Being an Outcast

Lightness of soul

He woke up to the sound of shower running in the adjacent bathroom. It was quite stark in that hour of the night. He covered his ears with a pillow hoping to dispel the disturbance. Suddenly he realized he was not alone in the room. He reached out to his phone and looked up the time. It was 2am. His 3-day-old baby was peacefully sleeping in her cot. His wife was nowhere in the room. 

"C'mon Cathy, how many times do you have to shower? At this time now really? Come back to bed" Prashant voiced lazily. He just wanted to go back to sleep. 

He heard some fumbling and then some shuffling and then rapid panting. He wasnt sure whether he was still dreaming. He slowly opened his eyes and adjusted to the dim light making its way through a small gap between the ensuite door and their bedroom. 

Catherine was hunched over at the edge of their bed making some crackling weird sounds. He sat bolt upright this time and reached out to her. 

"What's wrong?" 

"I need to rush to the hospital. I don't feel well" was all Cathy could say almost out of breath and in broken sentences. 

"But the baby....." his voiced trailed off. 

"I'll drive. You stay with the baby," was all she could say. 

He was too groggy from lack of sleep, he was unaware of how bad the situation was and he kind of didn't want to leave the warmth of his bed. It didn't hit him until long after she was gone and until the phone rang and he saw the time on it to realise how long she had been away. It was now 6am. Four hours had elapsed. Cathy still hadn't messaged or called him to update him. She knew the baby would be hungry soon. How could she be so reckless he initially thought. Then he realised she had felt unwell enough to leave them in the wee hours of the morning. What could be wrong he wondered. 

                                               

                                                            ***

He ignored the unknown number in his phone screen buzzing almost eerily. His three day old baby was now wailing for milk and in all the helplessness and frustration he just kept letting the calls ring out full. When the phone rang full for the fifth time, he picked it up and curtly answered. 

"Yes, who is it?" 

"Is that Mr. Gurung, husband of Ms. Catherine Riley?" 

"Yes it is. Who is this?" 

"Hi, my name is Patricia Lamington, I'm the consultant cardiologist here at St Mary's Hospital. Your wife had a cardiac arrest and is undergoing intensive treatment. I'm sorry to have broken this news to you this way on the phone but you needed to be informed. You are her only family listed on next of kin. I called you to get consent for an emergency surgery we will have to carry out on Catherine as soon as possible. Will you be able to come to hospital to sign the consent please?" 

Prashant's heart sank. He could not believe what he was hearing. His eyes welled up and there was a huge lump in his throat. He was trying to speak but words failed to come out. 

"Are you still there?" 

"I'll be there as soon as I can. I don't know whom to leave my baby with. She's just three days old"  Prashant said clearing his throat. Catherine had long been estranged with her parents.

"Bring the baby in as well" Dr Lamington replied. 

"Where is she now? Can she talk?" He implored. 

"Catherine is in Emergency Department in a very critical condition". 

He hung up without a proper end to the conversation. 

His mind was racing. Back and forth. Remembering all the time his wife had given him joys. Flashbacks to the times when she had been not so great too. He looked at his crying daughter. Catherine had blessed him with her birth. He was grateful to her for that. 

                                                         ***

When he first met Catherine at a book fair in Pokhara, she was this confident, funny, witty 30 something blonde woman from London. He soon discovered how honest and child-like she was. He had never come across any woman like that so far in his expansive dating spree in his country. He had fallen in love many times, yet he had not felt enough in those relationships to make him want to commit. There was this distinct masks those women had been wearing, hiding their inner core from him, withholding something from him. That always left him feeling deprived and fake and undernourished. 

At the book fair, Prashant had struck an interesting conversation with Catherine. That’s how they had met. He was stationed at one of the stalls selling books of international authors and his fingers carelessly stroked the paperback copy of J.M.Coetze’s “Disgrace”.

“Have you read much of Coetze?” Catherine had asked him.

He had looked upto answer her and found himself squarely facing an atrractive blonde girl with big imploring doe eyes.

“Just this one” he had replied shyly.

“You either love him or you aspire to be him, that’s how Coetze is. Don’t you agree?” she had suggested.

“I disagree” he sheepishly uttered. It wasn’t that he disagreed. He just wanted to pursue conversation with this girl.

“and your perception is different because??” she almost quizzed him for an answer.

“Do I need to have one?” he smiled.

“Beg your pardon?” she seemed confused.

“Do I need to explain why I disagree to what you mentioned about Coetze?”

“Not really. Only if you wish to” she eased.

He was taken aback. He was expecting half argument, half backlash, half demands as to why he would say such a thing without a proper back up. But she didn’t do any of that. She seemed different. Not like girls who dramatised everything and demanded to know everything without giving away much of themselves.

“Hi! I’m Catherine”. She introduced herself first.

