Book Excerpt: My Patient Died; What I Said To Her Husband Right After

The woman deserved at least some tears for her selfless service to him, but here he was, already thinking about his remarriage.

She was indeed pale and her recent haemoglobin was just three grams. That was barely enough to keep her alive and she was pregnant on top of that. Such a low haemoglobin meant years of poor nutrition and neglect. Even the livestock in the villages were better looked after. They didn’t look very poor either. Her husband appeared healthy enough.

‘Why can’t you take care of yourself?’ we reprimanded her.

‘Madam, I hardly get any time. There is so much work at home. We have a big family,’ she said slowly. Her domestic chores were more important than her health.

‘Why didn’t you see a doctor earlier?’

‘Doctor sahib, our women deliver at home by our village dai (midwife). It’s not our custom to take womenfolk to hospitals. I, at least took her to the dispensary yesterday.’ The husband was quite proud of the fact that he had brought her to a hospital when the majority of women delivered at home in his village.

‘Our dai has been delivering our women for the last two generations. She never told me of any such danger and had rather warned me that the city doctors scared people unnecessarily and complicated things.’

‘Obviously, if cattle and goats could deliver in the fields easily, why not women?’

The sarcasm was, however, lost on the insensitive man. He kept on grumbling for having to wait so long. He could wait nine months for a proper visit to a hospital, but couldn’t wait for a few minutes in the hospital.

‘Look, she needs urgent admission and blood transfusion.’

Kyun?’ (‘Why?’) The husband didn’t understand the need for either. It was a struggle explaining the gravity of the situation to him.

‘She will die if you do not.’ When we persisted, he agreed.

Thik hai madamji, aap mangwa do. Hum mol pe lenge.’ (‘Ok madam, you order for the blood. We will buy it.’)

‘The hospital doesn’t accept blood bought from outside. It is nothing more than Ruhafza, a soft drink, with the possibility of infections. You will have to donate, or ask somebody to donate.’

Main khoon dene laga, toh kaam kaun karega?’ (‘If I start donating blood, then who will work?’) He was already regretting coming here. He just would not hear of it.

‘OK, then you will have to sign the negative consent and take responsibility if anything goes wrong.’

After a lot of arguments with other doctors, and nurses also scolding him, he agreed for blood transfusion but at a condition!

‘I will inform her brothers. Let them come and donate blood for her, and then I will admit her,’ he declared generously.

We were taken aback. She was married to him for five years – the dutiful, undemanding wife who would bear him kids. Didn’t she merit even a drop of life from her husband? All the while the woman kept quiet, her face hidden in her saree. I marvelled at her tolerance. How easily they succumb to the norms dictated by their husbands!

He sensed our scowl and explained, ‘Actually the first delivery is the responsibility of her father. We follow these customs in our village.’ Of course, there was no custom of humanity followed in his village. It was pointless arguing with him. He didn’t realize that it was indeed a miracle that his wife was still alive. They were sitting on the top of a volcano. Anytime the system would decompensate and she would collapse.

‘You at least get her admitted. The hospital would arrange blood and, in the meantime, you can arrange the donors.’ We insisted on admission, assuring him, but he refused to budge.

She was to be admitted only when her family came in. We had no choice but to take a negative consent for admission. They signed the papers willingly and walked out of the hospital, the obedient wife silently towing behind her selfish husband. We doubted he would come back and looked sadly at her retreating back.

We were living in the capital city. If such things happened here, the conditions in other parts of the country were unimaginable. Were we indeed a sadistic nation with no right to call ourselves a civilized society?

A week later, I was on emergency duty.

‘A patient with severe anaemia had come in labour. Her heart could not cope with the stress of delivery and failed. She collapsed and is very critical. Chances of her survival are very dim.’

