What The Universe set forth

It was one fine morning in the month of August on the outskirts of the town of Bardhaman in West Bengal, India. “CHEST CLINIC” it read in bold font in the Sub Divisional hospital.

The child who stood at the doorway was silent, seemed to be barely breathing. Piyu felt peals of alarm course through her in remembering what her Professor (who had taught her everything regarding Chest Medicine) had said. A patient of asthma without a wheeze could be worse off than one with a wheeze.

The parents confirmed she was having a wheeze before she stopped having them. Piyu quickly looked for breath sounds with her stethoscope – but found a silent chest – which indicated that she needed urgent management.

“Nurse!” she called.

“Inject her with 10mg/kg hydrocortisone i.v. stat and nebulise her with salbutamol (beta2 agonist) and ipratropium bromide (anticholinergic) immediately!”

A nurse jerked into action.

“Whoever took so long to bring her here?” Piyu barked.

“I am so sorry,” said the child’s mother. “We had taken her to the Tantrik who stays in the temple close to where we stay.”

After fifteen minutes of rigorous attempts, she seemed to get better, her sp02 (reading on the pulse oximeter) went up, and Piyu breathed a sigh of relief.

“Did she have asthma since before or is this a new attack?” Piyu asked.

“No this is her first, ma’am,” the child’s mother answered.

“No small-scale attacks either?”

“Only when she played in the dust ma'am,” her mother recalled.

Piyu asked to admit her for a day to observe her and put her on levosalbutamol inhaler for four times a day to begin with.

This was the third time patients came to her in the hospital after having visited the Tantrik for help.

Piyu was exhausted after a day’s work but she decided to visit the Tantrik anyhow.

It was evening and the sun was setting. The red sun painted a pretty picture. When she came near the temple inside the Shmashan Ghat (cremation ground) the beauty of the place made her look around in admiration.

She kneeled in front of the idol of the Mother Goddess Kali with Her red feet and Her red tongue hanging, one hand holding an Asura head and another holding a Kharga – an instrument of war.

“Don’t let Your children suffer so much, Goddess Mother,” she prayed, silently.

When she turned around, she got mildly frightened.

Behind her had been standing a big burly Tantrik wearing red overalls. His shiny brow gleaming in sweat was covered in ashes and a red tilak.

“Come child!” he said, “Tell the mother of your troubles and let her deliver you from your problems.”

“Yes, I have come here, but only to pick a bone with you. Are you the one who claims to cure all your patients of their disease?”

“You have come to the right place!” he said.

“No. Stop doing that or I will have you in jail for fraudulent practises!” Piyu huffed.

The Tantrik laughed.

“The Mother has her ways,” he said.

“Of course. But we are the ones doing the real work, not Priests like you who take advantage of poor people who come to you in sickness hoping to get better.”

She continued, “For instance, today itself I found a child brought to me unable to breathe – how were you planning to cure her anyway?”

The Tantrik remained quiet.

Piyu went away silently.

Surprisingly, from that day onward, she received patients who were timely sent to her on the onset of any respiratory symptoms. She wondered if it had anything to do with the Tantrik.

India, a developing country, is burdened with one of the highest number of tuberculosis patients in the world.

One other day, Piyu was looking at the fifth patient who had a cough with expectoration for the last 14 days, with evening rise of temperature for the same duration. His morning sputum sample showed tubercle bacilli. Fortunately, he was sensitive to both Isoniazid and Rifampicin, indicating Drug Sensitive Tuberculosis. After having done preliminary Liver Function Tests he was started on four antitubercular drugs – Isoniazid, Rifampicin, Pyrazinamide and Ethambutol for the first two months followed by Isoniazid, Rifampicin, Ethambutol for the next four months.

However, there was one person who came with breathlessness and blood in sputum (hemoptysis) who turned out to be having Extensively Resistant Tuberculosis (XDR-TB). She didn’t see much hope, but started him on drugs immediately.

That day, she suddenly had an urge to look for the Tantrik again.

She went to the cremation ground, in front of the temple, opened her shoes and entered the temple.

She bent to offer pranam to Mother Kali. When she rose, the Tantrik was standing behind her Again.

“Hello,” she said, limply, remembering their last interaction and the subsequent result.

The Tantrik, though, appeared happy.

“Come, child. Sit down.”

Piyu did as she was told. She sat in the wide area near the steps of the Mandir.

“I took your advice, child. I send all the patients who come to me with breathlessness to you.”

Surprisingly, the man who had come to her clinic that day was there. “He does more than that,” Pawar said loudly.

Piyu looked interested.

“How?” she asked.

“LOOK –” Pawar said and pointed to an ashram not far beyond the temple premises.

Piyu inched closer but the Tantrik stopped her.

“You don’t have a mask, child,” the Tantrik said.

“That which you see has been made into a convalescent home for anyone who has been driven out of their homes for carrying the deadly infectious disease known to us as tuberculosis.”

Piyu looked abashed. It is true that relatives were counselled regarding the disease, but a lot of old and sometimes the young were driven out of their homes in fear of contracting the disease, inspite of taking the medicines.”

Piyu took a mask and wore it before she indicated that she wanted to have a look at the convalescent home.

She was surprised. A well balanced, nutritious diet was provided to all the patients. Light and air entering through the windows provided good cross-ventilation. All the patients wore masks – they slept well, ate well and looked happy.

“Where do you find funds for all of these?” Piyu asked.

“Mother makes way for all of us,” the Tantrik said.

“We have enough for the temple as well as for this home,” he said.

Piyu was standing there when a bunch of kids came to play in front of the temple.

Piyu saw the little girl she had treated playing in the dust.

Before she could say anything, she saw the Tantrik tell her off severely, like a big old father figure.

“What just happened here?” Piyu asked quietly.

“The first time she came to you, ma’am,” said another child, “she was playing in the dust inspite of what the Tantrik said to her.”

Piyu fell silent. “So the three times the Tantrik reached out to her –” “- was to stop her from playing in the dust,” completed the child.

Piyu fell quiet.

A while later, she said, “You could have told me.”

The Tantrik shook his head.

“Better you think I did this than make you think it the parent’s fault,” he said.

The Tantrik laughed heartily.

“It is all the result of your coming to me that I send all the patients to you. The Goddess Mother has blessed you.”

Piyu looked abashed again.

“May I stay for the evening aarti?” Piyu asked.

“Of course you may,” the Tantrik nodded grimly.

Piyu sat down cross-legged at the evening crept along. The Goddess Kali stood resplendent in a red Benarasi Saree and a garland of brilliant red Hibiscus flowers. The Tantrik started to sing a Shyama Sangeet as he showed Her a lit lamp and slowly made rotatory movements with his hands.

Piyu admired the scene and prayed silently.

“Let us all be happy at the end,” she prayed as the Tantrik offered her Prasadam (food offered to the deity) and she ate it.