“Hi, and I’m Prashant” he said.

“Nice to meet you Prashant. Do you wish to read more of Coetze someday? Like ‘Summertime’, ‘Life and times of Michael K’, ‘Boyhood’ ? I can lend you those books if you want” she almost teased him. 

“You read my mind” he answered upbeat.

“So do live locally or are you travelling too?” Cathy further questioned.

“Oh I live locally. I havent really travelled much. Just here and there. Been to Kathmandu once.” He responded.

“Well, I’m new to Pokhara. I only arrived yesterday for volunteering work. I’m with a school teaching poor kids. They bring volunteers to different parts of Nepal to work. But hey, I can get away with some hiking and local food tasting!”

“But I’m not a tour guide” Prashant seemed to panic.

“I figured that out when you said you havent travelled much. But do you mind being my guide for few days? I will share some books if you are interested” she lured him.

Their love for the books and writers drew them closer as they spent most days together reading paragraphs of their favourite books on the banks of Phewa Lake each day after Cathy’s school volunteering finished. His work as a freelance journalist didn’t occupy much time other than night time when he wrote incessantly for the next morning’s column. Two months seemed to have just flown by being in each other’s company. Sharing drinks and laughs, stealing glances, quavering voices, giddy steps, consensual touches, easy conversations, sharing dreams and secrets all became normalcy to both of them. Catherine was easy to talk to, easy to please and seemed to understand him more than he understood himself. She had emptied all her love on him without reserving much. This was new to Prashant. Getting love without reservation. It was obvious that Catherine was in love with him.

Catherine was all Prashant could ask for and a little bit more. She made him fall hard for her in no time. Her easy manner, her innocence, her openness and strong personality elated his heart to the point where he could easily see himself nestled with her. What he didn't realise at that time was how difficult it would be to merge two different continents in one, to overcome cultural and linguistic barriers, to adjust to new lifestyles and experiences, to give up his profession, passion and family in order to be with her. 

                               *****

When Prashant and Catherine decided to get married just few months into courtship, his family were distraught. They did not approve of their only son marrying a foreigner. There was language barrier to begin with, then there was Prashant leaving the country. Him being their only source of income, how could they bear to have him separated from them? Who would look after them as they grew older ? They knew Cathy could not stay back in Nepal any longer due to her visa conditions.

Prashant was madly in love to think things through. He was adamant about marrying Cathy. Their unfazed love won the tussle despite Cathy warning Prashant of her dark past and its disturbing effects on her life since the very beginning of their courtship. He only knew her carefree smiles and confident personality. She had a chirpy sunny persona. She couldn’t possibly be fighting the unseen demons she mentioned she carried inside. He later realised that what he nonchalantly dismissed as nothing significant was how haunted she was by her traumatic past. In fact, it turned out to be the very base of her overwhelming depression and its daunting effect on their relationship.

   

                                                        ***

Depression had its ugly grip. He could never fathom until much later into their relationship that depressed people can’t get themselves out of that rut no matter how hard they tried. Having had no exposure to the concept of depression, hailing from a small country of Nepal where sadness was common but mental health carried profound stigma, Prashant had initially grappled with Cathy’s constant mood swings, unsocialble inclinations and shelled personality. She seemed to be living in the cocoon of misery without wanting to break free from it all. She had painfully explained to him how she was molested by three of her closest male friends in high school and how her parents had dismissed her trauma as something salvageable through counselling. It didn’t really strike much cord with Prashant. He had considered it to be first-world problems and something he could deal with without much fuss.

There were definitely better days for Cathy. In fact most days she was her better version, humming to songs, cracking jokes, being her best, loving him so much. And then some days were grim, grim to the point of non-compliance, non-conformity, withdrawal, indifference, shunning, not going to work, not getting out of bed, suicidal even. It was hard for him to bring her back to her normal self every single time she slipped into her depression. It was in those days which spiralled into what seemed like eternal labyrinth that Prashant delved into the scary aftermath of Cathy’s depressive episodes. She would shut him out, she would turn bitter and angry, she would become impulsive and cold, almost making him shudder in regret for getting involved with her. He wished he knew what she was going through. It broke his heart not knowing. He wished he could share her sadness and help her submerge back to the light from what she described as "eternal darkness". 

He would find her out in the balcony in the middle of the night, smoking her life away. She would refuse to engage in coversations at times. Often she would wake up sweating and screaming after nightmarish past recollections and huddle upto him summoning him to stroke her hair to keep her company througout the night. Some days she would splurge on online shopping and order takeaways even after cooking up a storm at home. Other times she would obssess over cleaning the entire house in one go pursuading him to participate in her madness. It was rough on few occasions when Cathy kept crying everytime he caressed her, confessing how that reminded her of being molested. Prashant was often left speechless at Cathy’s unpredictable behaviour triggered by what she claimed as post traumatic stress disorder.

