Chapter 22 - Part A

"Start another round of CPR! And charge the defibrillator to 150"

"Clear"

One of the junior doctor's voice cut through the chaos swirling inside the white walls of the hospital as the body lying on the table arched up in response to the electric shock.

"Nothing"

"Continue the compression and we will go again in two minutes"

He nodded his head at the crisp command from his supervisor, heel of his hands resuming its movement.

"Ok, charge the paddle to 200 now"

"Clear"

And just like the last few times, not even a flicker registered in the body lying on the table.

"Dammit...still nothing. Push 2 of epi and shock him again"

Dutifully following the instruction yet again - flurry of activities ensued - with the exact same result yet again.

"Still no heartbeat"

Dr. Mayank Sinha clenched his fingers in frustration, his eyes leaving the sight of the bloody mess in front of him and connecting with the doctors and nurses around him. Everyone wide-eyed and exhausted. All looking at him for the next set of instructions. Something he didn't have. Well, he did have it - but he was too conflicted to say them out loud.

If this was any other patient, any one at all who had similar amount of injuries - Mayank would have already declared them dead.

He always believed science was easy. Not because it was for everyone to understand, but because it was straightforward. It was always what it was. It deeply relied on evidence. And for now, the evidence in front of him screamed that the man on his table was so far gone that the conclusion was simple - there was nothing he could do to bring him back.

However this logic, this belief did not fit Arnav Singh Raizada. The magnanimity of the man somehow still oozed out of his still, lifeless body. This was the man because of whom their hospital proudly housed some of world class doctors and equipment. Someone who never hesitated in donating millions year after year to ensure their hospital not only catered to the rich and famous, but also to the ones who couldn't afford but desperately needed cutting edge care. Someone who was respected and loved on every single floor and lobby of the hospital. Someone who now was hanging between the abyss of life and death. Someone, who as all evidence pointed out had already gone far past the line of no return - but still no one uttered those few words that could seal his fate and end this night for the people around the table.

"Dr. Mayank? Umm, can we...do we call it?"

Taking a long sobering breath he pulled his eyes away from Arnav's body and looked up again.

It was time for the decision. He knew that. How much ever he wished to, but he could no longer delay the inevitable.

So trampling on his emotions he cleared his throat and nodded his head. It was time to let go. "Time of death..."

---

"NO!!!"

Startled, Mayank and everyone else turned toward the source of the sudden and unexpected intrusion. On the entryway of now open door of the ICU stood Payal. Her eyes wide and bloodshot, body shaking with fury and pain equally. Her brows drawn together with so much indifference that Mayank physically took a step back.

Pin drop silence fell across the room, the nurses parting like the proverbial red sea as Payal strode in. Her eyes dead set on the lifeless body on the table. "Shock him again", a barely audible whisper left her lips. Her entire focus still zeroed in on Arnav.

"Ahem, what?"

The junior doctor who still had his palms on Arnav's chest sputtered in confusion.

"Shock him again". Repeated Payal without hesitation.

"Are you his family? You cannot be here Ma'am". One of the nurse spoke this time, getting a supporting nod from the junior doctor who was still shocked at Mayank's lack of reaction to an outside woman.

Payal looked up. Her red eyes connecting with the nurse and then the junior doctor. Furious words spilling past her lips impatiently, "It is not Ma'am, it is Dr. Payal Raizada. And I am not just his family, but one of the senior attending here. So, stop wasting time and Shock. Him. Again".

She completed her sentence with another scream, and Mayank finally snapped out of his shocked state.

"Dr. Payal, you shouldn't be here. We are doing our best here"

"I can see that. You were going to declare him dead"

"Payal, he has no pulse since he has been brought in. We did everything that we could..."

"No! You dont get to use that sentence on me. We say that to the families when we know everything is over. When we know we are just biding our time before we tear apart their world. You do not get to say it. Not yet. Now..."

Her voice shook with unrestrained emotion. She closed her eyes and taking a deep breath continued, "Shock him again and push another epi"

The doctors and nurses looked at Mayank hopelessly, "Doctor?"

