Week 11 (Government Hospital)
I couldn’t decide the severity of the injuries of the people laying on the eight gurneys scattered about the reception area of the JIPMER federal government hospital outside Pondicherry. Another 40-60 people (patients, family and friends) waited between the glass entrance doors, the intake clerks occupying the openings in the back left and the hallways at the far back leading off– somewhere. Three women sat together cross legged on the floor. A mother and daughter shared a bag of chips with a man on a gurney who was holding an IV bag in one hand. Waiting people filled most of the rows of airport waiting room looking seating. The bare metal surfaces of the gurneys had the concave appearance of weathered and taughtly stretched leather. I was told that some of the occupants had serious injuries. I couldn’t tell. Most lay motionless—perhaps sleeping. They wore the clothes they arrived with. Everyone was waiting.
The doctor said his father was a mathematics professor at a college in Pondicherry. I asked, “Do you like your father?” He laughed, but kept working, “Who doesn’t like their father?”
The driver woke me at the Institute in Bangalore that morning with a 5:30 call. He was ready to begin the drive to Pondicherry. He was supposed to come at 8:00, but the 350 km drive with a stop at the three hilltop Gingee Fort could take all day, and an early start would be good. I would buy the breakfasts and lunches on the road, and we could be across the subcontinent by dark. I objected to the tourist hotel he picked for breakfast and we drove on to an open-front, dirt-floor “family restaurant”. While we ate chapatti and idyli, passengers from two busses washed their hands at the row of faucets above the metal troths in the back before they filled the stackable plastic chairs lining long tables.
The driver, in his 50s, drove from Pondicherry the day before. This morning, he frequently stopped to ask which of the unmarked roads lead to the national highway back to the East Coast. I tried to show him on the Google maps on my Blackberry or to show him my compass when he turned west or north on the roads that we needed to take east or south. But he preferred to shout up to the open windows of a truck or to a passing helmeted (but unbuckled) motorcycle driver who had his daughter cradled between his arms while his wife in a cream and blue Sawalli sat sidesaddle behind him. An answer would be given and we would separate without the American expected courtesies of gratitude. Twice he missed his turn and drove in reverse back to the turn to correct his navigation error. He would touch his chest when we passed a temple, then momentarily touch his finger tips together in a prayer position and inaudibly, repeating something. He answered his frequently ringing mobile phone– as everyone in India does—and in the U.S. for that matter. We stopped along the road side several times. Once or twice he relieved himself. I don’t know why we stopped the other times.
I am not used to the no-room-for-error driving: the one car length tailgating behind a truck, the center line straddling default driving lane, the sharing of a lanes with another vehicles, or passing in opposite directions so closely that one would be nuts to hang an arm out a window. With right hand steering, my passenger’s seat is the left front seat—the position from which we habitually monitor the road. Fewer than a 100km from Pondicherry, but before the Gingee Fort, a motorcycle approached us as we drove side-by-side with a car we were causally passing. We had been in the oncoming traffic lane for a half minute. When we crossed the one second to impact barrier (Note: vehicles travelling 45+ mph close a gap of 40 yards in a second) and my driver hadn’t reacted, the motorcycle swerved sharply, corrected to upright for an instant; and then, as its rear wheel lost traction in a fishtail skid, dropped to the pavement and dragged a rooster tail of sparks to us.
I was woozy and achy, I had hit my head, probably on the dashboard, but I was OK. I opened the door to see how standing up would feel. There was a crowd 20 meters behind the car surrounding the motorcycle wreckage. I couldn’t figure out how they got there already. My driver was there too. I don’t know how he got there either. I stood up in the 100 degree heat, held the car to steady myself, and waited for my head to feel a bit more normal before finding out what happened or seeking shade.
We had been in the right side passing lane. I don’t know how the car came to rest sideways in the dirt across two lanes to the left side. My hand came back bloody from holding my forehead. The men around me urged me to sit back down. The patterns of blood on my pants and shirt looked like the splattering of thrown cups of coffee. But I was OK.
A bystander drove me a few kilometers on the back of his motorcycle to a rural government medical center. He wore a white shirt, and I didn’t want to hold on to him while I was still dripping. A young woman medical officer ran the center. She served several such centers, but they only did first aid and emergency work. Luckily that was what I needed. She and the staff gently and thoroughly cleaned and bandaged my head. “It is deep”, she said. I would need stitches within four hours.
