Muskan – The little nurse without PPE

This true story should be read by everyone especially those who are either affected or afraid of Corona Virus.

Prof Pankaj Chaturvedi

The little girl was crying inconsolably. Her father was equally distressed. He kept begging for being allowed to accompany her daughter in the Dedicated Covid facility. It was an emotionally challenging scene and I too was struggling to hold my own tears. As per the Government’s policy, only Covid positive person can be permitted inside the isolation facility. While Muskan was positive, her father was negative for Covid 19. I tried all kinds of arguments to convince the daughter and father that it was in their interest to live separately for 2 weeks. Standing under the afternoon blazing sun, the security staff at the isolation facility were losing their patience and getting restless. One of them in full body protective suit held the hand of Muskan and started to gently pull her inside the facility. Muskan was limping and could barely walk even with support. Whole of her left leg was bandaged and appeared swollen. She was in terrible pain. I still remember her teary eyes and folded hands begging me to allow father to be with her. She kept repeating “I cannot live without my father. Please let him in”. I was speechless and stood their frozen not knowing how to console her. Then something inside me compelled to make a commitment. I promised her that I will call her twice in a day and she could call me anytime of the day on my personal phone. My promise barely brought solace to the grieved child who had no other option but to be separated from her father.

The father was now agitated and getting hysterical. Since he carried the risk of being a carrier of virus due to the proximity with his daughter, I was trying to maintain a safe distance from him. To everyone surprise, he jumped across the barricade and rushed toward me. He fell on my feet crying loudly. I did not have the courage to run away from him and stood their dumbfounded.

Muskan is 14 years old and suffering from advanced osteosarcoma of the knee bone. She had undergone 9 hours of major surgery 2 weeks back at Tata Memorial Hospital, Mumbai. The surgery involved removal of her knee joint and replacement with a 14 inch metallic prosthesis. She had 20 centimeter scar on her leg. The family was devastated to know the fact that she has only 30 percent chances of survival beyond 5 years. Her mother has been praying all the time for her health and longevity. While recovering from surgery and eagerly waiting for her discharge, she developed fever due to Covid 19. Whole family was shattered and distressed. Muskan was staying with her father at the hospital while her mother looked after younger brother at the village in Jharkhand. Muskan had to go to an isolation centre situated 20 kilometers away from Tata Hospital. Dedicated Covid Hospital is a giant indoor stadium in Mumbai (National Sports Club of India called NSCI) that was converted into a massive isolation facility with the capacity of 500 beds with 75 beds dedicated for cancer patients. I volunteered with my team to look after the Oncology section of this dedicated Covid Hospital.

Unfortunately, her father had to be sent to a quarantine facility at another place. It seems, Muskan’s father lied to the Tata Hospital security pretending to be Covid positive to ensure that he accompanied his daughter to the isolation facility. However, the lie was exposed at the reception of the isolation facility when he could not produce the positive throat swab report. The desperate father tried all logic to be allowed inside but in vain.

My trance was broken by the screams of the cops next to me. They were very angry that I was so close to a high risk person. I quickly sprang away from Muskan’s father who was still sitting on the ground with folded hands. I convinced him that his daughter will be looked after well by my team. Grief written large on his face, the father slowly went away.

Minutes later, Muskan called me up from the isolation ward. She was bitterly sobbing. She was afraid and lonely.Muskan was the only child among 75 cancer patients of Tata Memorial Hospital. I tried my best to console her on phone but failed to pacify poor girl. At this point, I told her that I would treat her like my own daughter. I spoke to her about my family and my own daughter and how much I loved her. I kept talking to her for almost half an hour trying to divert her mind as much as possible from the agony of being alone and the separation from her father. I could only listen to her cries and she did not speak a single word. Once I put the phone down, I couldn’t hold my own tears.

When I reached home that night, I told my wife about Muskan and her plight. That night, we both spoke to her on a video call. What made us feel sad was her dejected look. She hardly spoke few sentences. She refused to eat anything for dinner. I could not sleep that night and kept thinking about her. Next morning, I was eager to reach NSCI to meet her and continue my counseling session. I kept calling her but she did not pick up the phone. Her father also called me up and told that she was not picking up the phone. I called up the nurse in the ward and she told me that Muskan was not on her bed. My heart sank. I grew very nervous and my mind was flooded with negative thoughts. I rushed to NSCI and literally ran towards the patient’s waiting area. I was startled to see that Muskan was waiting there flanked by 5 old ladies who were also cancer patients of Tata Hospital. Those 5 old ladies were less educated and Muskan had become their personal assistant since morning. She helped them speak to their relatives, guided them to take their medicine, boosted them morally and communicated their problems to the nurses. I couldn’t believe what I was witnessing. Muskan was transformed from a distressed kid to a compassionate caregiver. She was very busy talking to other cancer patients and hardly had time to talk to me! I was struggling to control my tears of joy. My adopted daughter had grown up in one night!

