It is raining. It rains here in fits and spurts superimposed on a general background of rain. Broken cobbles punch through tattered streams of water on the streets.

The streets are cobbled here. It’s one of the things I like so much about Bombay. Not just the picturesque bits of Bombay, though. Everywhere, up to about the middle. Many of the rooftops that you can see from flyovers are tiled, like in a village in France. The streets meet at circles, where pie-slice buildings rise up past the over-arching flyover, some with rich people in duplex apartments, and others accommodating the poorest of the poor amidst their cramped spaces and common toilets.

It will always be Bombay for me, though. Bombay brings to mind a city where the air is thick with dreams- a city where poor students rub shoulders with criminals on the trains; where irritable Parsee grandfathers look out alone from their balconies, waiting for their antique circular-dial phones to ring. In Bombay there is a place for everyone-every budget, every profession, and every idea.
Mumbai is, well, bomb blasts and extremist Hinduism.

There’s a temple here, and across the road from it a middle aged woman sits on the pavement, with a cow, and some bundles of grass. People who come to the temple pay to buy a bundle of grass to feed her cow. She has a large umbrella, a plastic stool to sit on, and cheap shoes. As I watch, she takes out some plastic gloves from her bag, the kind we use at the hospital to place IV lines, and puts it on. She gathers up the cow dung on the pavement, strips the gloves off of her hand around the dung with the ease of long practice, and tosses it into a large garbage bag marked with a biohazard symbol, off to one side.
That’s Bombay, man.
It’s something.
Bombay, you bitch, why do you make me love you so?

It's all right, I tell myself.
Adrenaline zithers through your bloodstream, I tell myself.
I tell myself, you're a strong powerful man, who does not whine. You have a job that needs to be done and you do it. People are depending on you. You need to do this.
Keep it together. Keep it together.

Fuck this. Its 4 AM, and I just want to go home.

I just want to go home.

We had a bonfire yesterday, at home.
We burned some papers, some twigs,
Some branches drained brittle by the dry air.
We started with paper and some packing material,
Promiscuous things
That gave themselves to the fire at once.
They burned, and burned in a flash,
But the twigs only flirted with the fire,
And the branches, I despaired of them.
I worried that we would never
Get the thing to start.
But it did. Quietly, and without any fuss,
The twigs caught alight,
And then even the branches were smoking,
And suddenly it was a grand blaze.
I wondered why I had been worried at all.
It felt like it was alive, that it would live forever.
It threw off such sparks, so extravagantly,
So recklessly,
Sparks that clawed afterimages into my eyes,
Surpassing the toothless winter sun.
But that passed too. At the height of its glory,
It fell into embers,
Which glowed longer than the fire had burned.

I’m in the corridor in the General Surgery emergency ward when the nurse calls to me, “Doctor, there’s an ER slip.” Shit. ER slips are patients who are admitted immediately because, well, they’re about to die.

I walk over, and then walk back. The patient is on a trolley in the corridor, there are no beds left. He fell from the first floor of a building. I look at the X-rays: he’s got a pelvic fracture and also one in the spine. The X-rays are from another medical college, they sent him away, they have no beds either. He was only admitted here because he was dying.

4.25 AM:
I yell for oxygen. I call to the staff nurse for injections, to help him breathe, to speed his heart, to boost his blood pressure. I’m thinking pelvic fractures can cause internal bleeding of up to two liters. He’s probably bled out into his pelvis. I’m not feeling at my best, I just woke up. I wish he’d fallen off his building at a more convenient time. I’m also pissed off, I wish the other medical college had admitted him. I wish Orthopedics had admitted him. I wish he had been admitted anywhere else, and then he’d be someone else’s problem. I start an IV line.

4.34 AM:
His pulse is at 40. I can’t find his blood pressure. I yell for more injections. I ask if any family is present. Thank God, these are people who work with him. I hate telling family about deaths. He must be what, thirty? All this time I’m trying to find the pulse at his wrist. His hands are cold. I should check his urethra for bleeding, but I have no time. He’s dying. Ah well, we are all bubbles, we only float along for so long.

4.38 AM:
I start CPR. I check the oxygen. It’s bubbling away, inappropriately cheerfully. This involves chest compressions; thank God I don’t have to do the mouth to mouth thing. Imagine getting Mono from a corpse. I almost laugh. Then I feel guilty. I wish I had time to call for a bag and mask for ventilation. Do we have a bag? Probably in pediatrics. Focus. Focus. Not important. I’m pressing on his chest with the heel of my hand. Keep the blood flowing. I wish I had time to call a senior. Heck, what would he do that I’m not already doing. I can’t believe I just said ‘Heck’. We are all leaves, we only stay on the tree so long.

4.46 AM: His heart is beating twenty times a minute. I wish I had time to start another IV line. Desperation time; I ask for adrenaline. I continue the CPR. Man, my shoulders are beginning to hurt. I hope I’m not breaking any of his ribs. Forget it, he’s got bigger problems. The nurse brings it. I find the appropriate place in his chest and push the needle into his heart and inject the drug. I know a doctor in this hospital who tried to commit suicide by pushing a needle into his heart and injecting air. He’s in a coma at Apollo, and his wife is pregnant. Man, stranger than fiction is right: you can’t make this stuff up. I continue CPR. Shit, this isn’t working. We are mayflies. We are rainbows. We are TV sitcoms.

4.50 AM: He’s not breathing. I check his eyes: pupils wide, staring. I touch his cornea with a wisp of cotton. No response. I listen for a heart beat. Wait! Is that a beat? No, it’s my fingers. I hold the stethoscope down with the palm of my hand. No use: I still hear phantom sounds, thuds, creaks, gasps: a factory closing down at the end of a workday that’s been busier than most. Is that a heart beat? Am I hearing my own? Oh shit, I can’t decide. I’ve called lots of deaths, and this happens every damn time. We are rainforests. We are perfect moments. We are election promises.