He hung his head is defeat. A small nod confirming what Payal instructed. "Lets do it"

The nearby nurse moved to get the shot ready, as he caught hold of the paddles again. Defying his scientific brain, he sent a quick prayer to the higher power, and then barked out, "Charge to 300"

"Wha..". Disagreement died a slow death on the nurse's lips as he took in Mayank's and Payal's expression.

"Just do it.. Now"

Payal closed her eyes as the metal plates rubbed against each other and the machine hit the 300 mark. She prayed, she begged, she tried to reason and then finally, she touched Arnav's cold lifeless hands and whispered in a hushed voice.

"Can you hear me Bhai? If you can then please - come back. You cannot leave like this Bhai. Di will fall apart. We all will fall apart Bhai. And, Khushi. Bhai please - she is stubborn, hurt and angry. But she loves you. I know it because I saw it in her eyes. She has survived hell but she will not survive loosing you. Please come back bhai. For all of us. For Di. For Khushi. You can still come back. Please..."

"Payal - hands off"

Nodding she withdrew her hands and the gelled metal plates once again touched Arnav's chest. His body jolting up for the umpteenth time that night. Filled with hope, Payal looked at the monitor in front of her, but the lines on the screen remained unchanged. She kept gazing at it for few more minutes - when finally she slumped down at the foot of the bed with a muted cry.

She knew this was it. He was gone. About to let go of her barely held tears when the steady sound from the monitor transformed slightly. She hiccupped in a breath. Twisted her body to take in the screen. The change in the sound still coming off the EV monitor as she blinked furiously to clear her eyes - hoping to see what she thought was too good to be true.

"Shit. We have a heartbeat doctor. It's faint, but it is holding steady"

Body still coiled in shock, she finally looked at Mayank who moved like a machine in the room. Yelling orders to stabilise Arnav, now that he had the pulse they were looking for.

Finally, after what felt like several minutes, Mayank bent down in front of Payal who was still sprawled on floor next to Arnav's bed. His eyes softening for his colleague, whom he in all the years of working together had come to like a lot as a friend.

"Payal"

"Huh". She looked up at Mayank and then his outstretched hands in front of her. Nodding she placed her clammy hands in his, allowing him to pull her up. Her mind still reeling from the plethora of movement around Arnav.

"Payal", Mayank repeated, "He is back. But his internal injuries are very intense. We have to move quickly. He needs surgery. And he needs it now. I am going to step out of this room to talk to every single member of your family who I presume are boring hole on this floor. Now I am saying this as your friend, they are going to need you. Whatever I tell them, they will look at you to verify and confirm. We both know this happens when you have one family member lying on the hospital bed and one is a doctor. You cannot go in front of them in this state. This situation, Mr. Raizada's condition is complicated enough - you cannot add yourself to the mix. Do you understand what I am saying?"

She closed her eyes, a shudder rippling through her body. Yes she knew exactly what Mayank was asking of her. Not many months ago she was the one doing the asking when one of her colleague's wife went into an early labour and almost died due to complications. She knew at that time how difficult that ask was - but now that she was on the receiving end, she also knew how heart-wrenching it was.

But she had to be strong, she knew that too. So taking a deep calming breath she wiped her face clean and nodded her head slowly. Then giving one last look at Arnav she followed Mayank to the waiting room knowing exactly the kind of battle they had ahead of them.

---

"Where is he? Oh my god! I need to see him Shayam. Why is no one telling us anything. What is going on? Please Shayam! Oh god"

Loud sobs of Anjali barrelled its way through the otherwise silent floor of ICU units. Her body shaking so uncontrollably that it took all the strength of Shayam to hold her still.

"Calm down Anjali. Payal should be back soon"

"Calm down? You are telling me to calm down. That's my little brother. Oh my god Shayam that's our Arnav lying there". Another hiccup escaped her, eyes going wider, almost as if she was just then realising where they all were. The weight of the fact that they all were waiting to hear about Arnav's condition felt too heavy that she felt her legs giving out. She would have collapsed on the floor too if not for Shayam's tight hold on her.

"How did this even happen Shayam", her tone soft now. Throat too raw to produce a sound beyond the whisper-like decibel. "What if something happens to him? What if he doesn't..."

