‘He stole my arm, it’s gone.’ Guran screamed when I reached his bedside. ‘Have you had dinner yet?’ he dramatically dropped his voice and whispered, as I began to prepare the needle. That stalled me. It wasn’t the question, but his whispering that gave me second thoughts about administering the sedative.
It was not unusual for people who have lost a limb to feel its presence. Such patients often complain of acute pain in their phantom limb or are even known to ‘stretch’ the limb out to receive something. They were not crazy, let’s just say their brains had not yet come to terms with the loss. After all, it was the limb that was severed and not the cells in the brain that controlled and received signals on behalf of the arm. Guran’s case was unique. He was declared clinically insane, and he had lost an arm. That’s why he was here at the State Neuro-Sciences Centre (SNSC) and not in a regular post-trauma recovery centre.
‘Why don’t we all like funny movies?’ he continued his routine without the anxiety that usually accompanied it. ‘Why do some of us like scary movies? Why do some people find it amusing when they see others frightened? Why did you come alone today? Where’s Dr Bhat? How does Dr Bhat know so much about me? How bad does someone have to be, to be called bad? Do you get more money if you treat me for longer? Have I paid all the bills?’
Guran did this routine almost every other week. Today, it was much earlier and I was still on duty. Usually, he would wake the nurse on night shift with an ear-piercing and bloodcurdling cry, just a little after midnight. He would repeatedly shout that someone had stolen his arm and then a string of unconnected questions would follow. I would be awakened and in response I would instruct the nurse to place a call to Dr Bhat, the department’s most experienced psychiatrist and somewhat a father figure to legions of doctors who passed through the training halls of the SNSC.
I would arrive to find Dr Bhat seated patiently by Guran’s bedside. He would offer a very faint yet decipherable nod to acknowledge my entry. I liked to think that during this time, he rehearsed the counsel that he was about to give Guran. I would check all the vitals and then administer a dose of Midazolam. Soon, the drug would take effect and calm Guran.
Almost like a storyteller who gets better with every retelling, Dr Bhat surprised me with little nuances in each of these late night sojourns that we shared. My surgeon father, who still practiced at the SNSC OPD block, always told me that a good surgeon was much like a stage actor. The surgeon had to prepare himself before every operation; he had to get into character, don a garb, mentally rehearse the moves that he would make, both scripted and otherwise and then set the tone of his entry so that the other characters — doctors and nurses —were snapped out of what had become a routine for them. Finally, the surgeon had to live up to all the expectation.
Dr Bhat would clear his throat and Guran would take the cue, straighten-up and listen intently. The doctor began the flashback by narrating the sequence of events that led to the accident in which Guran had lost his left arm. He would explain how Guran had made the right choice and therefore lived. The arm was a small price to pay. It was only during this period in which he believed that someone had run away with his arm, did Guran hold the stub of his left arm at the shoulder with his right hand. The rest of the time, he simply ‘clasped’his hands and placed them in his lap. Guran’s anxiety would eventually abate and he would begin murmuring softly. The combination of the drug and Dr Bhat’s reassuring flashback would always succeed in lulling him back to sleep.
‘Have I paid the bills, uh doctor, have I, have I?’
‘You have Guran, you have.’ I assured him. Unlike usual, I had held back from administering the sedative. Guran didn’t sound agitated. Today, Guran had not continued his barrage of questions endlessly and he began to murmur softly. Besides, I always administered the dose in Dr Bhat’s presence. It was a technicality, but the SNSC insisted on the presence of a psychiatrist and a nurse before a patient was given Midazolam or any such sedative for that matter.
Guran had fallen silent and I could now faintly recognise Dr Bhat’s mellow tone from across the hall. Knowing that I was still on duty and that I would respond to Guran’s outcry immediately, he must have decided to make a slight detour and see Milind first. So we had two agitated patients today.
Milind was a firefighter who suffered from Post-Traumatic Stress Disorder usually referred to by its abbreviation PTSD. He had been brought to the SNSC to go through a series of counselling sessions and then he was to be discharged. Two months into his stay, SNSC lost its first patient to suicide. Vineet, a long-time sufferer of schizophrenia, who constantly feared that he would be pushed to his death, had appeared to have jumped off the fourth floor and landed on an ambulance parked underneath. The driver, who was asleep in the ambulance, was rudely awakened by the thud. He bolted out of the ambulance and saw Vineet lying on the roof with his neck turned at an awkward angle. He instinctively looked up and saw a face peering down at him. It was only four stories up and the facility was reasonably lit. So when he was brought up to the ward and identified Milind as the face he had seen in the balcony, the authorities had little choice but to think that Milind was indeed guilty. They didn’t believe Milind’s defence hat he was merely looking down to see what happened and that he had not pushed Vineet.
