Scenario: A young 27-year-old male was brought by an auto driver to the Accident & Emergency Department with a history of road accidents. His body was completely mutilated with multiple broken bones, visible deformities, head injury and a ‘fountain’ of red blood from his right femoral artery due to a punctured wound. Though he was gasping while being shifted from the autorickshaw to the stretcher, his breathing stopped completely by the time he was wheeled into the resuscitation bed.

Despite immediate intubation and all our resuscitative efforts, he succumbed to his injuries.

My hands trembled as I looked through the contacts on his phone to search for ‘home, ma/mom, papa/dad, bhai, baby/sweetheart/wifey etc. I slowly gathered the courage to call on 'dada' (which mostly means 'elder brother') as I did not want to make the first call to his mother, father or wife.

I was at a complete loss of words when he picked up the phone. What should I tell him? The images running through my mind were of how my own elder brother would react if he received such a call. 

"Main Hospital ke Emergency Department se Doctor Mohit bol raha hun, aap please jaldi hospital aa jaiye."

"Doctor kya hua? Yeh mere bhai ka number hai, usne kyun call nai kiya?" he asked.

"Main jyada kuch nai bata sakta phone pe, aap aa jaiye aur kisi family member ko bhi sath le aiyega," I replied.

"Theek hai, main abhi office mein hun, thodi der mein Papa ke saath pahuchta hoon.”

The scene that followed cannot be expressed in words. The reaction of the brother, the father, all the tears, the disbelief, the trauma, the shock…the mother fainted on arrival and later with tears rolling down her eyes, she asked me, "Doctor, usne kuch bola kya marne se pehle? Woh kitni der tak zinda tha? Saasein chal rahi thi kya uski?” – probably she wanted to hear if he left any message or final words, and I didn't have a proper answer for that. Maybe I should've made up something? There are tears in my eyes as I think of that mayhem again to pen down these words. 

After a month, the father and the brother came to get life insurance forms filled. I found out that he just got married 3 months ago. On the day of his accident, his mother had just been discharged after an angiography (with a report of few coronary blockages, which could be medically treated) and he had just brought her home from the hospital and left with a friend to buy some sweets to celebrate her arrival. The brakes of a dumper had failed on Jogeshwari Vikhroli Link Road (JVLR) and the truck driver rammed into 7 vehicles and the body of the pillion rider was ripped into pieces at the spot of the accident.

The life of a doctor is complicated and gets even worse when he/she is working in the stressful environment of an Accident & Emergency department (A&E).

An emergency physician has to be a JACK OF ALL, AND A MASTER OF ALL as it cannot be predicted what will come in through the entrance door – an accident victim, a patient with a heart attack, a stroke, a seizure, a patient fighting to take a breath, a geriatric, a pediatric, a pregnant patient, apart from the regular emergencies across all specializations.

What makes this branch different is the number of emotions, expectations, always, dealing with blood and death on a routine basis, with no margin for error.

Seconds and minutes can make all the difference between life and death.

Doctors working in the A&E and ICUs have to be 2-faced, hide their humane emotional side when dealing with a critical patient and delivering bad news while thinking with a straight head about the best modality of treatment. The worst part of this job across the world would definitely be dealing with young deaths.

It would be a lie if I said I have never seen doctors break down and cry after declaring a patient dead.

Like most doctors working in the A&E department around the world, I too have had the MISFORTUNE of giving bad news to a father, a mother, a sister, a brother, a wife and friends about the death of their loved ones – at young age of 21, 24,27,29, 31, 37,42 etc.

And just while all this is going on, YOUR DOCTOR in the Emergency room pulls himself back together and gets ready to tackle another challenge – The Next Patient.

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