It was just another regular day. I had returned earlier that morning from a short trip to Bangalore. And, before we stepped out for work, I spent some time with umma, my mother, sipping tea, reading the morning paper, talking about Bangalore and all the people she knew. There has always been a part of Bangalore in her and it held a special place in her heart. We went into the office where my wife doubles as my partner at work and we were back home by 5:30. That evening, exhausted from train lag, I did not carry enough energy for the gym and decided to skip my workout. 

I was lazing on the bed in my room undecided on whether to watch Netflix or to get started on this book I had picked up from the IndieComix  Fest at Bangalore- Ghosts, Monsters and Demons of India, “an encyclopaedia of evil entities and folkloric fiends”. My wife had just stepped out to the gym and I asked my umma who was watching TV for a cup of tea. I could hear her in the kitchen. A few minutes later she brought it to me and placed it on my writing desk. She cut a slice of dilkhush which I had brought from Bangalore for herself  and said- we don’t get this here. I said yes, these ones you find in Bangalore. I returned to my room and as I lay there she came back and reminded me to have my tea or it would get cold. I sat up and finished my tea and as I lay there I heard her switching channels. I could hear the sports channel on. I knew she was not able to switch to the news channel and went back to help her. 

As I walked into the living room, I noticed her fidgeting with the SmartTV remote in an unusual manner. The moment I saw her I knew something was off. Something was not right. A side of her face had collapsed, her lips had drooped and she was slumped with her arm resting on the easy chair. I immediately sat beside her and spoke to her. She was able to understand my questions but her replies were slurred. It had all the symptoms of a stroke. I quickly dialled  my cousin, the rascal of the family and asked him to pick up my wife  and get back home. Sensing the urgency in my voice he did not ask why. It was 7:50 PM, and from now on every second counted. He did what I told him. Within no time he reached home with my wife. Meanwhile I had carried umma to the bedroom as she had an urge to use the privy after which I moved  her to the bed. I did not let her lie down. She sat upright beside me as she leaned on my chest. 

My wife nor my cousin did not stop to ask any questions, they knew this was not the time. We quickly moved her from the apartment to the elevator and to the car. There was no wheelchair available. My wife drove with my cousin in the front passenger seat and umma and myself in the rear passenger seat. I held her in my arms, comforting her and speaking to her. She was confused by the unfolding events, trying to make sense of why we were rushing her to the hospital. She didn’t know why.

Looking at my mother’s symptoms I knew she had suffered a stroke and it needed quick attention. Time was of the essence and we had a very small window to get her treated, the golden hour. A blood clot in the brain if not treated in time could be debilitating. We reached the emergency room of the closest christian missionary hospital in the vicinity of our home, the same hospital where my mother underwent monthly checkups. A nurse and a junior doctor walked casually to our car with no sense of emergency. We requested a wheel chair or a stretcher. As we asked for help at the emergency, I told them my mother was displaying symptoms of stroke and she needed immediate care. They refused to admit us and turned us away saying there were no free beds available in the casualty nor were there any beds available in the hospital to admit her. I knew there was no time to argue and no time to lose. We did not wait and started the car to get to the next available hospital. Sitting in the back seat of the car with my mother slumped and resting on my shoulder, I called another multispecialty hospital nearby and asked them if they could take in my mother. There too were no available beds. 

We decided to take her to a nearby clinic where she could receive emergency care and made a call to them. They asked us to bring her in and my wife drove caring little for traffic rules with the hazard lights on warning other vehicles. When it came to protecting her family, my life partner was a German Shepherd.

We reached the clinic and we were asked to get a CT scan without losing time by the doctor. We rushed to the closest medical imaging centre. The clinic had called them ahead and informed them that a patient was on the way.  We reached the imaging centre and they rushed us in and placed her on the patient table. My mother was aware of what was happening around her but was not able to make sense of it. The stroke had now begun to affect her thinking, awareness and attention. I reassured her and spoke to her every step of the way. Never leaving her hands for a moment. 

Once the CT scan was done, the whole process did not seem longer than 20 minutes. We rushed her back to the clinic, where the doctor advised that treatment be commenced to prevent any damage. She was immediately given medication and I asked him whether the case needs to be escalated. He said treatment can be immediately given at the clinic, but if required, she can be shifted to a hospital with better facilities. Having given her medication we had time to move her to the next best hospital close by. This time we took her by ambulance.

We reached the hospital in what seemed like forever. But there again we were refused to be taken in. With my mother lying in the ambulance, in a state of semi consciousness, doors open, waiting to be taken in.  There were no free beds available in the casualty. By this time extended family members had reached the hospital and there seemed to be a fog of confusion amongst them. Finally the doctors on duty decided to take us in giving consideration to the need for urgent treatment. We were told there were no beds available in the ICU. Calls were made to make sure an ICU bed was made available. While I was with my mother in the casualty, the doctors on duty took notes of her symptoms and most importantly the time the event took place. They made my mother make rudimentary hand movements to check her responses. She was able to raise both her hands but she was not able to grip with her left hand. Treatment had to be started and there was a window of time available to dissolve the blood clot using thrombolytic medication. They moved her to the ICU under the admission of the neurology specialist.