My grim faced colleague told me as she handed over the patients. I had a bad intuition about this patient and went to see her in the ICU. She was battling for her dear life. Multiple units of blood had been pumped in, but how could you reverse the chronic strain to the heart and tissues that had been deprived of oxygen for so long. The baby had miraculously survived. As I was leaving, I saw a familiar looking man standing outside the ICU. Yes, he was the same person who had taken his wife forcibly away from the hospital that day.

‘So you admitted your wife well in time,’ I told him sarcastically.

‘What to do, madamji? Her brothers took so much time in coming.’ Nonplussed, he went on complaining about her brothers.

The silent wife, whose husband refused to accept his responsibility, succumbed to her fate a few hours later. Her death left an overriding feeling of guilt and helplessness in us. If only we had somehow not let her go that day. However, we could not hold a patient against her will. Unfortunately, here the will of the husband surpassed any will of her own. Another victim added to anaemia, a leading cause of maternal death in our country. One just needs good diet and proper medical care to tackle it, but it kills remorselessly because the country is helpless against the deep-running ignorance and traditions.

As I came outside the ICU to finish the formalities, I couldn’t hold back my jibe to the husband, ‘People like you should be arrested. You have not lost anything! Now that she is no more, you will marry again. Along with a new wife, you get a new motorcycle and a fat dowry.’

He replied innocently, ‘Naah madam, it is not so simple any more; very difficult to marry in villages these days.’

I felt like hitting some sense into him. The woman deserved at least some tears for her selfless service to him, but here he was, already thinking about his remarriage. There was no trace of any guilt or remorse on his face. The immediate cause of death might have been anaemia, but the antecedent cause of death was lack of care, and neglect. If indeed we could sue such families and hold them accountable for gross negligence. A group of relatives were sitting in a separate corner, wiping away their tears. They were probably her parents and brothers. Maybe in their village, the custom was only for the parents and siblings to grieve; the husband’s family were not to be bothered.

A woman died of a preventable cause. A newborn was strangulated by her mother because of her gender. Probably, she too would have met a similar fate later on. Both were victims of the same patriarchal mindset that refuses to treat women as equals. Their deaths laid bare the hypocrisy that throbs in our country when it comes to treating our womenfolk. We have no qualms in accepting technology when we wear modern clothes, use modern methods of communication, and use hi-tech gadgets for our comfort, but when it comes to a woman’s health, we become all-traditional. A strange country we live in!

And we had failed. As a civil society, we were responsible for their deaths. As a country, we stood shamed, once again.

Excerpted with permission of Bloomsbury Publishing from Chronicles Of a Gynaecologist by Tripti Sharan. You can buy the book here.

30 COMMENTS

  1. Hats off to your selfless efforts Dr. Tripti for trying to save your patients as well as writing this blog to create awareness to the larger crowd.

    Feel ashamed that we have miserably failed in changing the mindset of majority of menfolks who I’ll treat women by merely considering them as housemaids and childmaking machines. Even mechanics would have some kind of emotions attached to their machines. Unfortunately we have beasts around in disguise of people who have no love, emotions attached to their women.

    • Thank you so much . Do read the book . It shows many other real life stories covering different hues of a woman’s life, not all tragic.

  2. Absolutely…thanks for putting this up. We shud question why her haemoglobin was so low . Why no medical care ? Are women equal to cattles and livestocks? Why shud a a healthy husban run away taking his wife knowing his wife’s life is at risk. No wife would run away in such a situation or sign a LAMA or left against medical advice. We should question these biases and mindsets rather than blaming doctors.

  3. Which self respecting man if he has the means to save his wife would take away his wife from the hospital saying the brothers wud come and donate blood. Why don’t we accept our own responsibilities? No wife wud drag her sock husband from the hospital in similar situation .Why don’t we understand that if we don’t care for our own friends and family ,how can we expect anyone else to do that? People throng to private blood banks to buy blood. Those who sell blood are poor people who have low harmoglobin. It’s useless and sometimes potentiality infectious too. The safest and best blood is the one that comes from voluntary doners and not commercial ones.

