Saturday 15 August 2020

Tarun Chakraborty, Short Story 2020, Featured Writer

Happy Mother's Day

10th May, 2020:
[Maa, you have suffered greatly, endured greatly which cannot be put into words and so I saw the light of the day. Yet, I am trying to describe that after such a long time and know that it is reaching out to you wherever you may be this day. Happy Mother’s Day.]

The Second Sunday of May, fifty years ago, without knowing that this day of the year would be called ‘Mother’s Day’:

Surprisingly, I am the sole passenger inside the belly or the fuselage to be more exact, with neither a crew member nor an air hostess. For that to happen, it would have to be either my own private jet or a chartered aircraft exclusively for me. Yet, why is it depriving me of that fascinating sensation which comes from coasting in the air for the first time? I am unable to peer out into the breath-taking beauty of the Earth below as darkness surrounds me. A parachute instead of being harnessed on my torso in the right manner, encapsulates me within its membrane as in a balloon. Only the back strap of the harness that is stuck to my seat’s back-rest prevents detachment and falling off. The airplane is flying smoothly high above the fairy land of powder puff clouds and gliding through the thin air like a bird. I can feel it. Then suddenly something goes wrong. Anti-Aircraft gunshots fired from the ground crack into the air. Shrapnel whizzing past the aircraft explodes, in a manner a meteorite bursts inside-out before touching the earth. A flying projectile punches a hole on one of its wings which also is a fuel tank and other rips through an engine located at the wing’s thicker front edge. The airplane has been shot at by its own territory’s anti-aircraft gun. A gun that is meant to protect this aircraft from enemy invaders has misfired on it, taking it for an enemy intruder— a case of mistaken identity. Fragments of metallic debris are shooting out from the wrecked Turboprop engine. Fuel is gushing out from the punctured tank. The airplane while cruising with only one engine and an oil tank on its unaffected wing is losing altitude fast and in matter of seconds plunges thousands of feet below to a level of normal air pressure. The pressure inside the cabin, which was already pressurised for flying at rarefied air at a high altitude, has shot up to an unbearable level due to clogging of pressure relief and outflow valves by fine particles of debris. The airplane is now finding it impossible to stay afloat even till an emergency landing, without jettisoning or throwing out some amount of excess load— that like ‘the last straw just going to break the camel’s back’, happens to be me only. With the damaged wing intermittently fluttering like that of an injured eagle, the whole body of the imbalanced twin engine airplane then starts shuddering like a washing machine in between brief spells of stillness. A severe jolt detaches my balloon rupturing the fastener strap from the back rest. The floating balloon that terrifyingly keeps on bumping has to be ripped out of the airplane in pieces, or else nosedive into the ground to end up everything in flames. Neither the airplane survives nor its sole passenger. The dilemma of ‘either-one-or-none’ baffles ground staff conferring in the Air Traffic Control. This hellish plight continues for some more time and then some miracle happens I know nothing about. All of a sudden I feel a savage push, as if from a huge squeeze on the fuselage resembling a toothpaste tube. The whole aircraft rocks like a hurricane for an instant. A door is flung open in front of me and another brutal thrust ejects me out heads down facing the airplane. As I start falling freely in the air like a skydiver, the parachute opens. Wind roars around me. It is a bright sunny day with the sky as clear as crystal glass. From the open sky, I peer out into my new world down below. It looks wonderful. I peer back to the aircraft for a brief second to see it speeding away for a safe emergency landing. Miraculously both are saved. I descend as slowly as a feather dropping freely in air from a soaring eagle until I softly touchdown to see mom sitting on the sun-lit, lush-green meadow in her agonising wait for me. 

“Maa, look at me, I have come down to you from the sky by an airplane just as you had once told me,” I cry out. Teary eyed she gazes at me and instantly forgets all her torments. Her soul smiles through her eyes that scatter an inexplicable glow that any analogy howsoever nonsensical, fails to capture. That is the joy of motherhood. My daydream ceases…

