’�
’�Iyersar tells us complication rate’s very low even in serially ill patient. Benefit’s much more than risk.’�
’�Yeah, if all of you think ’�’�
No one spoke. Yet their looks concurred.
’�Please ask Dr. Iyer to see the patient. See if he’s free.’�
’�Good morning sir,’� saluted Iyer as he entered.
’�Take a look at this youngster. Lathief, fill in the details.’�
After examination, Iyer looked at George.
’�We’re wondering if ’� now, is it the proper time to intervene.’� Unusually, George had difficulty articulating.
Iyer, in turn asked George, ’�What do you think? What’s your suggestion, sir?’�
That was good manners; it pleased George.
’�Well, I thought he should be stabilized before the procedure. I would treat him medically, a day or two, before angiography. Wouldn’t it improve his chances?’�
No one spoke. George felt that his suggestion did not go down well.
’�True,’� started Iyer. ’�Indeed! If we can stabilize him! But, if we can’t? If he develops more complication? That might be the end of the party.’�
’�Yeah, possible ’� How do we decide?’�
’�We’ve some experience. Acute stage intervention results are excellent. We haven’t lost a single case last year.’�
’�You’re sure, yeah?’�
’�Yes, indeed! Precisely,’� Iyer answered. ’�We must also remember that Radhakrishnan’s fairly stable now. He has come out of LVF. His lungs are dry. Your boys here have done a good job.’�
The burden of decision was on George. Fair enough. He avoided visual contact with anyone. Now he could go with the majority. He was playing it safe. For a brief moment, he was ashamed.
’�If we persuade the family, when can you take him up?’�
’�Within an hour. The lab will be waiting.’�
’�You make arrangements. They’ll agree.’�
’�You know,’� George addressed the relatives. ’�Radhakrishnan had some more complications. Condition’s critical.’�
It took all of his ICU-hardened resolve to tell Radhakrishnan’s young wife. She was devastated. Yet, there was hope too, safety at the end, if the turbulent ocean was crossed. One glance at her tear-brimming eyes was all that he could take.
’�Any more complications and his heart will be damaged further. We want to prevent that. He’s to have an angiogram, as I said earlier.’�
’�After that?’� asked the father.
’�Treatment depends on the result.’�
’�Operation?’�
’�Can’t say now.’�
’�Is ’� the treatment dangerous?’�
’�There’s some danger. But it’s the better chance.’�
’�Jayarajsaar tells that he can be cured by medicines.’�
’�We already tried!’�
’�But he says, chelation.’�
’�That’s not very safe ’�’�
’�But Jayarajsaar ’� Can we try it?’�
’�I don’t advice.’�
’�You sure ’�’�
’�Yeah. No doubt.’�
’�We believe you. Sir, please save our boy!’�
’�We’re trying our best.’�
’�You sure angiogram’s better?’�
’�Angiogram and follow up treatment’s better.’�
’�Sar, sure?’�
’�Yeah. Nothing is impossible for God; miracles did happen.’�
’�Yes, God is great.’�
Invoking the Almighty reassured him as much as the patients’ family. It gave him psychological and tactical advantages. It, gently and indirectly, but surely and immediately, conveyed the gravity. At the same time, it gave something for the family to hold on to, a glimmer of optimism, a bit of consolation and a trace of hope.
Religion may be the opium of the people. He knew the value of narcotics in combating pain. He had no hesitation, hang-ups, about using its metaphysical counterpart, to embalm the wounded psyches of his patients and their families.
Radhakrishnan’s wife spoke up, ’�Doctorsar, you told us. It’s angiogram and whatever you advise after that.’�
’�Yeah.’�
’�Sell my ornaments,’� she told her family. ’�What’s the use of ornaments without him?’�
No one could quarrel with that type of argument. George went back to his office.

Chapter 83

George was immersed in his work, when he received the phone call, around 2 pm.
’�Sir, we just finished,’� boomed Iyer. ’�It’s left main, about 70 %. Oh boy, is it a nasty looking thing! There’s more.’�
’�So it’s coming to Surgery!’�
’�Looks like.’�
’�Ejection fraction?’�
’�45%.’�
’�High risk.’�
’�Can you come down? We can review the cine.’�
’�Yeah, ten minutes. See if Jacob is free?’�
They reviewed the angio.
’�Don’t have many options,’� started Iyer.
’�We’ll have to ’� see,’� said George.
’�Anyone’s guess,’� Iyer said. ’�One more complication and it’s ’�’�
’�Waiting may be dangerous,’� spoke up Jacob, ’�Left main, active unstable plaque! Erupting volcano! No choice. It’s surgery. And now.’�
’�What’ll be the risk? This chap had a heart attack a couple of days ago.’�
’�Chances for complications, even serious complications, are high. But isn’t that his best chance?’�
’�Yeah, he needs CABG,’� said George. ’�But my question’s when?’�
There was a subtle rumble, barely audible. It was more a change in mood. George knew no one agreed.