Had the driver overestimated the speed at which he got out of the van? Perhaps he heard the thud and then sat still to gather his wits about him and looked around to ascertain the source of the noise. Then once he got out he realised that the thud he had heard was from something having fallen on the roof of his own vehicle. Once he saw Vineet, he must have taken a few moments to recover and then had looked up to see Milind, who had just then arrived. But the odds were stacked against Milind and now, even if he made it out of the SNSC, he would be locked up in a cell for a very long time. Though it seemed like a closed case, most of us believed that Milind was just a victim of circumstances. We had not certified him fit to leave the SNSC and that had kept the police and the court ruling, at bay.
It was my turn to give Dr Bhat the subtlest of nods as he moved the curtain and walked to the bed. He seemed his usual cheerful self. As he was about to sit down he jerked his head in the direction of the injection. I told him that Guran was unusually calm and hence I had refrained from giving him a shot.
‘How are we today, uh Schumi?’ said Dr Bhat, even as he laid a gentle hand on Guran’s forehead. Only the oldman could call Guran ‘Schumi’, referring to the famous Formula One champ, and fear no reaction. Others in the department were scared to throw him in a fit or remind him of the unnecessary. However, Guran shared a relationship with Dr Bhat akin to what he possibly shared with his comrades in the battalion. He looked up and smiled, ‘I’m good, Doctor.’
That surprised the old man. ‘Are you sure, Guran?’ he uncharacteristically added. I must have been quite tired, for I thought I detected a slight tinge of disappointment in the doctor’s voice as he anticipated the possibility of having to go without the customary recital. We said goodnight to Guran and walked together across the hall.
‘What was different today?’ Dr Bhat said in a hushed tone.
I looked at him for a few seconds and let the implication of that sentence sink in. ‘It was earlier than usual…’I solemnly said.
I continued, ‘I checked all the vitals, inquired about who he met today, what he ate, what he watched, just the routine; nothing out of the ordinary.’
We walked out into the lawns of the SNSC and took in the cool night wind. It was a bit chilly, but not enough to get our mufflers out. Dr Bhat turned to me and then gave his legendary smile; it was heart-warming and at the same time it was foreboding of something important.
‘It’s interesting you should say that…’ he said and recognising that I needed something more to go on, added, ‘you said, nothing out of the ordinary.’
‘Why does that amuse you?’I joined in.
‘Well, for starters, your Dad never liked it if anyone concluded their assessment of any case with that.’ He then leaned in to look me square in the eye and said, ‘he used to say if there was nothing out of the ordinary, then by definition, what you were looking for, was indeed very ordinary.’
As I drove home, I pondered over what Dr Bhat had said. It wasn’t new to my ears, for I had heard it countless times from Dad, but it had me thinking. I went over and over what the nurse had told me about Guran’s day. I then ran through Guran’s questions. While the questions were different with every episode, they were in a way, quite normal. I was certain they meant nothing, but I decided to run through them one more time.
I didn’t entirely recall each of them nor the sequence in which they were asked. Though, for some reason, I recollected more than I would have on days that I had sedated Guran.
He’d asked something about funny movies, about the things that frightened people, the regular bits about Dr Bhat, about how long I’d be treating him and if I got paid more to do it; implying that it was in my interest to keep him longer. I knew it was his delirious mind and not him directly accusing me. As usual he had ended his barrage of questions by enquiring whether he had paid all his bills. Had it not been for the fact that he had been repeating this every time, this last bit felt like the kind of thing that should attract one’s attention when they’re looking for ordinary in a crate of ordinaries.
I knew I had missed something. So I kept going back and forth. It reminded me of the feeling I’d get when I’m locking the house before leaving on a vacation; I’d never feel I got it right unless I did everything in a sequence. So I promised to do it one last time after dinner, before I went to sleep.
Over dinner I called Dad and as was customary on our calls, we always spoke a little about the case that was currently keeping us preoccupied.
‘Double surgery, patient had his heart operated on in the afternoon and we had to remove a tumour from the same guy’s brains a couple of hours later, stable though.’ Dad went first.
‘Just an aberration, this guy, Guran…’
‘Ah, the phantom limb,’ Dad interjected.
‘Yes, that’s the one…’I continued, ‘See, he usually throws a fit when, upon waking, he temporarily recognises that he indeed doesn’t have a left hand. Dr Bhat calms him down and then he eventually falls asleep. In the morning he’s back to feeling his phantom limb. Today was different, he was mighty calm. It could be nothing… just his whole behaviour got me curious.’
There was silence on the other side. Dad rarely jumped to conclusions. After a while he said, ‘If he was calm, then it has to do with him having got an answer, at least for one of his questions.’