Indeed, that was a daydream and not a dream. The one-hour morning flight from Calcutta airport to Guwahati was too short for falling into such long dreams. That was my first air travel. My first year final exams at IIT-Kgp just being over, I was on my way to spend the summer vacation where dad was posted then— AF station situated on the Shillong peak, which is also the headquarters of Eastern Air Command. A hill station during summer! I felt thankful to dad for going there on posting during my first year. I would be seeing mom a year after she cried buckets while seeing me off, as though to a School’s Boarding-House and not to any 'Hall of Residence' of an ‘Institute of National Importance’. It is all the same to a mother. And I would be seeing dad after he last saw me off in the Hall saying— “Remember that you were pronounced dead before you were born, yet you have come up thus far. So, you have nothing to be afraid of.” These parting words concluded that incredible birth story he began narrating to me on way to Kharagpur, leaving me wondering what kept him from telling all these to me until the panic of the imminent ragging started showing on my face. Perhaps I would have grown a bit bolder, a little more forward, rather than turning into a shy, timid and withdrawn PCM buff. Nevertheless, that feature alone saw an average like me through the IIT-JEE just in time, rather than missing the bus in an attempt to become all square too early. Five years at IIT or even the initial years at a job for that matter were there to take care of all that. Possibly that was more practical for a feeble ‘preemie’ like me.

As the airplane rose higher and higher in the air, (now that I am in Engineering,) roads appeared like strips of black tapes and rivers like thick aluminium wires to my eyes, looking from the aeronautical womb. And with that, mom’s reply— “You came down to me flying down from the skies in an airplane,” whenever I asked her, “Where did I come from?” kept on ringing in my ears. My absurd daydream went on stretching out further and further to cover whatever that could have occurred in reality. Mom’s evasive answer was good enough for a child to swallow, but not anymore for a sophomore like me, who out of curiosity, has dug out enough tips on this issue.


Now I know that the exact medical term for the homophone- ‘Ek-Lamp-Asia’ going into my ears in a configuration that a child could make any sense of, is in fact, ‘Eclampsia’- a dangerous condition of pregnancy, like the dangerous condition my wild daydream got the airplane into.

Pre-Eclampsia is a complication more common during the last trimester or the last three months of pregnancy, with symptoms such as build-up of high Blood Pressure— like the high cabin pressure of the airplane, together with high Proteinuria— like fragments of wreckage debris gushing out along with the fuel. But unlike common Hyper-Tension, Eclamptic high BP is caused when the antibody of mother's own immune system attacks its own placenta, mistaking it for a Pathogen or a foreign body, an enemy intruder such as virus and bacteria. That is medically an ‘autoimmune disorder’ or metaphorically ‘a case of mistaken identity’— like the territory’s defence force’s anti-aircraft gun shooting at its own airplane which intends to protect against enemy infiltrators. The only known way to cure preeclampsia is by prompt delivery of the baby prematurely, either through induction of labour or C-section— like immediate jettisoning that last straw from the airplane. But when delayed, Pre-Eclampsia can rapidly progress into full blown Eclampsia where the complications aggravate further, added by seizures and convulsions or vigorous shaking of the body occurring in between erratic gaps of deep coma— like violent shuddering of the airplane in between erratic spells of stillness. That potentially becomes a life-threatening situation both for the mother and the unborn child. Further indecision at this stage pushes it to the worst-case scenario with ‘placental abruption’, when the placenta gets detached or jerked out from the inner uterine lining before delivery— like detachment of the ‘balloon’ by rupturing its fastener strap from the back rest. Abruption results in severe haemorrhage or bleeding from the torn tissue, to the extent of both ending up in the ‘funeral pyre’— like nose diving of the airplane into the ground to end up everything in flames, unless some miracle happens. Flustered medical staff is conferring in the labour room— like the baffled ground staff conferring in the Air Traffic Control…

That was exactly the scenario from where dad had begun narrating his version of that incredible birth story on our way to where would be my first address of staying on my own away from home. And here is my own version of it, after digging out the related ‘medical terms and facts,’ seeming bland in his otherwise absorbing account of the connected events:

On a clear mid-September morning in the early fifties at Kanpur cantonment, powder-puff clouds lazily drifted on the autumn sky with no apparent signs of an untimely wind storm. A new life form throbbing inside her made mom feel euphoric like gliding high in the air, with no apparent signs of warning that a storm was brewing within. Nor anything remarkable was detected during the prenatal check-ups earlier to indicate what was to come. He had been feeling delirious with the expectancy of soon becoming three from two in the camp-household far away from the native town. Then suddenly everything seemed to turn upside down.