And he couldn't let her finish that sentence. So, keeping a lid on his own tears that were threating to spill, Shayam shook his head. "No! Enough! Anjali, look at me. Come on sweetheart look at me". Satisfied that her hazy tears-filled eyes were finally on him, he sighed. "As you said, he is our Arnav. And if there is anyone who can get through this is him. He is strong. We know that. He will make it through it"

"But you dont know that"

"I don't. But I am hoping with all my existence that he will be fine"

"But, what if...". She blinked, getting rid of another bout of fresh tears that made an unwelcomed appearance. "What if he does not? What if, god Shayam, what if my Arnav doesn't make it?"

He grasped her tight with desperation he can't remember feeling ever before in his life. He blew out a breath and nodded his head. "Then we will all break down together. But until then we need to hope. We need to stay positive. We need to be the strength I know he needs us to be. Can you do that? Please?"

She nodded her head that now lay against his chest as Shayam looked heavenward - commanding himself to not loose it. "Not yet"

His eyes then took in the rest of the family, every single one of them huddled together. Their faces almost pale white like ghosts. Eyes constantly flicking towards the door where Payal disappeared into few minutes back. With a soft curse NK suddenly stood up to resume his pacing that he stopped just few seconds back. His fingers tearing through his hair. Throat working up and down - indicating clearly how he too was trying to hold back.

Shayam's eyes dropped shut then. Unable to take in the amount of pain vibrating between every single member of his family. His mind once again sending a quick prayer to help him keep his words to Anjali. Arnav had to be ok. He just had to. Because he knew for a fact that if anything at all happened to him - this family will never recover.

Scenarios after scenarios swished past his mind - each one worse than the other. What if.... He shook his head to get rid of the start of that thought. No, he couldn't let himself go there. He ordered himself to not go there.

"Di"

It was Payal's soft voice that finally managed to pull him back to present.

Everyone stood up and gathered around.

"How...how is he?". Devyani was the first one to break the silence. Everyone too scared to know the answer to that question.

Payal looked up at Mayank and gave him a nod. Permission to take over. Or may be a plea to not ask her to say anything if he really expected her not to break down.

"I... Ahem, I am Dr Mayank Sinha. I am Mr. Raizada's doctor"

"Please - just tell us". Akaash asked. Eyes swinging between his wife and Mayank.

"He is ok Akaash", Payal knew the question was directed at her. She knew he, they all needed to hear her voice. So squeezing her eyes shut. Inhaling a long breath, she granted Mayank his wish, "He was not doing so good when he was brought it. But he is back. He is currently stable. But..". She gulped, "I will let Dr Mayank brief you on the next steps"

"There are too many of you. Any two of you please, if you can follow me to my office?"

Anjali took a step forward, only to be stopped by Shayam. "Whaaa.. No way. I am going in there Shayam"

"And you have every right to. But tell me honestly, are you in the state of mind to take the decision he will need you to make?"

"What? What decision? Arnav is stable"

Pained expression pulled Shayam's face taut. And she gave out a soft sob. Who was she kidding. She knew her brother was no where near stable. If he was, they wouldn't have been asked to follow Mayank.

"I need to know if he is ok Shayam"

"I know and I will tell you. But for now, you need to stay put. Please Anjali"

Satisfied with the little nod she sent his way, he placed a quick kiss on her temple and then motioned Akaash to follow him to Dr. Mayank's office.

---

"Doctor, whatever it is please be straight with us. How is Arnav doing now?"

Mayank sighed loudly. His eyes tracking Akaash's fingers that held on to Payal's mimicking the helplessness he heard in his voice. Yeah, this was the toughest case of his career. And not just because of the level of injury that Arnav had sustained. But because as a doctor he knew he always had to stay objective, and this case was making him stray from that oath. He straightened in his seat with a nod. Few keystrokes on his keyboard later he then rotated the huge monitor screen toward the chairs where Shayam, Akaash and Payal sat.

"Here are the latest scans of Arnav". His cleared his throat while enlarging one specific image on screen. "Mr. Raizada had a head-on collision. His airbags were installed immediately on impact. Due to which he sustained multiple rib fractures"

"Ok, fractures. That's not that bad then, right?"

Payal closed her eyes and took a sharp breath. Her fingers entwined with Akaash shaking at his pain-laced question. Oh how wrong he was.

Akaash moved his eyes off the monitor then. "Payal, what else is going on?"

