It’s 3 in the morning. And I’m tired. My legs hurt. My back hurts. I have a severe headache. My heels… oh… they are so tender that I can’t touch them on the ground anymore. So basically, I’m toe walking now. I’m a doctor and have been working as a general surgery resident for the last one year. And today I’m serving in emergency room which is usually a twenty-four to thirty hours shift starting from 8 a.m. to the noon next day. Around 2 to 3 a.m., we (the doctors working in ER) take turns to sleep for two to three hours to gain strength to work for leftover cases in the next morning. I’ve been dealing with patients of various surgical issues all day but the ER (emergency room) is quiet now. There are no more patients and we are sitting on our chairs, tired, at the brink of falling apart, praying that PLEASE GOD, DON’T SEND ANYMORE PATIENTS.

I look at the clock at the wall in front of me. It’s my turn to sleep and I just want to lie on bed and never get up. Just to think about sleeping at this hour of night makes me relax a little bit. But for the last few hours, I’m feeling stomach ache, probably because of something I ate earlier. So, I decide to take a little walk outside the ER before I sleep. I go out, pace a little, listen to the silence of the night, see the guards sitting on the chairs with their heads hanging down their necks in sleep, find the attendants of the patients snoring in their self-made beds over the muddy ground. I walk to the cafeteria a few yards away and sit on a chair spreading my legs on another chair. I close my eyes, lean backwards against the backrest of the chair with my head resting on it and feel lightened and vulnerable, and I’m afraid that if I sit here like this for an another few minutes, I would fall asleep and nobody could wake me up, not even the angels-of-waking-people-from-sleep (if such things exist). So, I forcefully open my sleep laden eyes, pull my head up and contain my legs. But I’m still not ready to go back in ER because of the stomach ache which is kind of getting harsh now. I look at my cell phone. It’s 3:15 a.m. Fifteen minutes of my sleeping hour have already been gone. If I sleep, probably my pain will go away. I shouldn’t waste anymore of my precious time because I have to get back at 6:00 (after two hours and forty-five minutes). Each single minute of sleeping hour is like a diamond and losing more minutes will be like losing more of my fortune. And while I’m thinking of saving diamonds, an ambulance pulls up in front of ER. The back door of the ambulance opens. The paramedics pull one stretcher out and then another one. These are two patients in one ambulance. So, something isn’t right. Then again whenever an ambulance pulls up in front of an ER, it’s never right. And there’s always an element of doubt that the patient might not be in severe condition. But two patients in a single ambulance at 3:15 a.m., it’s definitely not right. I’m still sitting in the cafeteria watching this entire picture with the knowledge that my colleagues will handle. Those two patients are still on their way in through the door that another ambulance pulls up. Paramedics pull the stretcher out. By looking at the attendants of the previous two patients following this patient, I assume that these three patients are related to each other which means something disastrous has happened.

     Okay. Enough! I can’t sit anymore. I run to the ER.

   The whole view of the trauma station has changed. Before I left, it was all quiet and peaceful, and now it’s all uproarious and swarming with people. And that’s the thing about working in ER, the situation is unpredictable. Nothing is for sure. One minute it’s peace; another minute it’s hell. I come to know that they are firearm cases. I see my colleagues tending to the patients. But their hands are full. They need help! I look at the clock, it’s 3:20 a.m. already. I’m losing more diamonds and I’m tired and having stomach ache and my whole body is crying for rest. But I can’t go to sleep now. Can I? Losing all my fortune is worth saving their lives. I buckle up. I put on gloves, cover my face with the mask and rush to those patients. Among the patients is one male in his thirties having multiple firearms in his left leg and a firearm shot in his chest.

Damn! It is going to take whole night now just to manage this one patient. Firearms in different body parts are a sign of how much time it’s going to take. If they are in the limbs, there isn’t much time it would take to manage unless an artery has been breached which is going to take a whole lot of your time. And if there’s a fracture, it’s out of my domain (because I’m a general surgeon). It’s going to go to orthopedic, and that’s a relief. If the firearm is in the chest, the time it would take depends where in the chest the bullet has made its entry. In some cases, the bullet is just beneath the skin over the ribs and that wouldn’t take much. And in some cases, passing a chest tube will do the trick. And in others, you may have to cut open the chest, and that can give you the idea about the time it would take. If the firearm is in the abdomen, that’s a red flare. It means we are going to cut open the patient and depending upon the damage inside, it takes about three to six hours of your time. If the firearm is in the neck, it’s another red flare. And if it’s in the head, it’s again out of my domain and it’s going to go to neurosurgery. And that’s a relief too!

