The curtains had been wide open for quite some time now, letting the sharp rays of the sunstream in through the open window, on to the face of a prostrate Dushyant, who lay in bed,covered in a worn-out hospital bedsheet, very uncomfortable in his sleep but still unmoving.His eyes flickered through the night and his fingers trembled. He was asleep and didn'twake up. It wasn't a good night's sleep.Finally, after tossing restlessly from side to side, he woke up and tried opening his eyes.One of them refused to open, swollen from the huge gash just above his left eyebrow, which had been heavily taped and bandaged. He touched the bandage with his hands and checked for blood with his other half-open, groggy eye. He sighed as he found none ... Only then did he venture to look around the hospital room. He was surrounded with medical equipment, a lot of it connected to him, a small television in one corner of the room and an empty bed on his left side. His thoughts wandered to what had brought him there. It wasn't the first time he was in one of these beds, but this time it seemed a little more serious than the other times.Landing up unconscious after a series of uncontrollable vomits and brain tremors was a way of life for him. It was his escape, his refuge. Being sober hadn't got him anywhere, and being drunk obliterated the possibility.He had tubes attached to needles, which dipped into his veins and arteries, and pumped liquids from transparent pouches hanging from the stand on his right side. He was sure his parents had no idea of his whereabouts. He knew none of his friends would have given the hospital authorities his parents' numbers or address. He was in no mood to see or talk to them. Not now, not ever.The hands of the watch on his cell phone touched. It was twelve—fourteen hours since he had been admitted. Last night, like many before, had been a night of debauchery, porn,poker, alcohol and smoke. Six of his friends in his cramped one-room apartment—a five minute walk from college—and a few bottles of alcohol, some weed, nail-polish remover and just about everything which could get them fucked up.The evening had started with casual banter about college professors, the new kids who had joined the college, girls and pornography. A few cell phone videos of girls bathingnaked were transferred over Bluetooth amongst them. A little later the bottles had been popped open. Dushyant—who had graduated just a few months back—was mentor to these kids. He knew the exact proportions for deathly cocktails and the people who would have as teady supply of highly potent weed even during a nuclear holocaust. He knew how to get out of trouble. But more than that, he knew how to get into trouble. Like he had the night before, when he passed out only to wake up in a hospital bed. He remembered a seizure; he remembered feeling as if he was dying, but nothing more than that. He waited restlessly for the nurse to come in and tell him what the hell was going on. I need to get the fuck out of here, he thought.On other occasions, he would just jerk off the needles that punctured his hand and walk right out of the ward, but there were too many of them this time and he wanted to know what was wrong, if anything. He was not scared, just concerned if it was serious enough for his mother to start crying and his father to start shouting at him for being irresponsible,disgraceful and a blot on the family name. What family name? He is a bloody head-clerk atthe MCD, he said to himself. He never got the flawed definitions of honour and family name. He didn't give a fuck, and frankly, he knew they wouldn't come this time. His head hurt and he thought he could do without the nonsense his parents always put him through.While he wallowed in self-pity and cursed the hospital, the door opened and a girl—short and fair—entered the room. She had big eyes—like the schoolgirls in Japanese cartoons—and looked like a confused kid in a candy shop with gold coins in both her palms, not knowing what to buy. But instead, her palms were clasped around the handle barsof her crutches. Her legs buckled at the knees and seemed to have no strength at all to bear the weight of her tiny five-foot-two frame.'Excuse me?' he said and waved at the girl, who was in a robe slightly better than his.'Can you call the fuc ... ummm ... nurse?''I think I can. But you know, I could have been a doctor. I am still studying,' she said, and looked at Dushyant and smiled. Dushyant didn't know how to react to that. He didn't remember the last time a girl had smiled at him.'But since you're not, can you call her? Argh.''Being angry won't help your case,' she said, 'but if you pull off that needle with the blue cap out of your right hand, a little slowly, it might help.' She walked over gingerly to the bed next to him and drew the curtain between them. And then pulled it away.'Excuse me?''Do it. There'll be no pulse. They will think you're dying and I hope, at least then, that someone will come running to check on you,' she explained and chuckled. 'And well, if no one does, you're in a really bad hospital. You should get a second opinion.''I am not going to do that,' he retorted.'Then ...' she said and slowly limped over to his bed. She picked up his medical chart which hung from the other end of his bed, her eyebrows knitted, and continued, 'You have to wait till three when a nurse comes in and draws some blood for some tests. Not a long wait,just two and half hours!''Whatever,' he said, closed his eyes and put his head back on the pillow.'Fine, bye. Hope to see you again. I might pick this room. I am here for some tests, but they need to admit me for a little bit.''Yeah, right. You won't see me today. I will be out by evening,' he said rudely.Pihu just smiled and walked slowly towards the exit. At the gate, she looked at the number and whispered to herself, 'Room 509.' Dushyant saw her nodding, and she disappeared into the corridor amongst other sick people. I need to get the fuck out of here,he said to himself.'I don't know what the fuck they are up to!' Dushyant shouted on the phone.It was four. The nurse had come and drawn some blood and given him zero