Dinnertime, instead of the relaxed occasion to which Leena was accustomed, was a tense affair. Rekha served their father-in-law, whom she called by the honorific title “Sahib,” then stood waiting off to the side for his reaction. If the dal was not spicy enough or the chapatis had grown cold, Leena was dispatched back to the kitchen. She ended up spending most of the mealtime there, reheating food and making adjustments to suit Sahib’s tastes. When Leena finally rejoined the table, the men had finished eating and Sahib was rising from the table.
“Rekha, the mango pickle is still not soft,” he said. “It’s like chewing on rocks. Are you trying to break my teeth, you worthless girl?” He dropped the metal spoon with a clang against the pickle jar, overturning it. “Clean it up!” he bellowed as he left the table.
Leena gently touched Rekha’s forearm in silent support.
“Well?” Rekha spun around and barked at her. “What are you waiting for? Don’t just stand there. Clean it up!”
LATER THAT night, Leena lay in bed, dressed in the new cotton gown her mother had packed in her trunk, waiting for Girish to join her. Weary from the long journey and the wedding festivities in the days before, her eyelids grew heavy.
She was aroused some time later by the pressure of Girish next to her. She opened her eyes and started to sit up, but he pressed her back down on the bed. “Shh,” he whispered and shifted his body on top of hers. Leena’s mother had told her what to expect, so she was prepared for the pain, clenching her nails into her palms to keep from crying out. When it was over, Girish rolled onto his back, and Leena felt a rush of satisfaction at having performed her first wifely duty. Perhaps now she could begin to know him.
The next morning she tried to engage Girish by asking him about the farmland and the crops they grew. “Do you raise any sugarcane? My father says it’s his favorite crop. Very hearty, even though the bugs like it too.”
Girish did not see her smile, nor did he respond as he combed his hair in the mirror with great concentration.
“I’ve never seen cotton bushes before. Is it very difficult to harvest?” Leena tried again.
Girish gestured with his hand for her to move aside so he could get into the cupboard. She opened the doors and chose a shirt for him, holding it out. “No. Just let me get it,” he said, tossing the shirt she’d chosen back into the cupboard.
“What are you doing today? Will I see you for lunch?”
“God, so much talking,” he said. “Before I’ve even had my tea.”
“I’m sorry,” she said. “I’ll go prepare it.” As she walked through the house, she noticed things in the light of day she hadn’t seen the prior evening: paint peeling off the walls, dust accumulated in the corners. The tables and shelves were largely bare, devoid of the trinkets and decorations she would expect to fill such a large house.
She found Rekha in the kitchen, annoyed with Leena for her late arrival. “You think you can sleep all morning? There’s work to do. Tomorrow, you get up when you hear the rooster crow the first time, understand?” Rekha turned away. “Worthless girl,” she muttered as she left.
THAT EVENING, Leena decided to try a different approach with her husband. She prepared two cups of warm milk with saffron and slivered pistachios and went to find him. The men’s voices were coming from outside and she followed them, pausing at the door to rebalance the tray in one hand. Girish was sitting with his two brothers around a small table holding a bottle of amber liquid. Her husband tipped a full glass to his lips, took a swig, and wiped his mouth with the back of his sleeve.
“What’s the best thing about marrying a leper?” Girish asked, then answered himself. “She can only give you lip once!” He took another drink.
His brothers laughed, and the younger one reached over to refill Girish’s glass. “She’s bad, huh?”
Girish shook his head. “Never shuts up.”
“I know one thing you can shove into her mouth to make her shut up.” The elder brother stood halfway out of his chair and launched his hips forward, gesturing crudely to his crotch. Girish threw his head back and slapped the table with his hand.
Leena closed the door. The glasses of warm milk, which now had a skin across its surface, clattered on the tray as she walked quickly back to the kitchen. She emptied the glasses, washed and dried them, and put everything back in its place, leaving no trace of her presence.
Leena went outside through the back kitchen door and into the washroom, where she began heating the water. In the morning, there had been no time for this step, and Leena had bathed quickly with cold water. Now, her muscles aching and her head throbbing, she longed to wash away the things she’d heard her husband say.