That particular morning she woke up much earlier than usual feeling restless. She complained of seeing spots in front of her eyes and having a bit of a headache and nausea. He was worried and wanted to stay at home for some more time. But she declined, taking these things as normal to occur at this advanced stage, which would go away if she had another round of sleep after he set off for the aerodrome. But just when about to leave he saw her wobble dizzily, he sprung forward in a reflex action and held her before she could hit the ground disastrously. She fell unconscious in his arms. The apparent depth of her unconsciousness, the irregular breathing, the bounding heartbeat that he could feel, told that something very grave had happened. An ambulance rushed from the nearby Medicare Centre. Yet, by the time the rear panel of the military ambulance was opened in front maternity ward of the AF Station hospital, she was already in the ‘worst case scenario’. A flurry of activity burst out as the medical orderlies whisked her away, finding it hard to retain her on the stretcher while under seizures and haemorrhage. Stunned at the terrible turn of events, he paced along with them in desperation till the door of the antenatal ward was forcibly shut before him.

She was diagnosed with ‘Eclampsia progressed into its terminal stage,’ in the space of just an hour or so, without even conceding the least attention time to its preliminary stage that would have responded to treatment. The only known prognosis was maternal and prenatal mortality for sure in those days.

She was immediately put on respiratory support and a mouth wedge inserted to arrest tongue laceration. She was given anti-hypertensive injections to control blood pressure. Infusions of Magnesium Sulphate was administered intravenously for calming convulsions like ‘pouring oil on troubled waters’ by Benjamin Franklin for quelling sea waves in storm. But even then, she had violent convulsive seizures and when it subsided, a deep coma would follow, to be followed by another convulsion, which would be terrifying to see, only if his eyes could meet all that while he hopelessly peeked through the window pane into the makeshift darkened enclosure prepared especially for her with partitions at one end of the eight-bed ward.

Though just enough to run elective or scheduled surgical procedures by only pre-booked specialists drawn from a small panel of surgeons shuttling between several hospitals, this AF station hospital was not as adequately armed for an unforeseen situation of such intensity.

But fortunately, not everything over there was as dismal or gloomy. On the brighter side, a real-life couple of Gynaecologist and Obstetrician (ObGyn), Dr Joshi and Dr (Mrs) Joshi, both from the Army Medical Corps (AMC) were very much present there.

Dr Joshi, by virtue of his posting as the Administrative Chief was rooted there, unlike other floating doctors. And so was Dr (Mrs) Joshi, who too was grounded there by the reason of her being the regular ObGyn at the OPD.

All looked puzzled except Mrs Parker, the middle-aged, Anglo Indian matron, caring yet firm, tender yet unyielding in her dealings, which made her vulnerable to recurrent transfers. Destiny seemed to have placed her here at this very moment for a different cause.

Left alone entangled with the darkest fears, no message either good or bad came out from the other side of the swing-door apart from the sound of a scuffle faintly reaching his ears, whenever nurses holding kidney dishes busily swung it open or close. What was going on? The uncertainty only served to make the wait seem even longer. Morning was almost wearing on to noon when the doorknob turned.

“Our matron is calling you inside,” a nurse hurriedly led him inside the anteroom that preceded the antenatal ward. He followed prepared to take the worst. His feverish eyes scanned the room until they fell on the figure of a lady in hospital uniforms, standing in prayer with folded arms before a wall crucifix in one corner. He took a few swift steps and stopped as though transfixed on the ground at hearing her loud whispers, “Save the child, save it from the butcher”.

What was happening? Even if it was taken that she was not overdoing her role as a Matron by praying to God for her patient, what she was muttering struck him as a terror adding on to the prevailing agony, trauma and suspense. What more was to come?

The matron turned towards him. Her demeanour put him at ease.

“Get this drug from anywhere in the town-- Just anywhere. Don’t worry about the money. For military prescriptions it can be adjusted later on. Hurry up, or else...” she handed him a prescription bearing the signature of Dr (Mrs) Joshi, the lady Obstetrician along with the name of a drug.

“Or else what?” he blurted out realising that the implications of what she couldn’t bring herself to tell must be very grave.

“Or else, you’ve got to sign these papers of consent to permit that mindless gynaecologist Dr Joshi to become an abortionist and rip the baby out in pieces to save the mother,” she disclosed the inevitable pointing towards the papers on the table in such a tone that sent him right away racing for the miracle drug.

