Mending Broken Hearts

34. Lessons Learnt

I had to bite my tongue instead of explaining to her that, 1) stress doesn't cause a viral infection, only a virus can cause a viral infection, and 2) perhaps he shouldn't have gone to his friend's son's wedding that they had held illegally by paying off some event space owner, despite the fact that these places were supposed to be shut down by the local government's decree.  

That wedding had now been linked to at least a dozen COVID cases, with a handful of the elderly in the ICU now. 

"Beta, zindagi or maut tou Allah ke haat mein hoti hai. Unhoun ne itne pyaar se bolayaa tha, hum mana nahi kar sakte the," she had replied to me, which made my blood boil further. (Son, life and death are in Allah's hand. They had called us so lovingly, we could not say no)

But that was all 5 days ago, and with my father's progressive worsening, there was a sense of foreboding at home and I had to let go of my own issues with my parents. Abu had gone from disdain to reluctant acceptance of my presence. Ami was obviously relieved to have me there, even if our conversation had been tense and strictly related to Abu's condition. Shadab bhai had shown his face once, very briefly to get some signature from Abu, and then disappeared. 

To say that he seemed like a vulture circling his next prey was an understatement. Made even obvious with his absolute disdain at my surprise visit. 

I donned my N95 and eye goggles, and entered Abu's room. Even I had to admit, that while he looked in reasonable shape 5 days ago requiring oxygen but not a BiPap yet, and the nebulized steroids that I had started seemed to have helped initially, his condition was not improving. In fact, his oxygen levels had been trending lower. 

"Sir maximum oxygen per hain, but koi effect nahi ho raha," the nurse told me. (Sir is on maximum oxygen but there is no effect)

That was a new downhill development. Previously we could raise his oxygen saturation to low 90s at least with nebulizers and good chest physical therapy. Now, they were consistently in mid 80s, and my father was obviously struggling to breathe. 

"Abu, I think we'll have to put you on the BiPap machine now. You can't keep breathing so fast. You'll tire out and your body will start to shut down."

He shook his head. "No. There is...no machine...available," he said between labored breaths. 

"Let me handle it," I told him and came out of the room to make a couple of calls. 

*******

"Omar! What a pleasant surprise. Kidhar gum ho yaar?" (Where have you been lost?)

That was Wamiq, my friend and classmate from med school. He had trained in UK as an ICU physician and had just recently returned to Pakistan. A mere two months before COVID hit. And now he was one of the city's very few properly trained Critical Care Medicine doctors at our alma mater's affiliated hospital. 

We caught up briefly but the conversation quickly turned serious.

"If I was in the US, we'd be admitting Abu to an ICU right now." 

"Sorry man, that's an on-going issue we are all having. ICU beds are completely filled in the hospital, and the ER is full of people waiting to come up. Its the same situation in every hospital across the city right now. There hasn't been a ventilator available in all of Sindh for the last 3 days. Your best bet is to try to get a BiPap machine," Wamiq replied. 

A BiPAP machine, unlike a ventilator, does not need a tube to be put down a patient's throat, and actively pushes air into the lungs. But many patients can't tolerate it, and there was a severe shortage of them in the city too.