’�It’s to be now,’� Jacob answered. ’�That’s his best bet.’�
George did not argue. Everyone seemed to agree.
’�Why don’t we consider angioplasty?’� interrupted Iyer.
’�Angioplasty for left main? Never ’�’� said Jacob.
’�It’s not preposterous!’�
’�No?’�
’�No! Much less traumatic, better tolerated.’�
’�High closure rate. Not a good alternative to surgery; not even to medical treatment!’�
’�Here it’s the best option. We can stent it. French and Americans are doing it.’�
’�Have we done one before?’� intercepted George.
’�No, not so far.’�
’�What’s the Indian experience?’�
’�I don’t know.’�
’�Were they doing it in the Institute, during your training?’�
’�No. But there’s to be a first time.’�
’�Initial cases have to be more stable! Patient selection’s important.’�
’�Okay!’�
’�Yeah, do we agree on operation?’�
Silence sealed the consent.
’�Right, take him up as soon as possible,’� said George.
But at that moment Jayaraj appeared there.
’�Why are you doctors trying to slaughter that patient?’�
Everyone was stunned.
George did not attempt a reply.
Jacob cleared his throat, ’�Jayarajsaare, this patient has left main disease, in addition to other lesions. We’re ’�’�
’�You don’t use medicines properly. Know about GIK? No one believed! Now you better use chelation!’�
’�But saar, this is too serious ’�’�
’�That’s why you should use. Anyway you are misleading the relatives. I’m not going to tell them. But this patient’s not getting proper treatment.’�
No one spoke. One by one everyone left. Jayaraj smiled mirthlessly.
George went back to his work.
He was busy seeing the patients, when the nurse told him, ’�One lady’s waiting to see you.’�
’�I’m busy. Can’t you see patients waiting? I can’t see now.’�
’�Sir, I told her. But she insists!’�
’�Who’s she? What does she want?’�
’�She says ’�’�
’�Let her wait. Let me finish the OP?’�
The nurse was back almost immediately. ’�That lady outside, she says she was your classmate, she says she’ll take only one minute. To talk about a patient, a serious patient.’�
Reluctantly George agreed.
A beautiful and, despite her advancing age, attractive leady walked into his room. A little overweight, but she had a good figure and she wore it well.
A bit irritated, George asked, ’�You came to ask about a patient? Who? I must’ve already told the family ’�’�
’�I wouldn’t waste your time. Do you recognize me?’�
George was curious now. He could not place her.
’�We’re together, pre-university. Maharaja’s. Oh, I didn’t tell my name ’� I’m Geeta. Geeta Ramakrishnan. But I was Geeta Sivadas.’�
George sat bolt up right. He could feel the hot flash on his face. His astonished look amused her. Now that he knew who she was, he decided that he did recognize that face. Even after so many years, the resemblance was unmistakable. She was mature, of course. She had become vivacious. Her student-day simplicity had gone. He was looking at the Nun.
She looked contended. She surprised him. She incited his interest and full attention. After all, she had studied with him for just one year, decades ago. She would have been satisfied with a few polite words.
’�Oh ’� I’m sorry I didn’t recognize you ’� I should’ve ’� but ’� sorry,’� his voice was trembling. ’�It’s such a long time!’�
’�We’re meeting after years. You’ve changed. If I had not known, I too wouldn’t have recognized you.’�
’�Of course you’ve changed, but not so much! Not unrecognizable. Now that I know, you’re the senior version of what you’re in college,’� George smiled. ’�Tell me where you live now? What’re you doing?’�
’�I’m a mother of two. My husband’s an engineer in software business.’�
’�How long have you been here?’�
’�About six years. We’re in the Gulf before.’�
’�For six years? In this city, and never met before. Strange!’�
’�I’ve seen you. But, you’re always very busy. Now that I’ve a reason I’ve taken a chance.’�
’�Oh, C’mon. You should have come ’� You and your husband must come to our place one day.’�
’�Yes, thank you. Now I wouldn’t waste time.’�
’�No, don’t worry!’�
’�I came with a recommendation.’�
’�Oh, yeah?’�
’�I’m a relative of your patient, Radhakrishnan.’�
’�This woman’s full of surprises,’� thought George. But, he asked, ’�Oh, you’re related to Radhakrishnan?’�
’�Yes, husband’s family.’�
’�Oh!’�
’�They’re not well off.’�
She smiled awkwardly.