While nobody needs to be explained what a modern Stethoscope is, a Pinard-Horn is a trumpet shaped wooden device with a uniform end-to-end hole. The practitioner places its flat end-disc on the ear, while the horn’s hollow end is moved around on the pregnant mother's abdomen for directly listening to baby’s heartbeat in utero.

A Fetoscope is a Stethoscope with its chest-piece replaced by a smaller version of Pinard-Horn that picks up the sounds and transmits to the ears through the tubing in the same manner.

Listening to the sounds from the heart, lungs or other internal organs, with a stethoscope is medically known as auscultation, whereas palpation is the process of using one's hands for feeling an object, such as a tumour inside the body with the sense of touch which Mrs Parker did instinctively.

All that drama had been unfolding here during a period when ultrasound was still under experimentation as a diagnostic tool even in the developed countries. Hence, the Fetoscope— a combination of the modern Stethoscope and a ‘Pinard-Horn’, that didn’t require ultrasound to listen to the baby’s heart-beat, was the best auscultation devise in their hands in the given scenario.

However, like an ‘eye of a storm’, only those intervening spells of stillness in between bouts of seizures provided that calm slot to the Fetoscope for picking up the foetal heart beats. But the Fetoscope drew a blank for the second time in succession.

“There’s no heart beat,” Mrs Joshi’s voice quivered as though her own heart had skipped a beat.

Ears of the midwife as well as the surgical nurse picked up nothing, as they took turns one after another, while Mrs Parker, the veteran Matron stood and watched silently.

“Mrs Parker, would you now try your ears at that,” requested Dr Joshi, eyeing the Fetoscope on the surgical trolley-cart, lying among other delivery appliances like— Amniotic Hook, Haemostat, Forceps, Sutures, Speculum, surgical gloves, sponges and cotton swabs.

“Please don’t show that to me. Even the cardboard spool of toilet-paper roll can serve the purpose of listening to heart beats, only if one understands the position of the baby’s head simply by palpation first,” Mrs Parker undermined them in a huff, sore at her relegation to fourth in the order.

She applied all her tactile skills in palpation and then held the probe precisely on the specific location expecting to be greeted by a faint heart-beat. But nothing got conveyed to her ears through the tubing as to ‘save her face’ after she had made all those boastful claims. She heard nothing, not even as faint as the ticking of a wristwatch under a pillow.

Nevertheless, her ears or anybody else’s for that matter, failing to perceive those decibels was no reason for the infant’s heartbeats however faint, not to exist, she reasoned. But the very next moment, intuition far removed from logic eclipsed her reasoning, when out of nowhere ‘silent screams’ seemed to reach her ears, as though the baby was still alive but in distress, medically called foetal distress. An electrifying feeling! Yet she retained her poise while straightening up, bearing a tender melancholy towards the tiny unborn bundle— so helpless, so vulnerable, so defenceless. How sad that a heart that had throbbed so vigorously inside the mother’s womb until this morning, should now be called upon to prove itself by sending out a beat that could be heard by these insensitive people, or else get lost forever without seeing the light of the day…

Yet, I saw the light of the day instead of being consigned to darkness forever, because someone had the backbone to defy authority and the courage to speak up for me. I woke up to life instead of being put to eternal sleep, because someone placed ‘clinical haunch’ above ‘clinical diagnosis’ when the two were in conflict.

“Do you need a hearing aid, Mrs Parker?” mocked Dr Joshi.

“To hear we always don’t need real sounds to hit our ear drums assisted by a hearing aid,” replied Mrs Parker, “I’ve heard the baby’s silent screams,” she said gently in reply to his caustic remark, not losing her cool.

“Was it your third ear, something like the third eye, Mrs Parker?” Dr Joshi joked.
“Not just third, it is my thirty-third year into midwifery, may be since you were in school, Dr Joshi. It just came out of nowhere and I’ve heard it. Can’t explain how. Not trusting my gut feeling will be a blunder,” Mrs Parker stood on her ground.

“Do you realise that another two convulsions at the most and the mother will die too,” Dr Joshi warned in a grave tone.
“What do you mean mother ‘too'?” Dr (Mrs) Joshi, who was silent until then asked.