"Umm", she helplessly looked at Mayank. And he nodded in understanding.

"Mr. Raizada, the problem we have right now is not Arnav's ribs. Because of the level of impact the windscreen of the car shattered into pieces and...". He exhaled and then clicked open another image on the screen. "Few shards of glass penetrated his facial, neck and chest area. Although most of these wounds were superficial, we found few shards that managed to penetrate quite deep"

"Ok?". Shayam finally spoke up. Still unable to guess where was this going.

"He has a punctured lung and some of his blood vessel are torn because of these glass shards. In simple terms, he is bleeding internally at a much faster rate than we can control"

"Fuck", Shayam dropped his head to his hands. And Akaash stood up with so much force that the chair he sat on toppled back.

"What the hell are you talking to us then for? Do something?"

"I am trying to. Please Mr. Raizada sit down"

"No. I will sit down when you tell me what is your plan here?"

"He needs a surgery"

"So?"

Mayank inhaled loudly. "If I cut him open right now, he will bleed out on the table. We need blood. And that is where we have a problem. Our blood bank is out of his blood type. We have contacted other local blood banks too - but we haven't yet heard back from anyone"

"What the fuck is this"

"Akaash please, calm down"

"Calm down? Are you kidding me right now?". His scream reverberated the room making Payal gasp.

"We are moving him to another hospital right now"

"Akaash". Shayam stood up too.

"Mr Raizada". Mayank spoke softly, "Please, I understand what you are feeling right now. But, moving him in this condition will be fatal for him. We are trying our best. He is our top priority right now. But, we can't do anything unless we get that blood"

"How much..". Shayam blew out a breath. "How much time he has?"

"He needs this surgery in next hour or two. Is anyone in your family matches his blood type?"

"I do. I am AB+ too"

"Shit". Shayam turned around toward the now open door of Mayank's office. "Anjali". He pinched the bridge of his nose and sighed, "What are you doing here?"

Ignoring everyone completely, Anjali moved further into the room, her focus set on Mayank. "You can run your tests and can do direct transfusion right? Take mine"

"Sorry Ma'am, you are pregnant. You are not eligible to donate blood"

"What"

"Anjali, come on"

"No! So, I am suppose to choose. I have to choose between my little brother and my child? Shayam, how can I..."

Code blue! 4th Floor, code blue, Dr Mayank to 4th floor.

Mayank bit back a curse and ran toward the door. Not before giving an apologetic look to everyone.

"What.. What just happened?". Desperate plea from Anjali fell on deaf ears, as Payal's arm went around her stomach. And that was an indication enough. Anjali knew what the code call was for. Or better yet for whom.

"No!". A loud sob escaped her lips, as Anjali fell on her knees. Her eyes closing in prayer. Hoping that this was not a beginning to the end.

---

"He is in V-fib. What the hell happened?????"

"He went into cardiac arrest again. Tear in the blood vessels surrounding his aorta is getting bigger at a much quicker rate than we predicted"

"Dammit!!! Charge to 200"

"Clear!!"

Up went Arnav's body again with the electric shock, but fell back on the table with an unmoving thud.

"Still nothing, charge to 300"

"Clear!"

"Shit! We are loosing him. Prep him for the surgery"

The junior doctor looked up at Mayank, his face pale in horror.

"But, Dr. Mayank, we still don't have blood and without that he has no chance"

"I know, he has no chance either way"

---

"In no fucking way we are signing this form Mayank". Scathingly Payal dropped back the bunch of papers like hot coal that one of the nurse handed her.

"Payal...". Mayank pressed his temple.

"You are the one who made it very clear few minutes back that his damage is too severe for him to get into a surgery without blood. You are the one who insisted that he has no chance without it. Then why in the god's name are you taking him to surgery???" Payal knew that she was screaming at her colleague, someone she respected a lot. But in that moment she just couldn't bring herself to care.

"Payal". A loud sigh. "He is sinking and he is sinking fast. I just cannot sit and watch him die. This is his best chance."

"Best chance? Tell me the survival percentage. If you cut him open, with the kind of extensive injuries he has and that too without blood, tell me what are his chances of survival?"

And he went quite. Payal had a valid question and to anyone else, he would have given the number in a heartbeat but once again it came down to the only thing that made this all so scary, this was Arnav Singh Raizada in question.

