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Friday, November 8, 2024

Chest Pain

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By Anamol Mani

Sunday

I pulled the curtain and opened the window. A soothing breeze gusted to touch all four corners of my room. A few papers on the table blew off to the floor. 

The sky was like deep blue quicksand, unfathomably spread out before me. The radiant sun rays had added to the color of the sky. My eyes were dazzled by the overt brightness. I blinked and shook my head. With both hands, I combed my disheveled hair and braced myself up. Under the same blue sky, a herd of birds flew past my window and away. If people could fly like the birds, where would we reach?

As a cold breeze caressed me, I closed my eyes. 

When I opened them again,I could see the city scattered with upthrust buildings. Vehicles passed in front of my house. The breeze rustled the leaves on the trees that stood by the side of the road. There came a sweet sound.  

The road I always use to go to the  hospital.

Today, an unusual patient got admitted to the hospital. I was busy the entire day looking after him and treating him. He said his chest was hot, that it burned.He also said that he felt pain in his chest. 

We ran the usual tests. There were no anomalies in the results of blood and urine. The preliminary report didn’t show any problems in his chest. His blood pressure was normal. 

I prescribed Ibuprofen to reduce the pain in his chest. 

Monday

There weren’t many patients in my department today. I went to see the unusual patient.

His eyes had reddened and his eye lashes tangled. His face was unnaturaly dark, lips chapped. 

“Did not you sleep the whole night?”

“No, I could not sleep, Doctor.”

“Why?”

“Unlike during the day, my chest did not burn and there was no pain. But I could not sleep.”

“Your eyes clearly say that you did not sleep last night.”

He kept quiet. My eyes were fixed on him. 

Still, he didn’t look any more serious today. I suggestedhim to discharge himself and go back home. But he wouldn’t listen. 

Instead, he kept rubbing his chest with his hand and said, “Doctor, I want to stay with you, in the hospital.”

“Why?” I said. “There’s nothing wrong with you. You don’t need to stay here.”

“Doctor, all I feel is pain ripping through my chest. Every tear is a shredding pain. It burns. Please. I feel secure here. Please don’t discharge me now.”

I stared into his eyes, as they filled with tears. His face was even paler than before. His forehead got squeezed to a thin fold of skin. He took hold of my apron.

“Doctor, this is nothing but a wound of tears.Please believe me. It burns me from inside, from very deep inside. Kill me please.”

I have treated a lot of patients, but I have never seen anyone like this in my years of practice.

“The hospital is not for death, it is for life. We are here to appeal for life, not for anyone’s death.”

I once again order for his total pathological work up. 

I took off his upper dress to examine his chest with my hands. Even withmy stethoscope,everything was perfectly fine.There were no signs of any type of internal injury. Any kind of injury that had been burning him from the inside couldn’t be detected by my stethoscope.

“Doctor, pain caused this wound,” he repeated.

The patient was curled up around himself.In a fragile voice he said, “Doctor, take another look. Inspect my chest deeply, doctor. There is a big wound, a big wound. Please, please doctor.”

I ordered a CT-scan of his chest. I knew the results of his X-ray already. I checked his torso again, looking for signs of internal infections, perhaps of the other organs. But I found nothing. Everything came out normal.

I kept reading the report. I read it twice, but could not find any problem. “What was going on here?” 

Since there was nothing wrong in the pathological report, I wondered if I should refer him to a psychiatrist. I pondered for a while. If there was nothing wrong in the report, he should be safe from anything dangerous. Eventually, I decided to keep him under observation for a few days in case other symptoms surfaced. 

“Do you smoke?” I asked him.

“No, I don’t.”

“Drink?”

“No, I don’t.” He shook his head.

“No doctor, I don’t do anything.”

“Do you normally sleep well?”

“Yes, I sleep till late in the morning.”

“How is your appetite?”

“My appetite is good. Usually I start my day with a cup of coffee, I eat lunch in the afternoon, and a full dinner at night.”

“So do you workout heavily every morning?”

“No, I am not any sort of athlete. I don’t tend to leave my bed until 8:30 in the morning.”

The conversation ended. I wentout of his room. 

His face was brighter today. 

Tuesday

Today was his third day in hospital. He was rubbing his back on the bedwith pain, rubbing his hand onhis chest and stomach.  He tried to arch up from the bed, screaming.

“It burns, oh, it burns. Please Doctor, I cannot take it.Kill me. Or cut some of my veins to take this pain out.”

He held his chest tightly while he spoke this. Steadily, he became quieter. 

His eyes were pale. I could see tears spilling out from the corners of his eyes.

“What addiction do you have that you have hidden?”