“All four out of four here, who are ‘medically certified for auscultation’, have not heard any foetal heart-beat. So, the objective conclusion should be that the baby is ‘stillborn’ and it needs to be ‘evacuated’ immediately to save the mother. So, better prepare for the surgery,” Dr Joshi who was the ‘Chief Surgeon’, officially addressed the surgical team that included his wife in the role of Assistant Surgeon.

“Prepare for surgery or butchery? Your diagnosis is suspect. I decline and so will the midwife and the other nurses with me,” retaliated Mrs Parker sharply with a glint of open defiance in her eyes and stood like a barricade beside the patient cot. She uttered nothing more, only glared at Mrs Joshi, telling with her eyes to take over the baton from her in the confrontation.

It was not surprising that an ‘extraordinary’ birthing situation should arouse such ‘out of the ordinary’ reactions, when even normal situations invoke their own measure of agony. And all this is because of the fact that, even normal birthing experience has never been without its own share of pain and agony for humans. But, why has a natural phenomenon like giving birth to an offspring never been that easy?

This is due the hypothesis called ‘Obstetrical Dilemma’, arising from nature’s need for striking a balance between two conflicting evolutionary demands at the same time— Human intelligence (demanding bigger head size) versus bipedalism (demanding narrower hip size), for which the female hip-bone compromised on a narrower size— a trade-off that gave a ‘tight fit’ to the skull at the narrowest cross-section it has to pass though en-route this world. This is the simple ‘mechanics’ behind all her pains and agony on the verge of attaining motherhood, eulogised over the ages.

Hence unlike other primates, becoming a mother has never been and never will likely be an easy task for humans. Yet, no woman needs to be taught how to give birth to a baby. Nature has put her airplane on route to motherhood on ‘autopilot’. Right from conception to birthing and post-delivery, the sequence of commands that her specific organs spontaneously follow are hardwired into her endocrine system. A hormone is a ‘biochemical messenger’ that is produced by an organ somewhere in the body, travels through the bloodstream to reach its specified ‘receptor’ on a distantly located target organ, and then tells it what to do. There are some other hormones too, which unlike travelling messengers are locally manufactured at site ‘as and when needed’.

For example, the process of birthing is spontaneously triggered at full term, when the baby’s head pushes against the cervix, causing it to stretch. This stretching causes nerve impulses to be sent to the brain. These nerve impulses cause the brain to stimulate the posterior pituitary gland to release Oxytocin hormone into the blood stream. Oxytocin released travels through the bloodstream and attaches itself to the ‘specific receptor membranes’ of the uterus and tells them to initiate contractions.

Accordingly, the walls of the uterus contract or shrink, thereby making the head to stretch the cervix further to release more Oxytocin. The cycle goes on and on, boosting the push further and further in a positive feedback loop. This is what happens after ‘going into labour’.

This is comparable to the turbocharger of my ‘daydream aircraft’, I began this story with. Hot exhaust flow from the engine, instead of being thrown out directly, is ‘fed back’ to the turbocharger to spin a turbine-wheel, which in turn spins a compressor-wheel. This compressor in turn compresses and delivers more amount of fresh ‘combustion air’ for the same volume, and with it more fuel, that delivers more power in a ‘positive feedback loop’.

If a toy or party balloon is any analogy for the uterus, then a ball entrapped inside the balloon is the baby’s head and the tubular neck, jutting out of the balloon and ending in a stiff rim, is the cervix. If the goal in this party game is expulsion of the ball from the balloon by squeezing it down, then the aim in natural-birthing is similarly expelling the baby from the uterus, through the cervix into the birth-canal. But this is only a fraction of the total interplay between the parturition hormones.

To begin with, a hormone called ‘Human-chorionic-gonadotrophin’ (hCG) enables her to recognise the presence of the embryo and begin its automated progress towards birthing. In response, a big player in this interplay of hormones— progesterone, initially produced in the ovaries and later in the placenta, comes into play. This hormone initially maintains blood flow to the womb, manufactures nutrients to sustain the early embryo and produces the decidua, a unique organ by which the embryo attaches itself to the inner wall of the placenta. As the foetus grows, decidua gets stronger to enable clinging, until auto-detachment at term delivery or preterm-detachment in case of an unstable pregnancy— like that severe jolt rapturing the fastener and detaching the ‘balloon’ in the airplane analogy of my story. Also there is enough evidence to suggest that, following conception, another hormone termed ‘Corticotrophin-releasing hormone’ (CRH) in the placenta, purposely supresses the mother’s immune system, to the extent that it does not mistake the foetus for a ‘foreign body’ and attack it, like the analogy of antiaircraft gun attacking territory’s own aircraft. The foetus nestled inside the depth of the womb is otherwise safe in a ‘stable pregnancy’.

