Photo Credit: Sajjad Hussain/AFP
Raksha arrived at 6 am, her usual shift, and entered Room No 8 A, a room right at the end of the hospital. The cold dampness had almost cemented itself onto the walls. Raksha had an urge to throw open the windows and let in some fresh air, but decided against it. She had been warned.
“Just do what you are told with her.”
To Raksha, nothing about Irom Sharmila seemed extraordinary. She could have been any girl from the North East. Raksha saw many when she went shopping in South Delhi’s flea market in Sarojini Nagar. They moved around in groups and were often buying plastic knick-knacks and clothes, the kind Raksha prohibited her teenager from wearing.
Not that her daughter would fit into those. At sixteen, her young girl was stocky and dark. Short skirts, sleeveless blouses, frills and all that stuff that they sold at the export surplus market didn’t really suit her. And her skin wasn’t as smooth and fair and clear as the skin of these women.
Raksha looked at Sharmila and patted her forehead gently, like a mother, though.
Sharmila would probably be as old as her. The night had clearly been tough. The pillow was damp and Sharmila’s porcelain face had remnants of tears.
Raksha rolled open the tubes, cleaned their exteriors and put them in a tray. A senior doctor was normally there, but today she was alone. She swirled the glass beaker containing a white viscous liquid. The vitamins and nutrients had settled to the bottom. Raksha had to give the beaker a few extra swirls for them to dissolve completely, sometimes small particles would get stuck in the funnel and make a mess.
Then came the only odd part about Sharmila, according to Raksha. She had to be force-fed or fed through a nasal-gastric tube. Raksha never understood why this woman who was quite capable of feeding herself, had to be fed through a tube. Gossip in the nurse’s station didn’t reveal much. No one knew anything about Sharmila.
“She’s from Assam side,” said one. ”She doesn’t eat or drink,” said another. ”She cleans her teeth with cotton, she doesn’t use water at all.” ”She is protesting about something there.” ”Arrey, dimag kharab hai, pagal hai.”
Something wrong in her head? Perhaps. But it seemed a strange kind of madness. Even the news Raksha and her husband watched every evening, and the newspaper, the front page of which she managed to scan most mornings, mentioned nothing.
After the first couple of times, Raksha had learnt that there was no other way to do it except to be as clinical as possible. She picked up the nasal tube and lubricated two to four inches of it with a Xylocaine gel. The procedure was uncomfortable, so in the first days Raksha would squirt a bit of jelly into Sharmila’s nostril; she also wanted to spray something at the back of her throat to alleviate discomfort, but Sharmila never agreed and as the days passed Raksha realised there was no need to.
The ward boy reminded Raksha that the tube had to go into the right nostril today. Pushing down the quilts Sharmila sat up at an angle and tilted her head back, as if surrendering. If she didn’t they would hold her up by her arms and make her sit upright. Sharmila would resist then; she hated being held by doctors and staff. But years of force-feeding had taught her that resisting was only futile and painful.
Force-feeding, ironically, needs the patient to agree and be prepared to be force-fed. Any real force on the part of the doctor would mean that the Ryles nasal feeding tube, about 16 mm in diameter, would get stuck in the nose or hurt the cartilage, leading to bleeding. Other things could happen too; the tube could coil inside or the patient could cough, in which case the tube had to be pulled out. Sharmila knew it all. She had had a thin PVC tube hanging down her nose for six years now.
Raksha tilted Sharmila’s head further, supported it with her arm and gently pushed the tube down the nostril. Almost on cue, and perhaps by habit, Sharmila, in an action similar to swallowing, started pulling the tube inside her body. With every swallow, the tube would go down a few millimetres. Within a few minutes about 15 cm of the Ryles tube would be inside her body, passing the epiglottis, past the pharynx, into the esophagus and then the stomach. Raksha would hear the rumblings of the tube going down through a stethoscope placed near Sharmila’s chest.
A marker on the tube at roughly 36 cm was another indicator that the tube had reached the stomach and it was time to stop. It was surprising to Raksha how easy this was, as if the insides of Sharmila’s nose, its membranes, had adapted to make a hollow tunnel for the tube to slide through.
Raksha swirled the beaker one more time and began to slowly pour the thin white gruel down the funnel, into the mouth of the tube and into Sharmila’s stomach, bypassing tongue, tastebuds, teeth and everything that makes life worth living.
There is an empty taste that hunger leaves in the mouth. For Sharmila hunger and eating had been detached, eating had become this scientific, precise, measured thing that involved assimilating nutrients and vitamins through beakers and tubes. An experiment where there was more vigilance than taste. Food was nostalgia; sometimes a memory and sometimes it came in her dreams: her mother Sakhi was feeding her rice with her hands. It was a good omen.
Raksha’s thoughts fleeted to her packed lunch for a moment just as the last bits from the beaker were trickling into the tube. This permanent abstinence, containing of one’s hunger, this austere, imposed tube diet, suddenly troubled Raksha immensely. Food was vital, an indulgence, why would anyone put themselves through this famine?
As the nutrients came down the nasal passage and the food pipe into her stomach, Sharmila would stay calm, but sometimes in moments of deep anxiety her body shook like a leaf, and she shuddered. Her lips and cheeks contorted. She closed her eyes. Tiny little currents ran through her body and her hands quivered. A sensation of discomfort, not necessarily pain, as if your eardrums are being pressed, sometimes even bleeding of the nose – all these are to be expected in patients of force-feeding, the senior doctor had told Raksha.
Raksha knew all of this, but realised that Shamila’s tremors were not of hysteria or pain. This was something deeper, perhaps sadder. She never understood why Sharmila chose this unfathomable torture. The others at the hospital had an easy explanation: “Dimag kharab.”
Big tears rolled down Sharmila’s sunken cheeks; her breath came feebly. A few minutes later when the beaker was empty Raksha would delicately pull out the tube, it was like a tight knot gradually loosening. And with a dab of cotton Raksha cleaned up the little blood that would sometimes appear around the nostril.
Back in Imphal the nasal tube was almost an extension of Sharmila’s nose. It was never removed. It hung from her nose like a thin elephant’s trunk, or a strange kind of umbilical cord. But here they didn’t know what to do. They would sometimes put the tube in, leave it there for days, then suddenly remove it, sometimes to clean it, sometimes without reason. They would take her for blood tests, check ups and carefully record her every movement, every intake. As if she were a patient, not a protestor.
Sharmila would wave her hand in a feeble frantic gesture, as if to say, as if to shout, “Stop this. I am not a patient.” But they rarely understood her or tried to. Raksha sometimes imagined Sharmila wanted to punch someone. In the end, Sharmila would shut her eyes or go back to her books or do yoga.
The impetus to grow and live was so powerful that Sharmila felt she was rotting here, like still water in a swamp. If the policemen on duty allowed it, she would walk off her restlessness in the corridor just outside her room, or in the small patch of garden just outside her window. She would look at the big black iron-grill gates, the scooters lined up in the parking, the row of long-stemmed, municipal flowers and careless weeds littered with a thousand cigarette butts, and feel happy.