answers. Why am I here? When can I go? Did you tell my parents? Did you? What the fuck is going on?She nodded to his questions unthinkingly, and told him the doctor would see him in a little while. He swore at her. In Hindi. He didn't think the Keralite nurse understood him. Cursing came as second nature to him ... His sentences often started and ended with abuses, most of which had been improvised and perfected over the course of years that had passed by.The first time he had hurled abuse was when he was in the eighth standard. Someone had addressed him as bhenchod and his comeback was that he didn't have a sister. Not too clever, but ever since that day, bhenchod became a way of life. It replaced emotions,feelings and entire situations, depending on how it was being said by him.'Just be back soon, man,' said the voice from the other side of the phone and he disconnected the call. Bhenchod!He had no visitors. He had no friends really. In the four years and the few extra months he had spent in the college, he had made drinking buddies, smoking buddies, getting-fucked-up with buddies, but none who would come to see him in the hospital. Had it been six months before, some of them might have come. But now everyone who had graduated with him was either working or waiting for their offer letters. He had been placed, too, but the large IT sweat shop company hadn't sent him a joining date yet. Stuck in a time warp, he didn't want to go anywhere. So days before college ended, he rented a flat just outside college and started to live like he was still studying—in his fifth year of engineering.Dushyant was about to doze off when a doctor—presumably in his mid-thirties—entered the room.'Hey,' he said. 'Are you fine?''Why wouldn't I be? I am just okay. When can I fucking go now?' he asked angrily.'I am afraid you might have to stay here for a few days,' he said and looked at his chart.'We are actually glad you woke up. It had been three days and we thought you were gone for good,' the doctor, Arman Kashyap, said with a smirk.'Three days? Are you fucking kidding me? You have the wrong patient, Doctor. I came here yesterday. Is everyone here an incompetent fool? Get me out of these things!''Irritation. Forgetfulness. And confusion. Well, these are common symptoms for hepaticencephalopathy. As far as I see it, it's good news for you, boy. You have every symptom in the book. It's easier to treat that way,' he explained and smiled.'Excuse me? I have what?''Hepatic encephalopathy,' he said. 'In other words, your liver has rotted and is playing games with your brain cells. You have had problems with urination for the past few day sand you didn't tell anyone because you were embarrassed about it. And three days back, you had a seizure and passed out.''But I didn't. It was just—''I am telling you what happened, not asking you for your confirmation,' he said, with a heady mix of arrogance and confidence. 'Now, give me your parents' contact numbers so that we can tell them what a bad boy you have been.''You don't need to,' he mumbled, confused. And the confusion was not a symptom of the hepatic whatever he had, but what the doctor had just said.'Hospital rules, Dushyant,' he explained. 'No matter how much I hate dead people, I hate unpaid bills more.'Dushyant, dazed and caught off guard, wrote down an old, out-of-service landline number of his house and asked him, 'You're going to call them now?''Not really. Not unless you have to undergo some drastic medical procedure which requires them to be around. Or you are broke and can't pay the bills.''Fine,' he said. 'How long will it take?''If you don't die, you should be okay in three weeks,' he said. 'But if you go back and try to drown yourself in alcohol again, you might not get out of here alive. I have some other patients to look into, who are not killing themselves. I will check on you later today.''Will it hurt?''Did it hurt when you stuck needles inside yourself, Dushyant?' he asked. 'But don't worry, the best part of your disease is that just in case you die, you will die sleeping.Hepatic encephalopathy is a very lazy disease—somnolence and acting stupid being the main symptoms. You have already done with being stupid, so I guess there is just one left.Go, sleep.'Before Dushyant could say anything to that, the doctor hung his chart on the bed and left the room. Frantically, Dushyant called his friend to confirm if what the doctor had said was true. It was. This is seriously fucked up, he thought.He punched the words 'hepatic encephalopathy' into his cell phone's Google browser and it took him a few times to get the spelling right. A few search results popped up and he read through them hurriedly. Combing through the labyrinth of medical words and terminologies, he knew where his problem came from—his excessive drinking. I don't even drink a lot! He was right, but he was into all kinds of stuff and the more he read up on the disease the more he realized that he was at fault. A few sentences stood out and he lay there breathing heavily and cursing everything that he had ingested in the last five years, but stillwanting some more of it at that moment. Ideally, he would have loved a couple of largeshots of vodka mixed with a few shots, big shots, of tequila. If worst came to worst, a cigarette. Dushyant had never been an addict, and unlike addicts who thought they could kick the habit any time, he could actually do so. Or so he thought Soon, sleep took over and he closed his eyes, wondering if he would wake up again.
What he had read circled his head for the entire time that he slept.Those with severe encephalopathy (stages 3 and 4) are at risk of obstructing theirairway due to decreased protective reflexes such as the gag reflex. This can lead torespiratory arrest. Intubation of the airway is often necessary to prevent life-threateningcomplications (e.g., aspiration or respiratory failure).Are they going to cut my throat open? he thought in his sleep.If encephalopathy develops in acute liver failure, it indicates that a liver transplantmay be required.Where would I get that! Even in his sleep, he wanted to get hammered. Vodka. Tequila.Whisky. Iodex. Anything.