                                                              ***

He remembered all the time when he felt frazzled by her. At times it was unbearable. He remembers the day when he felt some relief in his co-worker’s company. Sheila was an attractive, voluptous girl who had just started working at the Tesco store where he worked. She also happened to hail from Pokhara, his hometown.

Prashant wasn’t sure whether it was physical attraction, their shared language affinity or his emotional tiredness from Cathy’s frequent unstable emotional state that led him to stretch out his friendship with Sheila. They started texting each other regularly even during their days off. Sheila seemed to enjoy their increasing closeness as much as he looked forward to their working days. It started off just sharing some adult jokes followed by open invitation to “catch ups”. Sheila was aware of Prashant’s conjugal commitments, yet she seemed open to their potential extra-marital affair.

Cathy had never been the nosey type. She often ignored the beeps and buzzes on Prashant’s phone. She trusted him more than she trusted her own self. She had no reasons to doubt even when Prashant started spending his days off work outside catching up with his workmates. That was the excuse Prashant had opted for when he needed to meet up with Sheila. He kept reminding himself that he was not cheating on Cathy as he still had not slept with Sheila yet. It was just regular meetings that often included brunches, silly jokes, flirty remarks, some sexual innuendos that was greeted with equal approval and excitement by Sheila. Sometimes it almost seemed like Sheila wanted more out of their dates than he had initially thought of offering. In fact Prashant became more confused about his own attachments and emotions towards both women as his dates with Sheila increased.

As Sheila’s casual touches turned into almost brazen demand for more physical attention, Cathy’s physical reactions to her depression took a nasty turn. Cathy started purging and vomitting, almost bulimic, almost emaciated frame screaming silently for more care and attention from Prashant. He never quite got around forgiving himself for almost straying from his marriage when Cathy needed him the most. The day Prashant found out that Cathy had miscarried their child, he almost cursed himself for causing such an unbearable loss, for not even knowing they were expecting, for not looking after Cathy enough; but he knew it was just his way of seeking repentence. 

Both Cathy and Prashant had been unaware of Cathy’s pregnancy until the day Cathy collapsed on the sidewalk of  an alleyway whilst returning home from her work. One of the pedestrian had rushed her to the hospital after finiding her bleeding heavily. Prashant had been called to come pick up Cathy after the D & C was carried out. That same day Cathy had also discovered Prashant’s lengthy flirtation with Sheila after a chance sighting of his phone that had buzzed while he was fetching dinner for both of them at the hospital cafeteria. She had stumbled upon the strings of flirty texts between Sheila and him much to her shock. She was not sure whether it was the anaesthesia that was making her so teary and dizzy or was it the sense of betrayal amidst the loss of their unborn baby that trickled down through her eyes. Cathy had fallen asleep without her dinner or any words with Prashant that day.

                                                 ***** 

By the time Prashant reached St mary’s Hospital’s ED it was 8:30 in the morning. It took him longer than expected. He was hurriedly let inside the emergency room after letting the receptionist know why he was there. The sharp smell of eucalyptus on the hospital floors hit his nose. It felt sickly. He hated being in the hospital. After all, his few visits here earlier in the year had been an unpleasant reminder of their failing relationship.

He kept reminding himself not to let go of the stroller where his newborn was safely tucked in. Fatherhood and the responsibilities it entailed was still very raw and new to him. He had not had a chance to bask in its full glory yet. Nor had he been prepared for its awkwardly duties. He was totally unprepared for what followed next.

He was led to another station inside the emergency room. The receptionist introduced him to one of the nurses there. The nurse looked almost exhausted yet attentive when Prashant asked about update on Cathy’s condition. Without delay she rushed him to bay 14 of the acute section of the ED. When the curtains were drawn open, Prashant let out a loud cry.

Catherine was intubated; small plastic tube inside her open mouth, one end of the tube connected to an oxygen outlet and another to a bag held by one of the doctors who was bagging oxygen into Cathy manually. Multiple drips were running into Cathy’s veins on both arms. Cords attached to her bare chest that were “leaking” milk as their newborn lay hungry in her pram. Cathy’s eyes rolling in and out of consciousness. Screens above their head blaring unsteady numbers and alarms going off. Doctors and nurses hovering around Cathy’s swollen frame. Her wound on her belly from the cesearean surgery three days ago oozing some fresh blood. Huge machines standing next to her gurney ready to scan her fragile body. It seemed more of a nightmare than a scene played out in some random medical sitcom. It didn’t seem real. Yet it was a frightening reality Prashant was facing. Prashant almost collapsed to the ground.

Someone quickly grabbed him by his arm and sat him down on a chair just outside Catherine’s gurney. He faced a kind looking lady in her late 50’s who introduced herslef as Dr. Lamington who had called him earlier.