By afternoon, Muskan started calling me to help other patients and never for herself. One whole evening, she sat next to a seriously ill old man with the oxygen mask holding his hands and praying for him. She helped the nurses in holding arms of the patients when they drew blood for lab testing. She assisted in dietary intake of patients with feeding pipe in their nose. She turned into a baby sitter for few mothers who were isolated with their small kids. She was badly reprimanded when she helped a bed ridden terminally ill women move around on a wheel chair. Muskan wanted to fulfill the last wish of the Bengali women to watch sunset on the sea.

She quickly became popular among the NSCI staff and the patients.

She used to call me 4 times in a day for the first 2 days. Later it decreased to only 1 call every day. She narrated the day’s happening on every call. Thought it was not permitted, I used to smuggle biscuits, fruits, chocolates, cake for her. Since she had only two pair of clothes with her, my wife gave her new set of clothes. She had lost her hair due to chemotherapy. I assumed that she would be very conscious about her baldness. I gave her a nice cap to wear that she never wore. In her 10 days of stay I developed a strong emotional bond with her. I was very conscious about the promise that I had made to her and her father. After all, I was supposed to be like her father while she was isolated.

Ten days later, her repeat test again showed presence of viral infection. Her stay had to be extended for another seven days. I was surprised that she took this news very sportingly except a momentary dismay. Perhaps, she was enjoying her new avtar and forgotten her own miseries. This bald girl was helping others limping around with a long and painful scar on her leg. Any other child in that stage will be sitting on the hospital bed seeking attention of their parents. Muskan epitomized human resilience that is perhaps more pronounced in kids. While myself, nurses or other staff were moving around with Personal Protective Equipment (PPE), Muskan was helping people without any accessories with a smile on her face. Patients got very dissatisfied and disappointed to see me or Nurses in PPE. However, Muskan ensured personal care to all without any barrier between them. She was the darling of everyone in the facility. One day smilingly she told me on phone that she hoped that good wishes of everyone will cure her forever. She was aware of the dismal outcome of her cancer.   

Seven days later, she tested negative for virus. I had a strange feeling that was mixture of happiness and sadness. I was feeling sad that Muskan will now go to her father. Nurses were disappointed that they will lose a helping hand. Patients were sad because Muskan  will no more be available to them. She was the only care giver who was without a PPE and who could touch them freely.

Muskan and her father were excited. As Muskan walked out of the facility, I could see several sad faces standing behind her. As per infection control policy, we are not supposed to go close to people who come out of the isolation. I was standing 3 meters away from Muskan’s path and told her not to come near me. With teary eyes, she expressed her desire to touch my feet as a mark of respect. I don’t know why, I did not stop her or move away from her. That would have been very rude and humiliating. As she came near me, I stopped her from touching my feet and instead bowed to touch her feet. Startled and confused, she slowly limped towards her father.

Muskan taught me an important lesson. The best way to forget your own unhappiness is by spreading happiness around you. Contentment is the byproduct of a constant tussle between expectations and availability. Winners tend to tilt the balance by having little or no expectations. This story of transformation of a young patient into a compassionate care giver is a lesson for all the health care staff to consider their covid infection as a God – sent opportunity to serve without the PPE. Success is all about converting a challenge into an opportunity. Happiness follows.

My Muskan (happiness) was gone. So was the fear of corona virus. One thing is certain, Muskan will live forever.

Acknowledgement –

Dr Muffazal Lakdawala, Sharad Ughade, MCGM leadership and the entire team for running the entire facility with care and compassion.

Published by Chaturvedi Pankaj

Deputy Director, Center for Cancer Epidemiology, Tata Memorial Center, Mumbai. Professor, Department of Head Neck Surgery, Tata Memorial Hospital, Mumbai

69 thoughts on “Muskan – The little nurse without PPE

  1. Sir very nice article to read & having inspiration from MUSKAN we all r working for kindness & humanity also great salute to u & ur team who r working in this pandemic condition. Regards from all volunteers BARC COVID HELPLINE CENTRE.

    Like

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