Seinna Thomas

Seinna looked at the tall stacks of books lined up in front of her. Her lips curved into an

embarrassed smile. She looked around and hoped nobody had seen it. Examinations were

around the corner and everyone was stressed out and high on caffeine. Seinna was high on

anticipation. She had finished the course. Twice.

Seinna's parents were ecstatic when she had cracked the USCIS (US citizenship and immigration service) medical exams

and decided to go to Harvard Medical College, one of the best medical colleges in

whole world . Seinna had smiled, shaken hands and hugged. She knew it was just the beginning.

School never offered her the opportunity to bury herself in course books the way she had

always wanted to. The course was never a challenge. The entrance examinations were a

necessary evil. She knew she would sail through. When news broke out in her hometown

that her USCIS rank was third, cunning pot-bellied owners of coaching institutes

had flocked to her place, wanting her to advertise their highly qualified staff and fully air conditioned classrooms with a picture of their most illustrious student—Seinna Thomas. A

few days later, she was in the local newspapers. Her parents' dreams were fulfilled. Hers

had just taken root.

These were the first set of exams in her college.

'You don't look tense?' Sawyer asked as he underlined his book with a fluorescent

marker.

'I am okay,'she said, barely suppressing a chuckle.

She had the book Human Anatomy open in front of her. She had read it twice. She itched

to read something else. Her eyes had been on the book on pathology lying on the side. A

second-year student was sleeping on it. She wanted to peep in, worse still, whip it away

from under the senior's head, but she didn't want to come across as a nerd.

'You have finished the course, haven't you?' Sawyer asked suspiciously.

'Yes,'she said and blushed. 'But I still have to revise,'she added.

'But when? You spent all the time with us. When did you get the time? I didn't see you

study!'

'Promise you won't tell anyone?'

'I won't,' Sawyer asked and adjusted the spectacles on his hunched nose. Obviously,

he wouldn't. Seinna knew that. Sawyer and Seinna were destined to be friends after the first

roll call in their class of 335 students. Their roll numbers were consecutive, since

Sawyer Wright and Seinna Thomas stood for S. They were partners in dissection and had cut open their first corpse together

—it's the sort of thing that binds two doctors together for the rest of their lives. Kind of

what it means for two MBA students to have the first peg of whisky together. Other

than that, they were very similar. Middle-class families, dads in government service,

mothers as housewives and intetnational toppers of their own regions. In a parallel universe

where north and south US got along, it was a match made in heaven.

In the past three months, they had become the best of friends. They never kept anything

from each other. They didn't have to, since they led simple lives. Simple people with

simple desires. They had nothing to hide. They had never partied, never smoked, never

drank. Neither of them had stayed out of their houses after eight. They never felt the need to.

'I had gone through a few books before I joined college,' Seinna said.

'You had? Which ones?'

'Anatomy. Physiology. General Pharmacology. A few others.'

'A few others? That's like the whole course,' Sawyer gasped.

'I always wanted to read them ever since I started preparing for medical entrances.

That's all I have ever wanted to do.'

'You're crazy. Why would you?'

'I have always wanted to be a doctor. Ever since the time I was a little kid. At first, I

thought I liked the candy my paediatrician gave me! But slowly, it became an obsession. I

used to fake illnesses as a kid so I could go to the clinic and hear the doctor talk about

various medicines and cures. It's everything I have ever wanted to do. Haven't you?' Seinna

purred and batted her eyelashes shyly.

'I have always wanted a career. And being a doctor was one,' Sawyer responded. 'But

you're awesome. You will be a great doctor.'

'Thanks.' Seinna blushed. 'So will you.'

'I hope so. But why didn't you tell me before? You could have taught me. I am struggling

here.'

'I can still teach you,'she said.

Sawyer pushed the book towards her, rested his chin on his knuckles and commanded,

'Teach.'

'I didn't want you to think I was a freak,' Seinna said softly.

'I don't need to tell you that.' Sawyer laughed.

Seinna always thought of Sawyer as a sweet, well-mannered guy. He is an Indo-American.

Seinna had spent the first few weeks forcing him to

talk in Hindi as to teach her and laughing her head off. Somewhere between the lectures on human lungs

and lymph nodes, Seinna knew she had found a friend for life. She loved the way he cursed the

Hostel food, complained about the egregious hostel canteen's horrible foodie over mix with Continental, Chinese, Indian all Mix .Their bond strengthened over countless meals of butter

chicken and shitty salad and arguments about which tasted better.