Now, just imagine in that balloon analogy— that the ping-pong ball progressively grows up to the size of a billiard ball and then to the size and weight of a ‘junior short-put’ ball, to which the head-size and weight of a baby in-utero nearly equals at full term. The tubular neck jutting out from the balloon must be sufficiently stiff or un-stretchable, to hold load of the ball. Also, as the ball enlarges, the physical stress and strain it exerts on the balloon’s wall is on the rise, which it must be able to withstand. The same is demanded of a uterus for a ‘successful pregnancy’. Progesterone accomplishes these two tasks by thickening the inner lining of the uterus and structurally maintaining the ‘load-bearing capacity’ of the cervix till the end of gestation. But at full term, these same set of conditions which had maintained pregnancy until then, must be ‘reversed’ in order to accomplish the process of ‘natural birthing’. Prostaglandin, the next player in this game, (a hormone created at ‘work-site’), accomplishes this task by transforming the uterus walls from ‘firm to flexible’ to enable contractions and the squeezes. Prostaglandin also affects structural modification the cervix causing— thinning out of its walls (effacing) and ‘shortening’ it elastically, thereby widening the opening (dilation), till the ‘outward force’ exerted by the baby’s head overcomes the resistance faced, allowing passage of the baby from the womb to the outside world through a ‘favourable cervix’. This is looking at Biology from an Engineer’s point of view.

These hormones are only to name a few. But what is true for all of them is— just as a natural hormone produced endogenously, accomplishes certain tasks, so also do their synthetic versions or analogues, produced exogenously.

At that point of time when this story was unfolding, the synthetic version or analogue of Oxytocin, that mimics the natural one, had just found its way into the country under the trade name Pitocin. Its role as a therapeutic agent to induce or augment labour for ‘term delivery’ and initiation lactation after childbirth were known and also as a fall out from this, its non-therapeutic role or abuse for ‘milk-ejection from dairy-animals’ came to be known. However, though natural Oxytocin’s role as the hormone of love, bonding, empathy and ‘feel-good’ was known, it was not certain whether its analogue’s role or abuse as an addictive ‘mood elixir’ had come to be known.

In that airplane analogy, if a simple push on its ‘push-button starting switch’ for triggering the engine’s self-ignition is comparable with a push by the baby’s head on the cervix for triggering spontaneous contractions, then use of synthetic version of Oxytocin or Pitocin for artificially inducing contractions is comparable with ‘jump-starting’ the airplane using an external battery called ‘Rescue Booster Pack’. Under the conditions prevailing in the delivery room, synthetic Oxytocin could at least serve like that jump-start, in absence of self-excitation from the natural version at preterm.

Now, coming back to the delivery room…

C-section, the easiest option, like jettisoning some amount of load from the airplane, was ruled out for reasons of the likely blood loss in the procedure itself to gain access to the baby, after it had already suffered placental abruption with significant haemorrhage. Adding further to the constraint was the on-call anaesthetist's total inexperience in ‘administering anaesthesia to a comatose patient for C-Section’, which was still a subject of dissertation in medical journals.

Under those uncertainties, the way the low tone consultation between the flustered OBGYN duo, Dr. and Dr. (Mrs.) Joshi erupted into a heated argument, with scowling faces, pointing fingers and adrenaline rushes, it gave no inkling of their oxytocin rushes while sheltered in each other’s arms like love birds the night before. Voices raised and pitches soared, while each one of them tried to assert one’s point of view in a perfect model of ‘role-playing’:

“How do you go from saving lives to taking lives, Dr Joshi?” she was quite vocal on taking over the baton from Mrs. Parker, who along with the midwife got engaged with the patient, unseen behind the curtain around the cot.

“Mrs Joshi, the baby is stillborn, which means death inside the womb from 20 to 28 weeks of pregnancy at which it is now and even if taken remotely that it still has some life left in it, I am licensed to perform the evacuation if it becomes absolutely necessary in the interest of saving the mother,” he showed his powers.