But before moving her to the ICU, there was this minor and pressing issue we needed to take care of- hospital systems and processes. I visited multiple counters to get her admission paperwork done and file processed after payment and insurance formalities. Every second passed with dreaded anxiety. There was no system in place to bypass bureaucracy even in an emergency. A bypass of the heart is  far easier than that of red tape. A payment was to be made for the advance. A token had to be taken and I waited for my number to come up. When my number turned up on the screen I jumped to make the payment only to be made to wait longer as a software update had held up the system. A software update. I could only hear myself screaming inside.

My wife and myself walked beside my mother holding her hands reassuring her as we moved her to the ICU. The long wait outside the ICU had begun. The doctor on duty came and appraised us of the situation and the urgent need for decisions to be made. A blood clot in the brain is a harsh medical emergency and requires prompt intervention. The specific method for removing the clot depends on various factors, including the clot’s location and the patient’s overall health.

The doctor informed us of two treatment methods available to us-thrombolytic medication and mechanical thrombectomy. Thrombolytic medication was the best course to be taken considering her age and other health issues and we still had the window available to commence this treatment not necessitating mechanical thrombectomy which is a more severe treatment methodology with higher risk factors.

In thrombolytic medication, intravenous (IV) thrombolytic drugs, such as tissue plasminogen activator (tPA), are administered to dissolve the clot. This treatment is time-sensitive and is most effective if given within a few hours of the onset of symptoms. We knew accurately the time of first onset of symptoms- 7:50. The time was now 10:00.

When the clot is large or in a critical location, a mechanical thrombectomy may be performed. This involves using a catheter and a special device to physically remove or break up the clot. Considering my mother’s age and health factors this was not advisable and not necessary as of now.

I did not hesitate and asked them to take the best course of action and signed all the consent forms required for the same. More papers to be signed.

Remember, It’s essential to seek immediate medical attention if you suspect a stroke as rapid treatment is crucial to minimise the risk of permanent damage or even death.

It was 10:15 PM, we sat in the waiting area outside the ICU where many others waited tirelessly, for their loved ones who were being treated inside. Many slept on the floor. In hospital corridors, you see tired faces, sunken eyes from sleepless nights, people carrying the weight of their own bodies as if it were a burden.  And sometimes in the forlorn corridors there are moments of joy.

The doctor called us again and informed us that the medications had begun and we had to hope for the best. Exhausted, we decided to sleep on the floor that night. My wife prayed all night. She was my anchor and she loved my mother more than she loved me.

We rose early from the commotion in the waiting  room. People had begun to rise. I bought tea and waited for the doctors on duty to call us. Meanwhile I had befriended the security guard outside the ICU. A kind soul, from Nepal with Gorkha heritage. All the security guards at this hospital were enlisted from Nepal. Their knowledge of malayalam was effective and fluent enough to converse meaningfully though they did have their share of head-scratching muddles.  In the light of increasing incidents of violence against  doctors and medical workers, hospitals had begun employing security professionals who could handle a crisis and communicate well.

It was 10 AM. The doctor called us to update us of my mother’s status. She was responding well though her breathing was weak. I went in to see my mother. She was awake and she had an oxygen mask and feeding tube in her nose. She seemed anxious and was disturbed being in the ICU environment. The sounds of instruments and heart rate monitors never stopped. She was not able to speak. I reassured her, held her hands, rubbed her forehead and spoke to her. She calmed down. I said- we will be out of here soon. She nodded her head. 

By now most of the relatives had come to know and they were eager to call. We attended only the most important calls as the battery on both our phones were low. In the madness of moving my mother from hospital to hospital we were receiving calls. Importune at that moment and unhelpful. However bad news travels fast, faster than any good. But nonetheless the most important thing for us to do was to stay calm, focussed and block out the noise.

Wellwishers poured in with comforting words and support. Cousins I relied on called to assure us. Even if they were not present, I had the comfort of knowing they were around. People I could rely upon. I am forced to make an (dis)honorary mention of an obnoxious, obnoxious aunt with the most distasteful and unhealthy habit of imposing herself on others. Living alone and frustrated, her unhealthy habits had only gotten worse. She poured her pessimism on us like snake oil in a frying pan and we wiped off the grime clean. We have all encountered at least one crabby aunt in our lives. A rotten egg in a basket of apples. Optimistic and never giving up hope, we knew we would come out well from this. These were life’s little crucibles. We waited patiently. 

Later that evening, we were allowed to visit my mother in the ICU and my wife went in. On walking in she saw umma sitting-upright and leaning on the bed which was a very good sign. She was alert, aware and conscious. She was able to move both her arms and there was no threat of paralysis. She spoke to my wife with awareness though she was eager and anxious to get out of the ICU. My wife comforted her with words and the warmth of her hands as she left and assured her we will be seeing her soon. My wife beamed with happiness. Hope, the only thing we held closely had not deserted us. 

