Imagine yourself in a new place, where you are not familiar with the local language and culture. A task as simple as ordering food in a restaurant becomes a struggle. While in Suwon, Korea, I did pick a food joint that had pictures in menu card, still it became an ordeal to check the ingredients and get the food I could eat. Only positive thing is I didn’t breakdown similar to Shashi Godbole in Coffee shop in English Vinglish.

The above experience is nowhere near to what a mother goes through in Nagaram (City in English), a short story by Sujata which came out in 1972. In this story, writer recounts the experience of Valliammal who has brought her daughter Pappaththi, who is running high fever, to Madurai Government hospital based on advice from her village primary health care center. Stuck in a big city, she is overwhelmed not being familiar with the process, not able to understand the doctors’ lingo. We learn that Pappaththi has meningitis, need to be admitted immediately for treatment, else will not make it through night. Valliammal, of course, could not understand any of the discussions except that she has to get her daughter admitted. Did she manage to get the daughter admitted? Did Pappaththi get the required treatment in time?

Sujata starts the story with a short description of Madurai. With few lines he captures the randomness of the city, wall writings, big cut-outs, pots waiting in line for water, traffic / diesel / constables, boys playing in streets, people rushing through their daily life, processions, protests, all movements happening similar to a Brownian motion. Just another normal day in a city. In this environment, writer drops Valliammal in Government Hospital bustling with activity, nurses, doctors, coffee boys, policemen all moving in a hurry. Per Chief Doctor’s direction, she has to get her daughter admitted for treatment. Not being familiar with the process, she is directed from one person to another with a chit in her hand. By the time she reaches the right person for admission, she is told to come next morning since there are no beds. Till this time her daughter is in a stretcher in one corner of the hospital. She waits for few hours, not able to get any help or further direction, leaves the hospital with her daughter back to her village. Chief Doctor becomes furious when he realizes patient is still not admitted, and junior doctors, nurses, admins can’t locate her. Story ends with mother consoling her daughter, praying to God she will give two handfuls of coins once daughter gets better.

Sujata captures what ails our hospitals without sharing any of his thoughts or giving in to emotional outburst. He leaves the emotional breakdown for the reader. There are no villains in the story, no intentional bad behavior or malaise. So, what went wrong? Is it that the instructions of the Chief Doctor lost in communication when the order went down the chain? Incorrect assumption that everyone knows the process? Mechanical processes not taking any interest about the patient? Patient treated as a case than as a human? It feels cold when junior doctors check the symptoms of the daughter as an interesting case, there is lack of human touch. It takes just one person in the chain to ask the simple question about the patient for the storyline to change.

Situation has gotten worse since the story was published in 1972. While we have high class medical facilities in both Government and private hospitals, they are all run with a motive to make profit and service takes the backseat. Similar to other professions, money mindedness has crept in to medical profession too. It is hard to blame the doctors. There are good number of doctors who are service minded, but profit motive techniques come in the way between them and the patients. Like the mother in the story, it is more overwhelming to visit big hospitals now-a-days for anyone.

Michel Foucault’s quote on this comes to mind, Is it surprising that prisons resemble factories, schools, barracks, hospitals, which all resemble prisons?