Taking a deep breath, he looked up at Payal and then masked his expression.

"2%...his survival chances is 2%"

"God no! Please no. Oh my god". Anjali whimpered. The last few hours almost as if catching up with her suddenly as she succumbed to the onslaught of stress that the night was. Her eyes rolled back. Her body yielding to the unconsciousness.

"Di...di..."

"Goddammit". Frustration coloured Mayank's face. "Nurse, I need you to come right away into my office. We have a pregnant woman who just fainted. Also get one of the bed ready on third floor. She might need intravenous medications and glucose".

His mouth fired off instructions after instructions - his mind still reeling with the amount of chao that had ensued in just last six hours.

Within few minutes, as nurses wheeled away the gurney with Anjali - Payal sank into one of the chairs in Mayank's room.

How did everything go this wrong at this rate in handful of hours.

She inhaled few times and turned toward Mayank, who now sat on his chair. His face grim.

"As his family, I don't give my consent to operate on him"

"Payal, come one. Think like a doctor. You know as well as I do, if we wait anymore, he..". His eyes snapped up connecting with hers narrow ones. He knew she was daring him to say the word and he wouldn't be doing right by his patient if he kept quite now. So swallowing he continued, "he will die. He does not have a chance. Yes, I know he has little chance with the surgery too, but at least we would have tried everything in our power then"

"So basically you are just trying to satisfy your conscience"

"Dammit Payal, why are you being this difficult? He has few minutes before he will have another cardiac arrest. His heart is too weak and if he goes in V-fib again, we will not be able to revive him"

"Mayank, it is a suicide!"

"Maybe but we have no choice, he has no choice Payal. You have to take the decision"

"He will bleed out, even before you reach his lungs and heart"

Unable to hold back the loud sob, her body once again shook in pain. She couldn't remember the last time she cried and screamed this much in her life. She had been trying to hold on to some semblance of hope so far. But, now the weight of what may happen felt too unbearable. This couldn't be the end. This couldn't be it.

Mayank stood up to round his table, and placed his warm hands on her trembling shoulder. "I cannot begin to understand what you or your entire family is going through right now. Let me do something to make this ok. Let me try to bring him back to you all. We need that consent Payal"

Akaash and NK entered the office in that moment and immediately rushed toward Payal as sobs after sobs ransacked her body. Both of them stunned into silence. Unable to fathom that they were going to loose Arnav. They were going to loose their Arnav Bhai. The rock of their family.

"But, oh god! This is it...Isn't it? He is gone?". Payal wailed in between her tears.

They clung to each other. Mayank patiently waiting for them. Giving them the moment he knew they needed.

"He is not going anywhere. He will survive. I will make sure of that"

A soft but confident voice made its way inside Mayank's cabin and the trio felt their heart stop.

"Who are you?"

"I am O- and I am on no medication. My last full body check up was about a month back and I am completely healthy. I know you will still need to run tests to deem me eligible for a direct transfusion. So please do them.

"OK, But, who are you?"

"She is...she is my sister... she is Khushi"

"Oh! Right, that's great. Akaash, please sign the surgery consent papers and Payal, collect the formality documents from the desk for Khushi and fill it up. We don't have time, we need to go now. Nurse! Take Ms. Khushi over here to the room right next to the OR and start the list of tests needed for initiating blood transfusion"

Mayank barked the orders as Akaash scribbled his initials on the pages lying in front of him. Laying his reassuring hand on Payal, he then whispered softly...

"I will promise you this Payal, I will do everything in my power to try and get him out of this"

He then jogged out the room.

One of his nurse walked up to Khushi, requesting her to follow them when Payal's fingers circled around Khushi's arms.

"Ku, how? How did you know. What?"

"I will explain everything later Jiji. Right now, I have to save him. I need to save him"

---

Note for Author:

Hi all you lovely people!

Hope you all are doing good. Sorry again for the long pause since all these months. As I said in my old note, life got in the way. Things are still not normal - but writing always gave me the escape I needed from normal day to day. So, I finally managed to find some time to complete this chapter. It is not a big one - and i will try my best to come back soon with Part B.

Until then, lots of love! and Thank you all for being so wonderful and understanding!