The driver came by to check on me. A new car was coming. He would come back in 15 minutes, and we would go to a hospital in Pondicherry. I asked them to call Professor Indumathi who was awaiting my arrival. An hour passed. The medical center staff brought shared their lunches with me. My head continued to bleed through the bandages (as head wounds do) making the injuries look more severe than they felt.
A thin women in her late 80s woman put her hands together and moved her head side to side as she stood looking at me and speaking in Tamil. As the doctor dabbed the blood flowing towards my eye, she quietly and matter-of-factly interpreted, “the woman is worried for you”. The older woman took my hand in hers and held it. It was comforting, but I was receiving more attention than I deserved. I took a good hit, but I would be fine in a few days.
Another hour passed. The doctor’s father walked me to the police station a half kilometer away. My driver was now wearing a bandage on his lip. No one remembered an injury. He was engaged in an animated discussion. No one asked me what happened, and Indumathi told me later that there would be no investigation. In India a four wheeler crashing with a two wheeler is at fault: no law suit, no investigation, and no lengthy delay. But she said, “Both will end up paying.”
The new car and driver had arrived, but we waited for someone from the company to come. I walked around the crashed car for the first time. It was totaled. My side, the front left was the crash area. The fender was folded down to the wheel, the axel broken, and the hood was crumpled to the windshield. The windshield shattered in a concentric circle pattern as if a cinderblock had dropped on the glass—only the impact was outward from the inside the car. If I had gloves, I could have grabbed the upper-left corner where the windshield had separated from the car body, and pulled the shattered glass free of the car frame as if I were ripping insect screening from a window frame.
It was well more than four hours when the intake person—who turned out to be a doctor—asked rhetorically, “Who doesn’t like his father?” The good news he said is that “The wound is very deep and still bleeding: so we are still in time”. Very few people here have health insurance. The government hospitals are free and their quality has a good reputation, but they are far overcrowded. They have decent equipment; but doctors’ salaries, half that of the private hospitals. There are stories of patients and families living on the streets in front of government hospitals waiting to be seen while private hospital workers induce them to come to the private ones. The stories continue to tell of patients who accept the offers only to have botched treatments. A young surgery resident I met at the guest house told me that at his hospital they start the day deciding which incoming patients get beds and which lie on the floor.
I am fine. In fact, I realized some benefits from the crash. I get to buy new sunglasses. People who invited me are trying to make it up to me (although they have no responsibility what so ever for the crash), and then there is this other incident. Half way into the drive to the Government hospital, the replacement driver stopped at a market with a few tables to get some water. I stayed outside since my shirt and pants were stained with dried blood. I sat on the ground with my back against a wall; took off the ball cap I wore to hide the bandages; emptied my pockets into the cap; closed my eyes, and tilted my head back to face the comforting warmth of the 95 degree heat from the sun. I was startled awake by a passing shadow, I put my hand up to block the sun and squinted to see a silhouetted women drop a coin in my ball cap. “Oh lady, Thanks”, I laughed, “I’m fine. We just stopped for water. We had a car accident, and I’m on my way to the hospital in Pondicherry to check things out. I’m an American.” She stopped for a moment, walked back and dropped another coin in the hat. She turned to her husband and in a British accent told him, “Poor thing. He tried to say something in English, but his accent is so bad; I could only make out something about money to the hospital, and then he mistook for an American. That part was embarrassing.” I looked in the hat for a moment: then looked up and said, “Hey lady, what the fuck is this? This is only five rupees. I almost lost my eye here. What am I supposed to do with five rupees?”
Everything is recovering quickly and as predicted. Moreover, I have had a tour of the medical system. I have been to five medical facilities (both private and government), and have been seen by nine doctors including a neurologist, eye specialist, and plastic surgeon. I have had a CT scan; nine stitches in the shape of three widely spaced fork prongs (from the center of my eyebrow around the eye socket to below my eye level), and I have had special eye exams. My doctors have been attentive, easy to engage, concerned and confidence invoking. So far the bills, including medicines, are less than a few hundred dollars. Like the American medical delivery system, this one is far from perfect, but it has strengths. I am particularly grateful to Professor Indumathi who arranged the appointments, schedules, and transportation. Who checked on doctors, and hospitals and purchased medicines and who stayed with me to be a second listener to doctor’s instructions. I had no stress from logistics. I do not underestimate the recuperative and emotional value of that benefit.
Other than that, the drive from Bangalore to Tamil Nadu was beautiful and uneventful.
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