’�Yeah. I know the financial strain.’�
’�They ’�’�
Did she come to request a reduction in bill?
’�I wish I could do something about the bills. But I can’t ’� Not within my power. I’m sorry, I’m helpless.’�
’�We know that.’�
’�Oh, you do?’�
’�Yes. They’re grateful for everything you did.’�
’�Oh. I didn’t do anything ’�’�
’�I know all of you’re doing everything. I’ve no reason to come. But they wanted me to ’� I couldn’t refuse.’�
’�Yeah?’�
’�They wanted me to recommend special care for him! I know you are doing the best.’�
George felt considerable relief. No demands, other than special care. However, usually these demands irritated him. Few doctors provided better care because of a recommendation. What type of doctor would he be if he did? He did not understand the emotional strength many people achieved through such actions. He was brutally righteous.
’�There’s one thing more ’�’�
’�Yeah. Please go head.’�
’�I don’t know how to say ’�’�
’�You can tell me anything ’�’� He looked intently into those eyes. She looked away. Then turning her head and looking straight at him with suggestion of a naughty smile she said, ’�Now I can’t find words!’�
Was she reminding him their earlier encounter, in college?
’�What’s that?’�
’�No, they, Radhakrishnan’s family wants to know if operation can be avoided. Jayarajsaar tells other type of medicines ’�’�
’�Yeah. But we, er, I don’t agree.’�
’�Alright. I’m sorry.’�
’�That’s ok.’�
’�Please don’t mind. They ’� we all believe you.’�
’�That’s okay. Yeah, we’ll take care of him. I’ll tell him that my old ’� classmate talked to me about him!’�
’�I shall tell the family that he’s getting the best treatment. Thank you,’� she stopped for a while and then completed, ’�’� doctor!’�
Doctor! For no particular reason George was disappointed. He wished she called him by name.
George was sorry to end the conversation. He moved back in time to a brief, shining moment in life, when tender adoration filled his heart. Did she reject him gently then? But, it was no rejection. He did nothing to get accepted! At an age, when the mind gushed with romantic fantasy, he too had his dreams. But, his reticence did not allow him to speak up.
George was ashamed; he was acting like an immature adolescent, having an infatuation. But this was no desire; just a rekindling of a tender sensibility he had felt years ago. Pure nostalgia, nothing more.
That afternoon George tried to immerse in the overwhelming work. Yet Radhakrishnan and Geeta were not entirely out of his mind any time. The intensity of the emotion surprised him. True, he had thought about her occasionally, with a detached amusement. It had changed suddenly. Now, her unexpected entry roused a sleeping genie within him. He fervently wished that he could save Radhakrishnan.
George thought about his family. Infidelity was a serious affair. Thinking about another woman would not be wrong, not adultery. This was no abstract theoretical deliberation. Anyone could afford to be an idealist when debating intangibles. He was now trying to believe that, fantasy, even sensual delusions, if well hidden, did not hurt anyone. It was an innocent mental game. This obviously was the pragmatic rationalization of the degradation of values and ideals. He believed in the purity of mind.
George fancied that they flirted this morning. He somehow believed that she too knew this. Ten Commandments came up in mind. The seventh, ’�though shalt not commit adultery’� (Exodus 20; 14) became a grimly serious affair when combined with the Sermon on the Mount: ’�’� whosoever looketh on a woman to lust after her has committed adultery with her already in his heart.’� (St.Matthew 5; 28, 29)
Late that evening, the news from the operating room was still disturbing. They were still struggling with Radhakrishnan’s life. George was tired. He decided not to wait in the hospital. After all, he had nothing to do.
As George entered his house, he saw Mercy. She immediately called out, ’�The hospital called!’�
His heart missed a beat and then started racing. ’�Did they say anything?’�
’�No. They couldn’t get you.’�
’�Get me hospital, would you?’�
’�Okay, sure.’� Her laughter always reminded him of the church bells on the Christmas day. How fortunate to be able to come back to a pleasant home and a cheerful wife.
’�Pick up the phone.’�
’�George Thomas here.’�
’�Just a moment sir, Surgical ICU was trying for you.’�
A brief interval.
’�Sir, Jacob!’�
’�Yeah, Jacob?’�
’�Finally some good news. Radhakrishnan has made it. We did total revasularisation. Initially heart wouldn’t pick up. But soon it’s defibbed. Sinus now. Of course, with lot of support. Still a lot to go, but we think he’ll make it.’�
’�Thank God! Did you tell ’� relatives?’�
’�No, I’m going to. I knew you wanted to know right away.’�
’�Of course, and thank you very much, Jacob.’�
’�Hope he’ll make it.’�
’�Yeah, let’s hope.’�
_______________The End_______________