- Dr. Adarsh Nath | Letters from the ER
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- A High Five in the Storm
Click "Read Online" at the top of the email for a better reading experience.The Noise
The ER knows no silence.
Machines clicking and wailing
in their cold, coded tongue.
Stretchers clattering past
like coffins on wheels.
Nurses chanting vitals.
Doctors barking commands across the noise.
Relatives sobbing in dialects of despair,
their cries splintering against deaf walls.
It is not music.
It is not even chaos.
It is harsher,
the pulse of a place that never stops for grief.
Amidst this orchestra of endings,
I heard it.
A child’s cry.
A raw, piercing wail
slicing through the clamour like a blade
searching for the softest place to wound.
The Face of Fear
She held her daughter with both hands,
as if her grip alone could take the hurt away.
“I pulled her too hard, doctor, while she was running after the dog.”
Her face was every mother’s face.
Dragged into midnight’s glare,
trading the warmth of home
for the cold weather of fear.
But around us,
compressions hammering life back into a chest,
blood swirling in a suction canister,
monitor stuttering toward flatlines.
While my team was busy attending them,
my gaze fixed on the smallest of wars.
To an elbow that
slipped from its station.
A scream that refused to die.
Almost laughable.
If pain ever allowed laughter.
But a child’s tears are never small.
The Wail
Textbooks call it nursemaid’s elbow.
A joint unmoored by accident,
a name almost
mocking innocence.
But there was nothing clinical
in that child’s cry.
It was pure, like fire.
Relentless, like grief.
Her wide eyes were stunned
by pain’s sudden betrayal.
Tiny fists clenched,
her small body trembling with a question
no science can answer:
“Why does this hurt?”
I knelt.
She flinched,
pressing her face
deeper into her mother’s chest.
No swelling,
no bruise.
Only the limb held tight,
guarded against the world.
The Motion
There are gestures in medicine
that feel like science,
more like sacrament.
A twist.
A flexion.
A quiet pact
between doctor and bone.
I felt the subtle give. A click.
A radial head heading home,
a wrong made right.
And then, silence.
The cry stopped.
Not gradually,
but like a storm passing.
Her eyes widened,
sobs snagged in her throat.
Confusion.
Astonishment.
And then, a smile.
fragile as dawn.
Tears clung to her lashes,
but they no longer fell.
I asked her for a high five.
She raised her hand.
Soft, trembling
but brave.
A high five.
The Flood Returns
The ER paused,
just long enough for the mother’s smile
to break open
in jagged relief.
Nurses turned,
fatigue cracking into sudden smiles.
And I stood still,
asking why.
Joy never lingers here.
The next stretcher crashed through ER doors.
Blood streaking the floor,
like a Jackson Pollock painting.
“RTA, open fractures, low GCS!”
Gloves snapped on.
Suction roared.
Monitors resumed their elegy.
The child and her mother
slipped into the night,
carried by a silence
no longer mine.
The room
closed back around me,
as if the high five
had never happened.
And yet,
when the faces of the lost return,
when despair thickens like fog in my chest,
I feel her palm again.
The high five.
Not just a reduction,
but a reminder.
That even in the machinery of endings,
life insists on fragments of light.
“The happiness of your life depends upon the quality of your thoughts.”
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More soon.
Another moment.
Another reminder that we are still, somehow, human in all of this.
Yours,
Dr. Adarsh Nath,
Letters from the ER
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