“Why would I tell lies to you? I promise, Doctor, I don’t drink. I don’t smoke.”Looking at the ceiling, he spoke slowly. 

“What makes you suffer and burn from inside, then?”

“Poisonous tears in my heart,Doctor, but you cannot see it.”

I kept looking at him without speaking.

Slowly, he raised his head and looked at me and said, “You must be thinking I’m nuts, but believe me, it’s not true. This is nothing but pain given by tears, I’m sure of it. I knew from the very beginning that you’d be unable to discover my wound.”It seemed as if he was the doctor, not me.”

I passed my hand over my cheek and chin. Looked at him. I tried to smile and said, “Are you specialist now?”

“There is a big pain in my chest. My chest is ripped open and there are holes, each burning and full of painful blisters. Every second, I can feel those blisters burst.”

“How? This is impossible.”

“This is the reality, Doctor.”

“But how?”

He closed his eyes for a while, then opened them, blinking. Rubbinghis lips together, he tried to turn toward the right on the bed. His face gleamed. Stiffly, he seemed to smirk. 

He said, “Unlike usual, that evening she lay on my chest,weeping,and she said she wanted to live with me. She asked me to take her with me.”

Raising his eyebrows, he looked at me. He seemed to be trying to read my face.

Avoiding my look, he furrowed his brow. Heaving a long sigh, he said, “I was unemployed. Do you know the meaning of  unemployment in the city? I did not have a proper place to live. I was hardly surviving. I could not muster up the courage to accept her request.” 

Touching my cheek, I asked, “When did this happen?”

“It happened three days before her marriage.”

His face darkened and he pressed his lips together.

He looked at the wall.

“And what happened?” I asked.

“The same evening, for the first time, I felta pain deep inside my chest.Now she belongs to someone else. It happens in life. It is better that one should try to forget the past.I know that she still loves me. My cowardice broke our three-year relationship.”

His face darkened. Tears filled his eyes. 

“I couldn’t make her mine.”

He fixed his gaze at the wall while he clenched and unclenched.

“You will be fine soon,” I said.”This is all about your psychology.”

Again,the patient closed his eyes.

Wednesday

He mentioned his pain. I gave him the medicines that were required to soothe him. He wanted to tell me something. I gave him my time.

“Doctor, she has entered my heart so entirely that I cannot remove her even though I want to,” he said.”Even in the open wind, under the star-studded sky, I try to forget, but I imagine her. I observe the moon’s shadow, the dew and the dark night, but all I wish is to hold her once more and cry. Thinking about all these things makes me feel that life is uncertain, unclear and deep like night.”

He kept quietfor a while. 

He turned his head towardme. “Doctor, do you ever remember the one you loved the most? Have you ever loved anyone more than yourself?”

I gestured, said, “Hmm.”

He pulled his hair with both of his hands and yawned.

“I don’t understand why she keeps haunting me.She dwells inside my heart like a scar. Why do I remember her so much, even though she’s someone else’s now? Why do I stare in the mirror of the past and hurt myself?” 

I tried consoling him.”It is not good to be so sad remembering the past. You need rest now. Don’t think so much, take rest.”

“That’s very past is creating this problem. It does not allow me to take a rest, Doctor.”

“Don’t think too much.”

“I try my best to not think about anything, but as the pain begins, I remember that day when she cried leaning on my chest.”

I just looked at him.

He said, “Do tears contain any acid which goes deep down to the chest and cause this burning and pain?”

“No, tears do not contain any acid. It is just a medium to express one’s woes. It does no harm to the body.”

Raising his eyebrows, he also raised a finger. I am commanding voice, he said, “There is certainly something in tears, doctor. You should never let your beloved lean on your chest and cry, Doctor.Never let your lover cry over your heart.”

Friday

The nurses told me that he had been suffering even worse since the morning.

I entered his room.

He was rubbing his chest in slow circles.His eyes look like red. His eyes had swelled and his hair was uncombed.His body trembledso, not even two nurses could control him. Before I could do anything to normalize his condition, he layprostrate on the bed,holding his chest, his hands and feet stretched out tautly. 

Hewas breathing faster. Making aface, he moved his head and became restless for a while. After sometime, he became still. 

Examining his heartbeat and pulse, the nurse said, “It seems his heartbeat has stopped, Doctor.”

I pulled out my stethoscope to check for myself. 

His eyes were closed, his lips tight together.

Many patients die in front of a doctor. Many patients have died in front of me. His death was different.

I could not diagnosehis illness. The only complaint he had was that pain in his chest.

I felt the heat from inside my body. I could feel the sweat onmy forehead. 