After her bath, Leena redressed in the same clothes to walk back to the house and into the bedroom, locking the door behind her. She undressed again, opened the metal cupboard, and pulled out a clean cotton nightgown. Remembering thr rose-scented talcum powder her mother had packed in her trousseau, Leena reached to the back of the cupboard but could not find the slender canister. She took everything out of the cupboard, her clothes and Girish’s, all their toiletries, but the rose talc was not there.
Leena was pulling her empty trunk from under the bed when there was a sound outside the bedroom door. The door was forced against its jamb, the knob rattling back and forth. “Hey!” Girish slurred from the other side of the door. “What is this? Open the door, woman!”
Leena, still naked, fumbled back to the cupboard for her nightgown and clumsily pulled it over her head while Girish banged at the door. She opened it, confused between the shame and anger that rose within her.
“What is this?” he said, his eyes narrowed. “Don’t ever lock that door. This is not your house, understand?”
“I was getting dressed.” Leena retreated, pulling the gown up at her neck.
A smirk bloomed across Girish’s face as he moved toward her. “What a shame.”
Leena reached for her comb on the nightstand and began to pull it through her tangled hair. “I’ll be ready for bed in a few minutes.”
“I’m ready now,” he said, reaching for her nightgown. He took one of her hands and moved it toward his belt. “See?” He grinned.
Leena yanked her hand back and turned away from him. She climbed into the bed and continued pulling at the tangles with the comb so hard her scalp burned.
“What?” Girish crawled on top of the bed after her. Leena pushed him away. He stopped and looked at her with bloodshot eyes, as if weighing a decision. Then he pinned both of her hands above her head with one of his. Leena was surprised at the strength with which he held her down. She remembered the day she and Anil hid in the gully, smoking beedis, the terrible scene they’d witnessed. She’d never expected to be treated the same way by her husband.
The next morning, her shoulders and wrists sore from the force Girish had used against her, Leena rose and went to the washroom to bathe. As she arrived, Rekha was leaving, clad in a clean sari and carrying her old clothes in a bundle. As she stepped back to let her sister-in-law pass, the distinct fragrance of fresh roses lingered in the air.
When Leena returned to their room, Girish offered a halfway apology for the night before. “You shouldn’t have provoked me, locking the door and running away from me. I’m your husband. As long as you show me respect, you’ll never have reason to complain. Understand?”
“I want my rose talc back,” Leena said without turning to face him.
“What?”
“I put a can of rose talcum powder in the cupboard. Right there.” She pointed. “It’s gone. I think Rekha took it.”
Girish stared impotently inside the cupboard for a few moments, then slammed the metal door shut, startling her. “Why must you always make so much trouble?”
6
ANIL’S NEW ASSIGNMENT WAS IN THE INTENSIVE CARE UNIT, known for being a particularly brutal rotation. ICU patients were quite ill to begin with and often suffered a rash of new complications in the hospital, so they could
go from stable to crashing at any moment. His first night on call, Anil paid close attention as a fellow intern signed out her patients to him in the break room. Jennifer was a short, perky girl with flaming red curls, who wore glasses with invisible frames that disappeared into her pale skin. Huddled over her sign-out sheets, she spoke in bullet points. “Dina Jimenez. Sixty-two. Hispanic female. Motor vehicle accident.” Jennifer tapped the chart with the end of her pen. “Brain-dead. Son’s on his way from Arizona. If he shows up tonight, ask him for the DNR.”
Anil nodded, tuning out his apprehension. He had never asked a family member for a do-not-resuscitate order—permission to remove life support—but he was certain he could handle it.
Jennifer flipped to the next chart. “Lyndon Jackson. Fifty-four. Black male. Keep an eye on him, he’s a mess. AIDS, kidney failure. Came straight from dialysis in respiratory distress, then his right lung collapsed. Just a mess,” she repeated. “He’s intubated. If his O2 drops, you’ll have to call Renal. I asked the nurses to check his temp every two hours and watch for infection. If you suspect pneumonia, get a chest X-ray. And he’s on a rule-out protocol for MI, so you’ll have to check his EKG for changes at 2 a.m.” She shook her head. “Hopefully, he won’t crump before morning.