“Doctor Joshi, ‘showing no signs of life’ and ‘being dead’ do not mean the same thing. Evacuation, the option going on in your head will only end up killing both at such an advanced stage of gestation. So, expulsion by induction will be a safer procedure medically,” she contradicted.

“But, however dangerous, the risk of immediate evacuation outweighs the risk of your lengthy procedure whose duration neither mother nor baby survives,” he warned.

“But, however dangerous, the risk of inducing, even if the duration shoots up to more than 72 hours, outweighs the risk of such late term evacuation,” she asserted.

“And what kind of a normal delivery are you pestering me for, until its abnormal foetal ‘presentation and position’ is moderated to ‘heads down and facing the mother’s spine’ Mrs Joshi?” he revealed.

“And what kind of an evacuation are you vouching for while the patient is in coma, and cannot be given full anaesthesia as to not wake up during surgery, Dr Joshi?” she disclosed.

A silence fell. Flustered under moral dilemmas, first things didn’t strike them first. It happens. Their eyes met calmly, seeking compliance. But turning from being defiant to compliant over the next course of their exchanges it came out that: The synthetic version ‘Pitocin’ was only used to artificially induce labour in elective cases, when labour did not start spontaneously at full term or upon overshooting it. For planned cases, just the requisite dose was requisitioned from Command Hospital, where it was not there now.

Furthermore, premature induction requires much larger doses of the same induction agent or Uterotonic, for reasons of relative of paucity of Oxytocin receptors on the pre-term uterine walls as well as for the larger duration.

Moreover, after artificially inducing labour with Pitocin, the next set of cascading events like softening, ripening, dilating followed spontaneously at full term only, with Prostaglandin hormones getting released naturally. But this spontaneous effect does not follow artificial onset of contractions with Pitocin prematurely or before full term.

To top it all, synthetic analogues of Prostaglandin, that could initiate this effect artificially, were yet to be synthesised in laboratories. So, in absence of a purely non-invasive pharmacologic regimen, they had no alternative other than resorting to age old mechanical methods. Skill on such invasive methods among those present there, comfortable with routine procedures only, was also very much in doubt.

Feeling lost, they unwittingly looked in the face of Mrs Parker, who came out from behind the curtains just then.

“While listening to all that was passing between the two of you, the midwife and I have fixed all your doubts. Now just like a shot in the air when the preconditions are ready, try to get that inducing agent in the requisite doze for IV infusion, just from anywhere and within three hours at the most, or else, let Dr Joshi take the floor,” Mrs Parker recommended. That was at least better than killing or letting die from incisiveness. While Dr Joshi walked out to make the papers ready, Mrs Joshi wrote and handed a prescription to Mrs Parker.

“I know there is only one person in this world who will move the mountains for the magic potion,” her voice quivered as she walked towards the crucifix...

“My nerves racing, I madly pedalled from one corner of the town to other,” Dad hastened his narration as the destination neared, “I dashed into pharmacies and clinics, knocked on doors of maternity centres or even abortion clinics to which I was guided and whose existence I wouldn’t have otherwise known. But nowhere was it there. I even met with suspicious stares. Yet I carried on the hunt and time was running out. Suddenly, I suffered a blackout and fell down unconscious on the street. When I regained consciousness, I opened my eyes to an unknown person sprinkling water on my face. I faintly heard him telling the bystanders around me to move wider to let in more air and that he knew how to resuscitate, being a medical representative himself. I sprang up to full awareness. No further resuscitation was necessary. I showed him the prescription. He rummaged through the contents of his MR bag till he came out with a flasket containing vials of the panacea. He handed it to me saying he felt awed that a thing he had been carrying for a dubious deal, divinely got diverted towards a good deed. There are true stories about pilots bailing out from shot down aircraft, para dropping on enemy land and opening eyes to a rescuer who was miraculously present there. Any expiation?” Dad’s voice got choked.

His story stood at a juncture like that fairy-tale race between the ‘poison and the potion’ to save the princess— A do or die race which he had to win! He raced against time beating the abortionist and dashed into the anteroom where the matron still stood before the crucifix…

The airplane touches the ground. The exit door opens. As I get out and climb down the stairs, I can see my mom standing behind railings in the visitor’s gallery at the edge of the runway, in her eager wait for her ‘budding engineer’ son. That was real, not a daydream!

“Maa…” my heart cries out, “I have come down to you from the sky flying on an aeroplane just as you had told me”.

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