Cancer, Starvation and Happiness.

A wiry old man sat mute in front of me and looked on as I read his case sheet. His wife sat next to him in a blue nylon saree and was almost as thin as her husband.

“He has throat cancer and can’t eat, that’s why he is all skin and bones.” My senior muttered, after taking a quick glance at the case sheet.

“Her husband has throat cancer, that’s why she is all skin and bones.” I thought to myself.

He was wearing a grey baggy shirt that once used to fit him right but could now fit two of him. His bony arms rested, without weight, on the doctor’s table and the skin on his face was stretched thin along the outline of his cheek bones. The hair on his balding head wasn’t as white as I would have expected it to be.

Right next to his sunken cheek and over his dry wrinkly lips sat a black bushy moustache.

An untrimmed masculine moustache that sat proud on his hollow face.

“This is definitely not a dying man’s moustache.” I thought.

The case sheet had many pages in it and each page had notes in different handwriting. I looked at the man, his wife, and the case sheet I held multiple times.

I was holding years’ worth of pain.

The papers were written with blue and black ink, but his story bled out of them in shades of red.

His chronicle of suffering was coming to an end and they knew it. They were not here for a cure, not at this time of the night.

They were here because the tube that was inserted down his nose, bypassing the lump of cancer that closed his throat, to keep him fed, had come out accidentally.

They were here so that starvation wouldn’t get him before cancer did.

In the last 3 hours, many residents tried to snake a tube down his nose. Emergency medicine referred him to the ENT duty resident, and when even they failed, they referred to the Medical Gastro resident, but to no avail. They had sent him back to emergency medicine, where I, a mere intern was burdened with a task that many above my level had failed.

The room seemed to be growing smaller and the silence grew louder by the moment.

“Try da” My senior said, before turning his attention to the patients who could be saved.

I gloved up, grabbed a nasogastric tube, and coated it with anaesthetic gel.

His wife folded her hands and prayed before I started pushing the tube in, her eyes turning skyward. I was glad that she wasn’t looking.

The old man looked back at me in silent submission as he positioned his face exactly as he had been taught.

There was no hope in his eyes.

In fact, there was nothing in his eyes.

He grunted a little as I took my time, slowly moving the tube back and forth down his nose. I could feel the resistance at the end of the tube. The cancer was fighting back.

I stopped when he gagged and pulled the phlegm covered tube out.

I looked apologetically at both their faces. They looked back helplessly, but without blame.

I took another tube and asked their permission to try again.

The cancer seemed more adamant this time, but instead of forcing my way through, I tried shimmying the tube around to find a way past the tumour.

It took me a ridiculous amount of time, but the tube moved ahead.

I didn’t celebrate, not yet. The tube accidentally went into the windpipe instead of the food pipe in many difficult cases and I wanted to make sure that this wasn’t the case.

We took an xray and to my surprise, it was indeed in the oesophagus. I secured the tube with a million additional plasters and scribbled down some notes.

His wife thanked me over and over, her eyes wet and her hands still folded. She smiled a tired smile of reprieve.

He didn’t smile, but his eyes were no longer empty.

Happiness comes in different shades, I guess.

This one came from a lubricated tube that would let an old man die without hunger.