4.55 AM:
No peripheral pulses palpable. Blood pressure unrecordable. Pupils fixed and dilated. Corneal reflex absent. No heart sounds or breath sounds audible. I have examined the patient carefully and thoroughly, and I declare the patient to be clinically dead. It’s like a catechism, measured and bloodless. This is how you call a death. I call it. I tell the people who came with him. Someone covers his face with a sheet. I have to choke down a wild impulse to tear the sheet off and check for a heartbeat again. These people are okay. I’ve had people yell at me, or thank me for my effort. These do neither.

5.00 AM:
I do paperwork. I write everything I did, I write a bogus orthopedic referral, a bogus neurosurgery referral, the record of death. It takes me longer to do this than it took the man to die. I’m called away once in the middle to attend to another patient.

6.25 AM:
I’m back in the Junior doctor’s room. I stretch out on one of the beds. I look out. This is the first day of winter, so say the papers. Dawn has come and gone. Light hangs like silk in the air and photons lie thick as dust over everything.

The slow death of my intellect...

Gentlemen, women lead very comfortable lives. It's great to be women. Really.
Sure, we can pee standing up, and they have this glass ceiling thing, but really, can smaller lines at public toilets and greater economic freedom compare with the feel of a face after a face scrub has been used on it?

I tell you, you poor sods, it can't.

Two years ago, I was one of you- I thought aloe-vera was some kind of cheese they made from goat's milk.

But now, my friends, I have a hand sanitizer; lip balm; face scrub; and cocoa butter foot lotion. Foot lotion! (I never use it because I used it once and I fell, but I have it, none the less.)

I have three ply toilet paper to wipe my nose with when I have a cold.

I am delighting in the pleasures of a whole world I never knew existed.

This is almost entirely courtesy my girlfriend, who initiated me into the secrets of soft face-skin and uncracked lips. She bought me things, things that in my blind ignorance I left unused for months, but insidiously, one by one, these things have crept into my life and now...

Man, oh man. Women have it good.

I am the Mr. Botibol of air guitar.

Music sloshes against the walls of my mind.
Procrastination is going to kill me.

I went to the joo today to meet an old friend of mine who is leaving for another city. I always feel sad whenever any of my friends leave, even if I don’t see them very often. I think its because in the back of my mind I know I could see them when I wanted, if I went somewhere, but now, suddenly, I can't.

Anyway, while I was there, someone asked me what it was like to dissect a human body. After the longest time, I mumbled something lame, like “It was great,” and then I stopped because I had nothing to say.

How do I explain to someone that standing in front of a gutted corpse reeking of formaldehyde, my eyes and nose burning, was one of the single most wonderful experiences in my life?

Look. No one has to dissect anything in medical school. You must study anatomy, you must be able to identify structures and trace them, but you don't actually have to dissect.

I did because I wanted to. There were a few of us who did, and the four of us would get together and read up on it, and bunk classes to dissect specific parts of the body we were allotted.

The reason I liked it, apart from the academic satisfaction, was that, for me it was almost a mystical experience.

I feel vaguely foolish even as I write this. I am not a theist. Not from any philosophic sophistry, or anything, but just because I can’t make that leap of faith. I wish I could, actually. Or even that I could have the conviction that God does not exist.

I have neither. I exist in a limbo of uncertainty. I imagine having that kind of faith would be like warmth in my head, a feeling like you get when you screw your eyes closed and tilt your face up to the sun on a winter morning. Perhaps true faith needs a special arrangement of neurons or something: a faith organ. I wouldn’t know.

Your own winter sunshine in your temporal lobe. It must be nice.

But that is the only time in my life that I felt that I was something more than clay. That I was intricately made, beautifully designed; that I was special, not because I was smart, or talented or anything, but just because I existed, like I won a race just because I showed up. It was beautiful, a heady, wonderful feeling. It was magic.

All of this flashed through my mind when she asked me that question, and I couldn’t put any of it into words, and I felt so stupid.

That’s ok. It doesn’t matter. But I’m pretty sure that if, tomorrow, someone asked me the same thing again, I’d still be left winded, searching for elusive words, to frame unfamiliar feelings.

“Sometimes I think that we should move up to Vermont,

Open a bookstore, or a vegan restaurant.”

You know, sometimes I do think that. I’d love to have a bookstore. I was having this conversation with my sister yesterday.

I can just picture myself sipping coffee in a well lit bookstore reading Chuck Palahniuk, and I do love wood finish. But it probably wouldn’t work out. I’d probably pummel anyone who tried to ask me if I stocked Sweet Valley High books or something. Or refuse to sell someone who buys a Barry Manilow CD anything by Pablo Neruda. I’m finicky like that.

But I digress. The thing is, I will never have a life like you see in all the romantic comedies, the New York Life, you know, like one of those pathologically cute metrosexuals who own a bookstore in The Village and have more gay friends than straight. I won’t have that, and sometimes I really wish I could. Really.

The best I can hope for is a medical drama life. That’s not fun. House is miserable, and Angelina Jolie dies at the end of Beyond Borders.

Crap.

Ok, too many TV parallels.

The thing is, I’m not hippie material. I always knew that. Sitting naked on the grass singing Kumbaya is not my idea of fun, and I’m a firm believer in periodic haircuts.

I know I’m not a hippie, but what I’m asking is did I have to be a yuppie? And it’s no use telling me that I’m not.

Young. Upwardly mobile. Well I’m young now. And upwardly mobile? I frigging hope so!

All the books, and all the music I like, and my image of myself, it always made me feel like I was an individual. Not someone in the common herd.

Not me.

Do you ever feel dislocated? Ever feel like you are not you?