Rest in Peace: Ashma

Ashma was one of the most ebullient children that I have come across. Fate dealt a cruel blow to this pretty and vivacious teenager from a small village in West UP, when she was diagnosed with Osteogenic Sarcoma of the right femur (thigh bone). The  disease was at such a stage that the limb had to be amputated at mid-thigh level. Ashma's life was shattered and her poor parents and siblings devastated with this sudden turn of events in their ingenuous and pastoral life.

To add insult to the injury, the disease was found to have spread to other parts of her body and she was administered metronomic chemotherapy (a low dose chemotherapy protocol that does not cause too many of the common side effects, yet is theoretically said to retard the growth of the cancer).

Ashma came to our Centre nearly two months ago in excruciating pain she experienced in the stump of her amputated leg. She was suffering from ‘phantom limb pain’ and was constantly whimpering in agony. Within a day we managed to alleviate her misery with morphine, clonazepam, pregabalin and amitriptyline. The concern of her parents too was somewhat allayed. 

Once her pain and other symptoms were resolved Ashma showed her true joviality and impishness. One day our conversation went thus:

Ashma (handing me her battered cell-phone): मेरे फ़ोन मैं देखो कितना बैलेंस है।

Me: मुझे तुम्हारे फ़ोन मैं  बैलेंस देखना नहीं आता।

Ashma (annoyed): किसने डाक्टर बना दिया तुम्हें की फ़ोन मैं बैलेंस देखना नहीं आता।

I was left speechless. She grabbed the phone out of my hand and frowned in mock anger and then gave me the most beatific smile that moved me to tears.

She was ready to pounce on me for the slightest slip-up on my part. 

God forbid there was a power outage that lasted for more than five minutes; डीज़ल बचने की कोशिश कर रहे हो। जेनेरेटर चलवाओ was the retort. जो आज्ञा आशमा बेगम I would say genuflecting in mock servitude and comply with her wishes.

Pointing at the relatively bland food that we provide form our kitchen, Her Highness Ashma wanted some तीखा अचार to spice up her lunch one day.

She loved to dress up to be photographed and pestered our other team members for bangles, ear-rings and a necklace. Her other passion was listening to devotional music on her cell-phone. If she was in a good mood she indulged in some Bollywood songs. She complied with my request when I asked her to reduce the volume so as not tho disturb the other children in the Ward. However, slyly she would gradually increase the volume; this was a perpetual tussle between us and she invariably got the better of me.

One day I found her arguing with her mother in her typical petulant way - she wanted to go home to attend Eid festivities. I let them go home armed with a two week supply of medicines. As she waved to us she said ominously मैं वापस आऊंगी ... like a Hindi-speaking Arnold Schwarzenegger.

  

She was back within a week. She had had a good time but she was again in pain. We had to titrate the dose of her medicines upwards till she was pain free. However, her condition had started to deteriorate. The size of the tumor kept increasing in her amputated stump and there was stony hard swelling in her abdomen. One day her kidneys just stopped functioning and she became comatose. I spent the night at the Centre. Her mother asked her father to come urgently. As Ashma's respiration became shallower, we administered oxygen. By 1 am her father and relatives had arrived. The father called out to her and lo and behold, Ashma opened her eyes! She looked around her, pulled off the oxygen mask and glared at me  यह क्या लगा रखा है!?

She went home once again but was back within a week in severe pain. This was a turbulent period with more bad days than good days. Her appetite and vivacity diminished and the requirement for analgesics increased. Her natural resilience failed and she gradually withdrew into her private world. A few days ago she expressed the desire of going home to attend her childhood friend's marriage. I wondered what her innermost thoughts would have been - did she visualize herself as a bride if she had not fallen ill, did she blame anyone for her sorry state? When we tried to draw her out she just closed her eyes and pretended to sleep.

When she went this time she did not bid any of farewell or look at anyone. I kept in touch with her father and he told me of her progressively getting worse. Yesterday she was in a delirium and today at 11 am she quietly passed away amongst her loved ones.

The father tearfully informed me that one of her last coherent sentences was मुझे सर के पास वापस ले चलो। I was too overcome to offer solace to the bereaved father.