“Last one.” Jennifer pointed her pen to the final name on her list. “Jason Calhoun. Fifty-seven. White male. Diabetes and hypertension. Went in for his regular physical yesterday and the internist felt something in his abdomen, so he did an ultrasound. Aortic aneurysm. Eight centimeters,” she announced with pride, as if she’d discovered it herself.
“Eight?” Anil craned his neck to see the details. An average aorta was two centimeters, was classified as an aneurysm at three, and required surgery when it reached five centimeters.
“Yeah, can you believe that? No abdominal pain or anything. Lucky guy.” Jennifer pushed the thin gold arch of her glasses up the bridge of her nose. “Had an angiogram today and he’s clear, so he’s booked for surgery in the morning. We’re just babysitting him overnight. Shouldn’t give you any problems.” She traced her finger down the chart. “I ordered two milligrams morphine every two hours. He was complaining of back pain when he came out of Recovery. Probably just sore from lying on that hard-ass angio table. Then again, I’d probably fall asleep if somebody let me lie down for a minute.” Her laugh, sounding more like a loud bark, reverberated through the break room.
THE SENIOR resident on call tonight with Anil in the ICU was Dr. Sonia Mehta. She seemed taller than her diminutive size as she breezed into the break room and poured herself a cup of coffee. Her surname suggested she might be Gujarati, but Anil didn’t venture to ask. Sonia Mehta was unlike any Indian woman he’d met, and she made him uncomfortable. Her hair was short around the sides and fell down a little over one eye, a style that might look pretty on an American woman. Under her scrubs, she wore a fitted long-sleeve black shirt, a functional uniform of sorts. Reportedly, as code leader last month, she’d run twelve codes in one night and lost only two patients. Another intern had breathlessly described watching Sonia perform a risky bedside pericardiocentesis—inserting a long needle directly into the sac enveloping the heart to remove lethal fluid—saving the patient right there in the ICU.
“Ready for your first night on call in the ICU, Anil?” Sonia sat next to him on the olive-green couch that carried the residual scent of human sweat and stale pizza.
“Yes, definitely,” Anil said, looking up from his papers. Sonia’s large almond-shaped eyes were framed by dark lashes; small silver hoop earrings hung from her ears. He wondered why she didn’t wear gold like other Indian women. There was a flutter of attraction in his stomach and he immediately tightened his abdominal muscles to quell it. She was his superior, a third-year resident and a legendary one at that.
“Listen,” Sonia said. “I know some residents say it but don’t really mean it. If you need help, call me.”
“Thanks,” Anil said. But in this place, calling for help was admitting failure, and he certainly wasn’t going to admit failure to a woman like Sonia Mehta. Among the conflicting emotions Anil felt toward her, his determination to prove himself took precedence.
AT THREE o’clock in the morning, the ICU was an eerie netherworld: completely dark except for the fluorescent lights seeping out from the central station into each patient’s trapezoidal area. Most patients were asleep, but the wheezing of ventilators and beeping of monitors created a continuous soundtrack. Anil checked on his patients one more time, determined to stave off any problems overnight, then found Sonia at the central station, looking just as she had at the beginning of the shift, her skin smooth and her eyes clear. After nine hours, Anil knew his eyes were blotchy and stubble had surfaced on his chin. He rubbed it self-consciously as he gave her a report on his most critical patients.
“Lyndon Jackson, kidney failure, has a slight fever. I was about to send him down to Radiology to check for chest infection when his O2 dropped to seventy-three, so I paged Renal to come dialyze him emergently. I’m ordering a portable chest X-ray to check for infection.”
“Good,” Sonia said. “He’s so compromised, we need to be vigilant about pneumonia.”
Anil jotted a note in the chart. “The diabetic woman you admitted earlier from the ER, I ordered an additional blood draw because her most recent blood sugar was borderline.” It was a precaution, but he’d tried to anticipate anything Sonia might ask for. “Jason Calhoun, abdominal aneurysm. Just some discomfort from the angio table. I upped his morphine and gave him oxygen. He’s going for surgery soon.”