“Mr. Gurung. I’m not going to pretty things up for you today. Brace yourself for some bad news”, she said in a solemn voice.

There was a chill to her voice. Prashant shivered.

“What is it?” Prashant almost begged.

“Cathy had a massive cardiac arrest. If she had been any late in presenting herslef to the ED, this morning would have been the last time you would have seen your wife alive”, Dr. Lamington broke the news to him in the same tone as before.

Prashant was fighting back his tears. He pictured his wife early this morning, gasping for breath, he pictured himself deep in sleep unwilling to get up, he pictured his infant child peacefully sleeping, unaware of the almost tragic event that followed that morning. What if it had been the last time he had seen his wife alive? Prashant almost choked with the feeling of loss.

“She is too young to have a cardiac arrest. She is now out of danger though right?” he asked.

“And now she’s slipping in and out of consciousness. There is no such thing as out of danger until she is haemodynamically stable. That means until her blood pressure comes down to normal, her heart pumps and beats rhythamatically and her oxygen level comes up, we cannot say anything. We did some scans on her heart, brain and lungs. There is fluid overload in her lungs and heart. We might have to operate on her as soon as possible to drain out those extra fluids. That is the standard procedure in such cases. I hope you do understand that there are risks involved in any kind of procedure. We cannot guarantee you 100% that she will be back with us. Do you understand and give consent for the procedure Mr. Gurung? We don’t have much time”.

It hit him like a bolt. Prashant was hearing those words, yet his mind was trying to block off all the weight those words were carrying. He thought of the baby. He thought of Cathy. He thought of the house. He thought of his family back home. He thought of all the possibilities. He thought of all the travel plans they had made before baby’s arrival. He thought of all the days of happiness he had shared with Cathy. He thought of the hardships he would have to face raising this baby alone if something happned to Cathy. He did not want to imagine his life without Cathy. He was not ready to let her go, not this way, not now.

“What are other options doctor?” Prashant asked Dr. Lamington.

“Excuse me? I don’t think you quite understand the gravity of the issue here Mr. Gurung” Patricia Lamington seemed quite baffled by his silly question.

“I mean, do all patients with fluid overload need to have surgery when there is no 100% guarantee of successful outcome? What would be the other options doctor?” he asked again.

“To answer your question simply no, not all patients go that pathway of surgery. There are cases where diuretic medications are given to patients to get rid of the extra fluids. Sometimes it works, sometimes it doesn’t. In Cathy’s case, it’s not just her fluid overload that is over-straining her heart, but also the high blood pressure that is refusing to come down giving her heart a run in the mill. Her heart is over-tired. It is exhausted. Do you understad? We will try to release that pressure and strain from her with the surgery”. Dr. Lamington was almost rushing now to get his consent and to start on the said surgery.

“Cathy….what did Cathy want?” he asked her suddenly.

“The reason we wanted your consent is because Cathy had clearly outlined in her last admission three days ago, prior to her delivery, that she did not wish to be resusscitated which means no active invasive treatment can be given to her in case of cardiac arrest. We only became aware of her wish after we began intravenous interventions. As per our hospital and NHS policy, only ‘next-of-kin’ can revoke that decision when patients are incapable of changing their decision. Like you mentioned, Cathy IS too young for us to carry out her choice of ‘Not For Resuscitation’. However we cannot override her decision, only you can Mr. Gurung”  Patricia Lamington expressed.

                                                      ***

After all, that would be so much easier. Cathy had once expressed to him that if she was ever to become a lump of flesh and a burden to family, then to let her go. She was a strong advocate and supporter of euthanasia. It would be easy to honour her wishes. He wanted to be free of her dark days and free from heartaches. He wanted Cathy to be free of her miseries too.

In front of him laid a woman he had loved so much. A woman who had shown him the true meaning of unconditional love. A woman who taught him so much in this foreign land. Woman who supported him regardless of her friends telling her otherwise. A woman who had so many options yet who had chosen him to be in her life. A woman who was repeatedly advised by her friends to move on and find a suitable partner after he nearly cheated on her once. Yet she dismissed all those warnings, yet she trooped on with him, beside him, holding him, protecting him. He knew he would never find another woman like her in his life now. He knew his heart could only hold her now. He knew he would never be with any other woman. But he also knew he would be much lighter with her gone. 

"Mr. Gurung?" 

Prashant was startled by Dr. Laminton summoning him. 

"Yes?" He answered. 

Doctors draped in surgical gowns and masks were still surrounding Cathy's limp body on the gurney, waiting for his decision.

"So have you decided yet? What do you want us to do? Resuscitate? Surgery? Or……” Dr. Lamington’s voice trailled off.

Prashant slowly looked up to face her. He got up and hovered his loving misty eyes on Cathy and slowly walked towards the exit. 

                                                   ***