Hope is the last to leave

It was a case of a road traffic accident. The patient had sustained severe trauma, multiple fractures and a significant hemoperitoneum. His pupils were fixed and dilated, a silent beacon of what was to come. The residents had already recognised the inevitable; his injuries were incompatible with life. And yet, the ventilator and the maze of machines he was hooked up to continued to sustain him, holding him in that narrow, suspended space between life and death.

His vitals began to fade, the beeping of monitors slowed down and before we could process it fully, his heart stopped. A resident rushed in and immediately began CPR and called out for help. I stepped forward instinctively. We performed compressions with everything we had. Those forty five minutes felt like an eternity. What I remember most vividly is how, two or three times, the monitor flickered a tentative heartbeat of 25, maybe 30. And, each time my own heart kept clinging to that fragile sign of life. I looked at the resident, my voice barely steady and asked what it meant. He glanced at the screen and then at me, ‘Nothing. Sometimes the body just does that.’ 

But how could a heartbeat mean nothing? 

From behind the green curtains, I could occasionally glimpse the bowed heads of his relatives, peaking in. Their eyes searching for signs, their hands folded in silent prayer. Each flicker on that monitor felt so monumental to me. And then it struck me, how little it takes for humans to hope.  Just a single line on that cold, wretched, lifeless screen, That wavering pulse of light for a moment made me feel like life could return even when everything had slipped away. 

I remember my mind going through a cacophony of emotions. As my hands moved in a mechanical rhythm, compression after compression, I silently prayed for a miracle. But deep down, I think we all knew. NO one could survive injuries like his. And still, I found myself clinging to the stories we all grow up hearing, the ones in books and movies, how our entire lives flash before our eyes before they shut forever. Maybe those faint pulses on the monitor were that. Maybe they were his body’s final attempt to make peace with the inevitable. His heart and mind offering him a farewell, one last montage before letting him go. 

In that room, I remember feeling the irony so sharply. In that same room, by the same bedside, we stood hopeless while his family waited with desperate hope. My hands trembled, yet I kept pressing on his chest, elbows locked, counting under my breath. It was the only thing that anchored me and kept my thoughts from going into a spiral. 

I thought about how the human body fights beyond what seems possible while being hooked up to all these machines. But hope? Hope fights even harder. In moments like these, we come to realise that hope is never rooted in the tangibles. It exists in small spaces. In between heartbeats. In the silence between two breaths. In  the narrow distance between the green curtain and the flickering monitor. 

Hope is always the last to leave. It lingers long after reason has surrendered and science has spoken. It lingers after everything else has let go. And then, only when the body finally gives up, the heart stops its final fight, when every effort is exhausted, only then, hope releases its firm grip… and gently slips away.

-Dhruvi Joshi