“Good.” Sonia’s pager beeped and she glanced down at the screen. “I have to head back to the ER, might be a while,” she said, walking toward the elevators. “Hold down the fort and page me if you need anything.”
Moments later, while Anil was filling out charts at the central station, a high-pitched beeping sounded through the unit. “Seizure in seven!” a nurse called out. She and Anil ran toward the patient, whose body was convulsing violently. The nurse grabbed his shoulders, and Anil helped roll the patient onto his side. Foaming saliva was drooling out of the corner of his mouth, and his eyes had rolled back so only the whites were visible. The nurse wrapped her palms on either side of the patient’s head to keep it steady while Anil held the man’s wrists together. As soon as a second nurse arrived, Anil shouted to be heard over the monitors. “Gi-gi-give him point one milligrams of lorazepam.” The nurse injected the medicine through the patient’s IV, but the convulsions didn’t stop. Both nurses, struggling to restrain the patient, were looking to Anil for direction. The patient’s skin was beginning to turn a bluish tint and he knew there was risk of brain damage if the seizure lasted much longer. He called out for the nurse to try another anti-seizure medicine. Within a minute, the patient’s limbs gradually stopped jolting.
When Anil released the man’s wrists, he felt the dampness in his own armpits and around his neck. He closed his eyes and breathed deeply a few times, then proceeded to examine the patient carefully for injury. When the patient regained consciousness a few minutes later, Anil asked a few questions and, miraculously, other than being slightly disoriented, the man appeared unaffected by the violence that had wracked him. The same could not be said for Anil.
By the time the seizure patient was finally stabilized, it was 4:30 a.m. The nurses were doing their last rounds, checking vitals for the night, and morning labs would be back in an hour. Anil leaned over the counter of the central station, trying to rub away the dull ache in his temples. It might easily have been remedied with one cup of strong chai, but the Parkview cafeteria carried only weak Lipton tea bags, brewed in barely hot water carrying the trace flavor of coffee. He decided to lie down in the call room for a few minutes.
“Dr. Patel?” Another nurse called out to Anil as he passed the counter. “Mr. Calhoun’s blood pressure is down again—mid-nineties. Pulse is up and breathing’s up to thirty.”
Anil removed his specs and rubbed his eyes with h
is thumb and forefinger. “He’s probably dehydrated. Give him a bolus of saline to help his pressure and flush out the angio dye. He’s going to surgery in a couple of hours. Let me know how he responds. I’ll be in the call room.”
Anil didn’t remove his shoes or white coat before stretching out on the call-room bed. His eyes burned behind their lids when he closed them, but he was too tired to reach for the drops in his pocket. He felt the slightest bit of relief that none of his patients had crumped. Jennifer would be happy. Sonia would be proud. Despite his sore, wobbly knees and the dryness of his eyes, Anil would survive his first night on call in the ICU, along with all his patients.
ANIL WAS aroused by an unfamiliar voice. Woozy, he opened his eyes to see a pyramid of white light casting into the dark of the call room. He squeezed his eyes shut and opened them again, blinking rapidly to focus on the stout figure in the doorway.
“Dr. Patel?” came the voice from the door.
Not another seizure, Anil thought.
The figure spoke again, the muffled words traveling to his ears as if through water. “Dr. Patel, I bolused Mr. Calhoun but his pressure’s slightly lower. Low nineties now.”
Anil sat up and focused in on the nurse. Falling blood pressure in an aneurysm patient meant one thing. But how could it be a rupture? He’d checked for that. He swung his legs out of bed and grabbed his specs. “Where’s Dr. Mehta?”
“Running a code.” The nurse followed him down the corridor. “Should I page her?”
“Yes, but let’s get a CT first.” If the CT scan showed blood in the abdomen, it would mean the aneurysm had ruptured. It was the first thing Sonia would ask him, and he needed to have an answer. “Call CT and tell them we’ve got a STAT patient.” A new rush of adrenaline coursed through Anil’s body when they transferred Mr. Calhoun to a gurney, but as they headed down the hallway toward the elevator, a feeling of horrible dread filled his chest. “Page the vascular surgeon operating on Calhoun today,” he called out to the nurses’ station. “Tell him we might have a rupture.”