This man in his thirties is in my care now. He’s conscious. Breathing. Responding to my commands. By looking at his chest wound, it seems like the bullet is just under the skin. That’s a good thing and it has saved me from going through a whole lot of trouble. I count six holes in his leg. Probably three bullets have pierced their way in. And by looking at the contour of his leg, there’s definitely a fracture. I check his distal pulses and feel the vibrations of his vessels over my fingertips. They are intact. Thank goodness! So, this case is going to orthopedic, but his vitals are gradually dropping. His BP is falling. He’s tachycardiac and sweating. He has lost a lot of blood through the holes in his leg. Before sending him to ortho, I have to resuscitate him first and make him vitally stable. And I need blood for that. I run to his attendants and ask them to arrange it as soon as possible. As I wait for the blood, I ask nurse to pass IV line and start fluids. That will give the patient enough time to survive until the blood is arranged. A few minutes later, I come to know that this patient has a blood group AB negative and nobody in his family is a match. And they are a long way from home. About a hundred kilometers away.

    I’ll be damned!

This blood group is so rare that people who have this type of blood group are just 0.36% of the world population. Of all the types of blood groups, this patient had to be AB negative. And I live in a country, where there are blood banks but still it is the family of the patient who has to arrange the blood. I go into a state of temporary paralysis. I’m standing still, deprived of sensations, not knowing what to do next and this is the worst kind of feeling when you are losing control. When everything is going out of your hands. And then suddenly, I break. I holler! I holler at the attendants that do whatever the hell you can to arrange the blood because I’m not losing this patient tonight. I have seen so many people losing their lives in this same ER because they couldn’t get the blood in time. I’m angry. I’m helpless. And now I’m sweating and can feel my heart jumping in my chest. I check his vitals every 5 minutes. My eyes are fixed at the monitor, beeping at his head side, showing his pulse and his oxygen saturation. His systolic blood pressure is in 80s now. Pulse is revolving around 120. He’s shivering. Hypothermic. Confused. Slowly closing his eyes. I shake him every two minutes to make him stay awake. All this is happening in front of me and I can’t do anything about it. I’m losing him and I can’t do anything about it! And in that moment, when I have done everything I could, I close my eyes and pray which I haven’t done in a long time.

    OH, DEAR GOD, SAVE THIS MAN. DON’T MAKE HIS CHILDREN SPEND THEIR LIVES WITHOUT A FATHER. DON’T MAKE HIS WIFE SPEND HER WHOLE LIFE WITHOUT A HUSBAND. OH, DEAR GOD, SAVE THIS MAN BECAUSE HE’S TOO YOUNG TO DIE NOW. BECAUSE HE STILL HAS SO MUCH LEFT TO SEE OF THIS WORLD. OH, DEAR GOD, SAVE THIS MAN FOR IF HE IS SAVED, I’LL BE SAVED.

   While I’m holding this man’s hand, praying to the Almighty, my heart still pounding, my body still sweating, I hear a voice.

  THE BLOOD IS HERE!

  WHAT?!

  AB negative?

How is that even possible? I don’t know how the family arranged it, but they did it and I’m grateful. The blood is transfused. I monitor the patient’s vitals every five minutes. An hour later, he’s getting better. He’s no more confused. No more shivering. His BP is coming up. His heart is going back to normal. He’s slowly opening his eyes. I’m relieved. I’m thankful. I’m happy! I see his family and tell them that he’ll be okay, that they need not to worry anymore. Their melancholic faces have a new look now. They are blooming. And to see them like this makes me feel proud. When he’s fully stable, I patch his wounds up and shift him to orthopedic bay for the orthopedic surgeons to deal with his fracture. My work with him is finished. I look at the clock, it’s 07:00 a.m. I’ve lost all my diamonds. My pockets are empty but my heart is alive and filled with solace. I’m tired but kind of feel rested. I’m having body aches, but they are not killing me. My stomach ache has gone. I’m no more sleepy.

    I’m a doctor and this is my life. I chose to live this life because when I was ten years old, I fell down the stairs and had a laceration on my knee which hurt like hell. I was taken to a hospital and the doctor stitched my wound and gave me medicine to relieve my pain. I was new again in a few days. I had no more gap in my knee. There was no more pain. All of it made me wonder about the life I was going to live. I was going to save lives as my profession! And here I am now seventeen years later in a hospital stitching people wounds, relieving their pain, saving their lives. It’s just one incident I have mentioned here which occurred during a few hours of this night and I deal with these kinds of situations every day. I try to save people. Some I do, others I lose. And it’s not just me. I have my colleagues here who work day and night, sacrifice their sleep, their comfort to save lives. We are just like the labourers. The difference is that they are in ragged clothes building houses brick by brick for the people to live and we are the labourers in white coats saving lives of those people.