  4. and sanghi snakes will say we indians worship women and never mistreat them.. men like these are nothign worse than parasites and snakes..

  5. The doctor herself is as responsible as that woman’s illiterate, idiot husband for her death. The husband may not understand the seriousness of medical condition as most of the ppl don’t and it’s not a crime as long as he was willing to buy blood. It was/is the responsibility of the doctor to do the right thing. When the husband was ready to pay for the blood why didn’t she advised him to bring it from blood bank ? If I have to believe what she has written as communication between the husband & the doctor herself then I have to say it reflects her snobbish, castist attitude and clear disdain for that man. I believe that clouded her judgement. Saving that woman was more important than proving her husband wrong.

    • You have a strong point there. The attitude of medical profession can fill any number of blogs…I travelled and stayed across the country…hardly come across a good doctor who has some ethics…very sad for the country..

  6. though i despise his not willing to donate blood, still had medical care been free / affordable such decisions could have been easier. women are not forced to not take care of themselves, it’s just that some just have a different thing on their mind. if you are cooking for 12 people in a family then who to blame if you yourselves do not eat ? nobody is monitoring everything minutely. health care is a farce, it is easy for a city doctor to comment, why dont they go to villages conduct camps make pregnant women healthy with the help of NGOs if they are so concerned. else just keep silent and leave everything to fate

  7. A Good doctor should have admitted the lady and should have transfused blood first and stood by the patient rather than asking husbands permission .
    Law will protect.
    No way .. we can’t dream of first world country if we continue to follow stupidness !!
    Wake up Medical professionals !! Fight for your patients.

  8. Doctor, is it not within legal purview to call in the police immediately when that shameless husband irresponsibly walked out on first visit – To begin, it’s a clear case of threat to life of the pregnant woman. And, It’s a case of years of domestic torture and neglect on the woman – resulting in severe anaemia. Doctor, Why didn’t you stop them!! Why weren’t the police called in?? I don’t discredit – infact have full praise for – your selfless efforts in saving the lady’s life on both the visits, but a bit more push from your side might have turned the tide in the poor-lady’s favor.

  9. A frustrating situation very beautifully expressed by Dr.Tripti .As a Doctor I have myself faced situations where available treatments cannot be done due to family resistance.The only remedy I think would be better education and awareness .

  10. Madam , please note that a doctor cannot hold a patient against their will . We cannot touch a patient till she gives consent. Admission is always voluntary and in such cases we take a negative consent . We can only try our level best , trust me we do. We even donate blood when attendants don’t do but then this cannot become a routine. And we never wait for a donation to start transfusion. Many a times multiple transfusions in emergency are given just on assurance of relatives which they may not comply to later. A bank will exhaust if not invested into and it’s the duty of attendants to arrange and donate for their patients

  11. It is easy to pontificate, but what are we/I doing as an individual ? Every little bit counts and it does make a difference, a dent in the glass ceiling AND one day it will crack n break. Till then let us mortals at least persevere to do our utmost. Amen !!!!

  12. Unfortunately the Captal Delhi and its surrounding regions are the worst. I’m proud the southern states are more civilised.

  13. Yes doctor, please bring some change and bring laws to punish such people for neglect and carelessness. If doctors can be punished for negligence these days then why not relatives of the patients? This must be handled as both a legal and social issue.

  14. Madame Doctor why are you saying that if this is the situation in the Capital what will be the plight in rest of the country. Hope you have heard about a state called Kerala in the Indian Union of States. If you have not visited this state. Please do visit. The Maternal Mortality rate and Infant Mortality rate in the state of Kerala is the lowest and it ranks on par with Scandinavian Countries that have the lowest rates in the world.

