Intensive Care or to the operating theatre. This time there were women too, because it had been a street bomb. All survivors in the outer circle of the explosion came in within the hour. The doctors didn’t use names. Tags were put on the right wrist, or on a right foot if there was no arm. Red for Neuro, green for Orthopaedic, yellow for Surgery. No profession or race. He liked it this way. Names were recorded later if the survivors could speak, in case they died. Ten cc’s of sample blood were taken from each of the patients and attached to their mattresses, along with disposable needles that would be reused if they were needed.
The triage separated the dying from those who needed immediate surgery and those who could wait; the dying were given morphine tablets so time would not be spent on them. Distinguishing the others was more difficult. Street bombs, usually containing nails or ball bearings, could cut open an abdomen fifty yards from the explosion. Shock waves travelled past someone and the suction could rupture the stomach. ‘Something happened to my stomach,’ a woman would say, fearing she had been cut open by bomb metal, while in fact her stomach had flipped over from the force of passing air.
Everyone was emotionally shattered by a public bomb. Months later survivors would come into the ward saying they feared they might still die. For those on the periphery, the shrapnel and fragments that flew through their bodies, magically not touching any vital organs, were harmless because the heat of the explosion would sterilize the shrapnel. But what did harm was the emotional shock. And there was deafness or semi-deafness, depending on which way one’s head was turned on the street that day. Few could afford to have an eardrum reconstructed.
In these times of crisis junior staff members did the work of orthopaedic surgeons. Roads to larger medical centres were often closed because of mines, and helicopters were unable to travel in darkness. So all versions of trauma, all versions of burns, surrounded the trainees. There were only four neurosurgeons in the country: two brain surgeons in Colombo, one in Kandy and one in the private sector—but he had been kidnapped a few years earlier.
Meanwhile, far away in the south, there were other interruptions. Insurgents entered the Ward Place Hospital in Colombo and killed a doctor and two of his assistants. They had come looking for one patient. ‘Where is so and so?’ they had asked. ‘I don’t know.’ There was bedlam. After finding the patient, they pulled out long knives and cut him to pieces. Then they threatened the nurses and demanded they not come to work anymore. The next day the nurses returned, not in uniforms but in frocks and slippers. There were gunmen on the roof of the hospital. There were informers everywhere. But the Ward Place Hospital remained open.
There was little of that kind of politics in the base hospitals. Gamini and his assistants, Kasan and Monica, managed a quick nap in the doctors’ lounge when they could. Half the time curfews kept them from going home. Gamini wasn’t able to sleep, in any case. He hadn’t come down yet from the pills he had recently started taking, the adrenaline still in him though his brain and motor senses were exhausted, so he would walk outside into the night under the trees. There would be a few people smoking, relatives of the wounded. He had no wish for contact, there was just his blood racing. He came back inside and picked up a paperback and stared at a page as if it were a scene on another planet. Finally he would go again to the children’s ward to find a bed where he was a stranger and felt safer. A few mothers would look up with suspicion, concerned to protect their children from this unknown man, like hens, before recognizing him as the doctor who had come to the area two years before, who could never sleep, who climbed now onto a sheetless mattress and lay on his back, still, until his head fell to the left watching the blue light. When he was asleep the desk nurse unlaced his shoes and removed them. He snored loudly, and sometimes it woke the children.
He was thirty-four years old then. Things would get worse. By the time he was thirty-six, he was working in Accident Services Hospital in Colombo. ‘Gunshot Services,’ they called it. But he remembered