A question lingered in my mind.Was it the tears of his girlfriend that caused pain in his chest?

When I wrote his death certificate, the letters jumbled up on the paper.

“Please send him to the morgue,” I said to the nurse and left. 

I could see a few drops on his chest that looked like sweat.

Saturday

This is the second day of his death. It would have been the seventh day sincehis admission to the hospital. The room where he stayed is empty and lonely now.

No matter how hard I tried, I couldn’t find the cause of his pain. All of thistechnology at our disposal, yet Istill could not discover his problem. Why did he getbetter for a time and then fall severely ill the next moment? Everything looked so normal when he was checked.

Maybe there are invisible wounds inside every person, wounds that science cannot discover. Was that pain truly caused by his lover’s tears, like he said? CT-scans, X-rays, nothing worked.

Was it really the tears? 

With this post I hold, how did I fail to discover his true illness? How does a patient die with no visible wounds?

Indeed, there is always room for new innovation in science. But it is the failure of doctors when a patient’s disease isn’t discovered, when a patient can’t be helped.

I’m thinking that death challenges Science to open other ways toshow the wounds, invisible ones.

Sunday

“How can this happen?”

While I was approaching a new patient’s room, I heard a womantalking from inside.

“Before dying, he said his chest was wounded by the tears of his beloved,” she continued.

“Exactly,” a second voice replied.”Really, do the tears of love, hurt the chest or the heart?”

I recognized them as nurses.

“It should not have happened,” said the first nurse. 

“Yes, if the tears of one’s beloved can make such a wound, then there would be many in the world who would carry such injuries.”

“But people say that uncanny things happen in love.”

“Yes, the entire world revolves around love.”The second nurse spoke in a soft voice.

“Seems the world exists because of love.” 

“Did you hear his story?That his beloved laid on his chest, crying, and how that wounded him, deep inside? That he died from wounds inflicted by love?” 

“Look at her,” said the first nurse. “If there were no love in this world, why would shefall unconscious when she heard the news of his death?” 

The second nurse said, “Is it true, do you think? That her tears infected his heart?”

I entered the room at that point.

“Doctor, you’re here.”

It was the first nurse. She was arranging medicines in a cart.  Probably getting ready to go to the next ward. The secondnurse was standing with a pen and a file in her hands beside the window. They were facing each other while they talked.

“Look here, Doctor.” The nurse gave the file to me before I even looked at the patient.

“Did that patient, the one who died, did he have any relatives?” I asked. 

“Yes, there is a middle aged woman,” the nurse replied. 

I thought his words. Maybe the woman who is here is his beloved.

“And?” I asked.

“She fainted when she heard about his death.”

“How is she now?”

“Pulse rate is fine, as well as blood pressure. But she is still unconscious.”

“Okay.”

I moved toward the patient.

The bed was waist-height. The patient was covered up to her stomach with a green blanket.

Many things happened at once—my chest became heavy, sweat appeared on my forehead and my bladder felt too full. I lost all strength in my legs and my hands. I felt a sudden pain in my head. Something started boiling inside my head. My ears stopped up. 

I felt a tremor in the patient’s bed.

My hands weretrembling. My lips and tongue were dry. There were beads of sweat onmy face. A lump got stuck in my throat. I stood, rooted, in front of the bed. 

I heaved a long sigh. I turned aroundslowly and stood by the window. 

I rubbed my eyes. I pulled out a handkerchief and scrubbed my face. I held my head with both my hands, closed my eyes and turned my head upward. 

When I opened my eyes, the sunlight dazzled me. When I saw the sky, I felt as if I was in a void. I could see smoke far away onthe horizon. 

The first nurse asked, “Doctor, are you okay?”

I could not speak. I could not focus my eyes on what I was seeing outside.

The second nurse said, “Doctor, what happened?”

I slowly turned around. I could not face them.My body felt become heavy.  It was difficult to take even two steps toward the bed. I reluctantly walked toward the head of the patient. The tears lingered in my eyes. 

The nurses were staring at me, wide-eyed. 

“Doctor…do you know who she is?”

When I heard the question,my heart felt blank, empty.Something heavy gripped my chest. 

I closed my lips tight. I caressed the patient’s forehead and I combed her hair with my fingers. 

I said, “She is my wife.” 

[Anamol Mani is a Nepali poet and storywriter, now based in Canada. Also a journalist formerly associated with the Kantipur daily, Anamlol Mani has written extensively and has been received quite well. His major works include Neelima ra Gadha Andhyaro and Unnais Number, both collections of short fictions, while Sabut is a collection of his poems. He had edited Aajaka Nepali Katha, a collection of stories by  young Nepali storywriters.] 

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