If you haven’t done a road trip with your mother, you haven’t lived your life. My mother is the kind who loves to see the world. Very observant of people and events, she enjoys travel. I have been fortunate enough to take her on more than a few road trips. The most recent one being to Mysore and Coonor via Veerapan’s Satyamangalam forests and Bandipur. She loved it. She was excited to see the hills where the brigand once reigned. Sitting in the rear seat, she had a lot to say on the people, the villages, the small towns and the landscapes we passed through. Travel healed the bruises in our souls and brought us together unlike anything else.

We visited Makkah to perform our Umrah together. And there was no greater blessing than being able to complete the tawaf as I rolled her in the wheelchair. We had a trip planned to Turkey and Kashmir. In her words- we haven’t lived our lives unless we have seen Kashmir. It sits there waiting for us to visit her. 

She loved animals and was especially sympathetic towards elephants and dogs. Stories of Arikomban, Padiyappa and PT-7 fascinated her. PT-7, she held closely to her heart. The news that PT-7 had lost vision in his right eye had saddened her. Umma too was blind in her right eye from birth. And with the sight of the one eye, she taught me letters, numbers, colours and so much more. About life, people and the right from the wrong. We have our flaws; we could have been worse if not for our mothers.

She disliked sleepovers at unfamiliar places, be it at her sister’s or relatives. The only place she found herself truly comfortable apart from her own home was her paternal house, where she was born and raised. It no longer stood where it once was. That home was now symbolically replaced by her late brother’s home. Familiarity is always comforting. It soothes our senses. Now, for her, nothing could be more comfortable than her bed at home. Not this unfamiliar room, in this unfamiliar hospital bed.

Meanwhile the rascal of the family who had reached our home within no time to our aid kept tabs on us to see how my mother was doing. He had reached home without asking questions to help us. He held my mother gently, put on her slippers and helped us carry her to the hospital. Without him, it wouldn’t have been possible to make sure my umma made it to the hospital on-time. And yet he is considered the rascal of the family. Be a rascal and you are labelled a rascal your entire life. 

The doctors came with good news the next day. There was no paralysis though there was some damage from the blood clot. Umma had made a remarkable recovery. Now we could breathe as she did. Hope kept us alive. 

Her oxygen levels were normal and creatinine stable with no spikes. We were informed she would be sent for an MRI scan to check for signs of bleeding. Issues with the MRI imaging machine had pushed the scan late into the night well past 12:00. It poured without a break that night. I could see umma was anxious as we moved her from the ICU to the imaging facility. We shifted her by ambulance as it was located in a building across the road. This was the first time my mother had come out of the ICU since her admission. She looked weak and tired. A bit after 1:00 AM we took her back to the ICU with the attending nurse. We took a bystander room nearby and slept. 

We became acquainted with the parents of a young boy, Andrew, who lay in the bed next to my mother in the ICU. The eighteen year old was now in his 25th day of hospitalisation, most of it in a state of cold, sedated unconsciousness in the ICU. He had a very rare disorder, a mitochondrial disease. It was incurable and could last a lifetime. I am told there are fewer than 100 thousand cases per year in India and treatment is very expensive with no scope for health insurance. The mother and father stood all day, all night outside the ICU. When they had the opportunity to visit their son, they spoke to him as he lay there hoping that he could hear their voices in his subconscious state. They asked us to pray for him and we did.

Early next morning we were called in to meet the doctor and visit my mother. There were no signs of bleeding in the MRI scan. My mother was much better and she spoke with awareness. She spoke about the patient lying in the bed opposite her. Her name was Sharifa. We had a Sharifatha at our home for many years. The familiarity of the name brought some comfort for my mother and she laughed at her northern Kerala dialect which befuddled the doctors and nurses. Umma has this sense of timing for her verbal wit and sharp-edged repartee, cutting both ways.

The doctor assured us that we can move her to the room the next day as she had gotten a lot better and I told my mom that we would be moving. She was relieved. She hadn’t watched the news for a few days nor read the paper. 

Meanwhile, the hospital had informed us that insurance was denied. By god’s grace I was on good ground so paying the bills wasn’t a worry. I was aware of the possibility of insurance being turned down due to pre-existing diseases. My father never had any health insurance for the family and I had got my mother insured with great difficulty.  Denial of health insurance to senior citizens in their twilight years is simply unfair and deserves a space in the front pages of newspapers and television prime time news. 

Now, mom was far more alert and aware. She was scheduled to be moved to the room later after a CT scan of the abdomen. The CT scan was taken late in the evening and we went straight to the room from the CT imaging centre and my mother was relieved. With the feeding tube and respiratory mask removed she could speak.

I switched on the news for her and handed her the television remote along with the day’s newspaper. She was happy to hold the paper in her hands as were we and to her relief there was some excitement in the breaking news of the day. And she was glad to see India playing Pakistan in the world cup.

As we left the hospital, we met Andrew’s mom and dad. Andrew was still under cold sedation with few responses. When they visited him earlier that day, in a state of unconsciousness he cried and tears rolled down his face as they spoke to him. That was a sign. Hope. That’s what keeps us alive. Hope. Nothing more.