    • My mother in law is from Kerala but I am not. She harassed me during my pregnancy by asking to press her feet and massage her knees when I was 8 months pregnant. Every single day she said I must not have a girl. I traveled 2 hours to get to my job. She would stay at home and only cook meat and I am a vegetarian. She was only 16 years older than my husband making her an active and young mother in law. She insisted on me to find Malayali friends and bring movies and magazines. She feigned fainting every other day. Needless to say I had a girl child and of low weight. I am proud of my daughter. I am also a very highly educated person. The whole Indian mentality is sick and nauseous so please don’t compare states.

    • Agreed whole heartedly to that. North Indian states have worst gender sensitivity and that reflects in the screwed sex ratio.It needs lot of introspection. But the line that was mentioned was intended as sarcasm as we expect to see better in the capital city. No offence to other states which have better indices. I am so happy that you are proud of your state. But india is still way behind in treating women better. We need men who can help woman in breaking the stereotypes a woman is expected to conform to.

  15. Real shame! Such men must be hanged! THIS MEN should be tortured & killed with severe pain to making a beautiful woman’s life hell.
    I feel so sorry for the Lady who died.She deserved a second life.

  16. why the heck we call our selves independent nation when its citizens are still being ignored by its rulers for their selfish means. There is no difference between princely/british and current India.

    It is high time to bring full control and bring the people on disciplined path.

    Reduce population (even if it is by strelizing all men by force after first child), abolish all illogical customs even it is bound by religion. Provide basic security (like health care, old age care, food availability, security atleast).

    Lets have some control over its people and its resources.

    Lets STOP BECOMING MARKET for WHOLE WORLD. And Government of India must act fast on this please.

  17. Doctors know the condition of the patient than the eelativea. they could have saved her by giving a bottle of blood and get from her parents or siblings later
    Humans not humane

    • The patient needs to give consent to a blood transfusion. Having a blood transfusion can have serious, life threatening consequences , so doctors need consent first, otherwise they cannot force a person to have a blood transfusion.
      If you read the note by the doctor, the doctor offered blood transfusion straight away but the husband refused as he wanted her brothers to donate before he signed the consent form.
      Doctors can do nothing against a patient ‘s/ husbands wishes.
      It is the mind set that women’s health does not matter and that his blood and “strength ” is more important — that is what the doctor is trying to highlight.
      Did you know that donating blood is actually good for you! Don’t believe it????Do some fact finding and open your mind!

      • Absolutely…thanks for putting this up. We shud question why her haemoglobin was so low . Why no medical care ? Are women equal to cattles and livestocks? Why shud a a healthy husban run away taking his wife knowing his wife’s life is at risk. No wife would run away in such a situation or sign a LAMA or left against medical advice. We should question these biases and mindsets rather than blaming doctors.

      • So true. It’s like shifting the blame on the government for everything. No rights and duties of people themselves. I think one should spend one full 24 hours with the doctors in a government hospital to realise the kind of stress and pressures under which the medical fraternity works, Blood is not to be bought but donated . And for safety of patients hospitals majority of them do not accept from commercial sources . Blood transfusion is fraught with life threatening complications and ideally speaking such situation should not even arise in pregnancy and if it does the safest blood is that of a relative or friends

    • IAM ashamed of the doctor and its hospital. When the doctor knew the situation hospital could have given free blood to her for humanity sake or called NGOs and arranged blood. No you had to get payment for admission. Again you should be ashamed.

      • This was a governement hospital where there was no cost involved. The doctors themselves donate blood and cannot do more than that. And who is the govt who shud arrange? It’s people like us who donate and fill the blood banks. Most of the time when blood is asked for the sasural people disappear. A common scene is mother in law pulling out the son/ husband and scold him if he agrees to donate. Indians who overcrowd hospitals complain of no friends and relatives when it comes to donation. The moment it’s a man who needs blood everyone agrees to donate including the wife or frail mother. That’s the situation for majority Indians, Even this patient was assured of transfusions. Hospitals start transfusion just on assurance. People generally bring doners later on and generally fail to do and no action can be taken on that. Try to understand the position of hospitals which are already overstrained by the thousands of poor destitute and homeless , and bleeding patients.

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