They called her Devi

She walked gingerly into the emergency room, her eyes looked tired, her saree was old and worn out, the once vibrant colours now tattered at the edges. She was pregnant with her third child – her tummy looking disproportionately large as compared to her tiny malnourished frame. She was white as a sheet, holding her hands to her back and clearly in labour pain. She smelt musty, a mixture of sweat, blood and neglect met my nostrils as I reached out to examine her. She was burning with a fever, and when I asked her what was wrong unable to answer she turned to her husband. He too was a tiny man, his big eyes shown with hopelessness as he spread his calloused hands and proceeded to explain what had happened. She was pregnant with her third child, the first one had been delivered by Caesarean section only 4 years ago, the next one was a normal delivery at home, and this was her third. She had been to a few ‘doctors’ before us where multiple unsterile per vaginal examinations had been performed and the last one had indiscriminately administered Oxytocin to induce labour. When the labour did not progress they referred her to a higher center. She had been bleeding for a few days, her urine was blood tinged, her pulse was racing, her blood pressure was unrecordable, and even after giving her fluids was dangerously low. She had ceased to feel her child moving for the last 2 days and on doing an ultrasound we found that her baby was dead.

Her haemoglobin was very low, her white cell counts very high, her fever never seemed to subside, they had no relatives to donate blood, and no money to pay for the surgery she most urgently needed. In the operation theatre, on opening her abdomen we found that her uterus had ruptured from the pressure of contracting against resistance for days, the torn ends were sealed by a huge clots of blood, the anatomy was hard to make out, her baby was lying in one corner of the abdomen, a perfectly healthy baby which would’ve had a 100% chance of thriving had the Caesarean been done electively before the pain started. Lower down we saw the bulb of the urinary catheter sticking out through a huge rent in the wall of the bladder, it had also burst. This explained why her urine was blood tinged. The bladder and uterus were repaired and her abdomen closed. She was stable, for now.

Over and over, we tried to measure her blood pressure, at the most optimistic of times the reading was still very low. In the ICU her condition worsened, and still no blood. Her husband sat next to her bed on a little wooden stool staring at the moniter beeping loudly, and the alarms going off as her vitals destabilized. She lay on the bed with multiple supports going through veins which we had struggled to cannulise before the surgery and as I stood there looking at the moniter I felt the sinking feeling that she wouldn’t make it. I thought back to the time before the surgery when we had shifted her to the operation table and tried to distract her from the pain of the IV cannula pricking her. I remember asking her why she didn’t go to a hospital earlier, and she just laughed and said, ‘Humko kya pata’ (How was I to know?). She had laughed completely oblivious to the fact that those would be her last words. Like she rightly said, how was she to know? Even when she did go to a so-called doctor, she was given grossly faulty treatment all in the name of ‘normal delivery’. ‘Do no harm’ a dictum from the Hippocratic oath, isn’t said without good reason. She died that night, without resistance, without a fight. A result of incorrect medical treatment. When the very people you trust to fix you are so grossly out of line, who does one turn to?

I checked her pupils – dilated and fixed. No pulse, no heart rate, no breath sounds. A fresh JMO, I went over the motions of confirming her death once, twice and a third time, and turned to tell her husband. He shook his head and thanked me for all our efforts. He explained that he was a daily wage worker, he and his wife were both orphans with no close relatives to support them. ‘I wish I’d known what to do,’ he said, and with that he left.

Her name was Phekni Devi, doomed from the day she was born, her very name shows us that. Phek meaning thrown away. Abandoned. Unwanted. A fate a large number of girl children in rural India meet. Devi, referring to a goddess. A surname every woman adopts once she is married. In a country which worships female goddesses like Kali, Sita, Laxmi while mourns the birth of every girl child, it seems to me, like the worst kind of hypocrisy and the cruellest contradiction, for nothing could be farther than the truth. When I stepped out of the ICU I heard devotional songs blaring through the loudspeakers all over our little town of Madhepura.

Ironically, Bihar was celebrating Saraswati puja.