My mind was racing now. I mumbled a goodnight and hung up. I started running through Guran’s questions, in order, out of order, even jumping randomly from phrase to phrase. Then I started all over from the moment I had responded to his scream, right from when I had rushed across the hall and waved the curtains away. What did he say first?
‘Someone no… he… stole my arm…’ Guran had used he. He always said someone. Was I making too much out of this? How did it matter if ‘someone’ or ‘he’ stole the arm? The arm wasn’t there to be stolen.
It still bothered me. Why had he used he after all these days? Could he be referring to somebody in particular? I could ask him, but once he awoke, it was another day and he would have no recollection. Besides, his phantom limb would no longer be missing from his point of view. There was another way I could find out without troubling Guran. When Vineet had jumped to his death, the SNSC administration was instructed by the board to install CCTVs. They didn’t have enough funds to put a unit in every nook and corner, but each hall did get one camera overlooking the beds. I decided, I would go have a look at tonight’s footage. Sleep could wait.
When I reached the SNSC, I was surprised to see Dr Bhat’s car in the parking lot. He must have been called to handle some sort of emergency. I entered the main wing and immediately took the stairs to the right. I didn’t want to bump into Dr Bhat, lest he should ask me what brought me back here. I didn’t have a sound reason. I knocked twice on the security room and then waited. Balraj answered the door with a surprised look, ‘Doc, what brings you here at this time? First Dr Bhat, now you?’
Balraj was stationed in the security room but he mostly helped with admin and facilities.
‘Something odd with Guran… just wanted to see if the footage lends me any clues.’ I explained. Balraj said, ‘You’ll only get a week’s footage, the rest is in a hard-drive in the storeroom.’
‘I only need tonight’s..,’ I smiled back.
Balraj explained the keyboard controls and showed me how to go back and forth. ‘It moves fast, so you can lose entire bits if you don’t keep an eye on the time code. I’m off for the night. If you need help, just call me on my cell. Good night, Doc.’ he said as he collected his bag and lunch box. ‘Ah yes,’ he added, ‘once you’re done, just pull the door behind you, it will lock automatically.’
Just as he turned to leave, I casually asked, ‘So what brought Dr Bhat back here?’
He chuckled, ‘Now the firefighter is having nightmares!’
‘Oh, yes,’I re-joined, ‘I should have guessed… good night then.’
The room was too dimly lit for my taste and though it was on the first floor, I felt like I was in the basement. I rewound until the time code read 21:00:00. It was shortly after nine that we had heard Guran’s scream. The CCTV unit was located just across Guran’s section so I had a decent view of the aisle and Guran’s bed, but only a portion of the hall. As I sat peering into the monitor it occurred to me that I had no clue about what I was expecting to find. For what seemed like eons, nothing in the bluish hall seemed to move. At around ten past nine, the nurse appeared to dart across the hall. Just then I let out a yawn, and fearing that I had closed my eyes for a bit, I rewound to the point where the nurse had walked and watched again, this time at a slower speed.
I was just about to speed up the replay when a movement caught my eye. I crouched and went closer to the screen, and then I froze. I thought I saw somebody flash by Guran’s bed. I rewound and put it on normal speed. As I watched and the implication of what I was seeing dawned on me, I felt a chill run down my spine.
I went over it repeatedly. It was unmistakeable. Though it was only for a split second, Milind seemed to be tugging at Guran’s ‘left’arm. He then ran away even as Guran screamed after him. When Guran said, ‘he stole my arm’ he was referring to Milind who had acted like he was making off with Guran’s infamous phantom limb. All these days Guran had woken to see that his arm was missing and he felt someone had made off with it. In reality, those were just brief episodes wherein the brain cells that usually ‘felt’ the phantom limb were in some state of suppression and did not register the usual presence of the limb. In these episodes his other senses rightly saw the stump for what it was and that alarmed him. Today, for the first time he had woken to see someone making off with his limb. What he seemed to fear everyday was true after all, he wasn’t mad, he must have reasoned. It was this thought that had left him less agitated than usual.
So Milind liked to play pranks. Though, it wasn’t this that had sent a chill down my spine. Wasn’t Vineet afraid of being pushed from the roof? Just like in Guran’s case, everyone knew about Vineet’s fear. Quite often the nurse would spot Vineet peering over the balcony and then she would call out to him. He would hurry back to his bed, feverish and soaked in his own perspiration. When we feared something, we often went to the edge just to confront it and console ourselves that it wasn’t real. What if on that fateful night, he had walked to the balcony, peered down as usual and then when he turned, his greatest fear seemed to have come true, for Milind stood there an inch away from his face? Milind probably didn’t even move a muscle. Just his presence and the very realisation that his greatest fear had come true had tipped Vineet over the low railing.
Milind was no longer a firefighter. He had taken a life.