Seinna stared at the books again wondering what had gone wrong. Fear clouded her mind. A

million possibilities battled each other and she cried. She had read about 'hypochondriasis

of medical students', a condition in which medical students diagnose themselves with

diseases they don't have. It stems from the paranoia one suffers from after obsessing over

different symptoms throughout the day. But she knew for a fact that she wasn't imagining

things.

She had left the examination hall thirty minutes before the scheduled time. She knew all

the answers. She had wanted to write them. The pen was in her hand, and the answers in her

head. But her hands had cramped. It wasn't the fear of the examination; she didn't know

what it felt like to be afraid of an examination. There was something wrong with her hands.

It wasn't the first time she had felt it, but she had chosen to ignore it earlier.

She had tried moving her hand in vain. After struggling with intermittent pain and the lack

of sensation for half an hour, she had started to write. She had written three beautiful

answers when the pain and the lack of sensation came back. She had tears in her eyes. She

didn't know what was wrong with her hand. Every page from every medical book she had

read came rushing back to her mind. Her head hurt. Tears streamed down her face. Half an

hour before the exam ended, she left the hall, tears in her eyes and strange cramps in both

her hands.

'Why haven't you been picking up your calls?' Sawyer asked, worried and flustered.

Sawyer had been calling her for quite some time now. Seinna had disconnected all calls

till she asked him to join her in the library.

'There is something wrong with me,'she explained. 'I had not given it too much thought

earlier, but I know something is definitely wrong with me.'

'Yes, I know. You study too much,' Sawyer suggested and smiled.

'It's not that. It's the examination.'

'What? You did well, right? Everything you taught me was perfect! It was like you knew

the questions beforehand. You are teaching me everything from now on!' he chortled.

'I didn't write anything after the third question,' Seinna said, tears flooding her eyes.

'Hey … Hey … Are you crying? What happened? Were you nervous? But you knew

everything, didn't you?'

'I knew everything.'

'Did you blank out?' Sawyer asked, concern writ across his face.

'NO! I knew the answers.'

Shhh. The librarian asked them to be silent.

'Then what happened?'

'I couldn't write. My hand … I had no control over it,'she said and broke down in small

sobs. Sawyer looked puzzled. He took her hand in his palms and applied pressure at a

few points. He asked her if she had any sensation in her hand. Seinna could feel the warmth in

Sawyer's touch, but she knew something was wrong. Why can't I feel it!

'Can you feel my touch?' Sawyer asked.

'I am scared,'she said. She picked up a pencil from her neatly arranged geometry box.

She tried to write her name on the piece of paper in front of her. She couldn't control it.

Sawyer watched in horror as she scribbled. It wasn't the usual curvy, artistic font she

used to write in. It was hardly legible. It looked like she was using the wrong hand. 'I can't

control my hand.'

'Let's see a doctor?'

'I wanted to be a surgeon,'she said and put her head down on the books. She cried.

'C'mon, Pihu. You don't know what it is. It could be something as simple as Vitamin C

deficiency. There are cases reported where Vitamin C deficiency causes paralysis. Even if

it's not that, there could be a million other innocuous reasons! I think you're overreacting,'

Venugopal assured her.

'What if it's not an innocuous reason? What if it's something more?'she asked, her voice

breaking off in sobs.

She looked at her hand. Pale and useless. Stop being so negative! Maybe it's not that

bad. This can't happen to me. Maybe Sawyer is right. All the possible causes for the

symptom started to shadow her mind. She was freaking out, her tears were uncontrollable.

What was it? Stroke? Nerve injury? Poliomyelitis? Botulism? Spina bifida? Multiple

sclerosis? Guillain–Barré syndrome? All of a sudden, it looked as if she could have every

disease she had read about till now. The deadlier the disease, the more convinced she was

about its possibility. Sleep evaded her that night as she looked up every possible cause of

her problem. By next morning, she had a list of eighty-nine possible causes. She scheduled

herself for a plethora of blood tests the next day.

Sawyer had a horrendous next exam. Seinna and Sawyer had spent the night looking

over all the possible causes of Seinna's loss of control of her hand. They narrowed it down to

twenty types of blood tests and visited a pathology lab at night, rather late for them. She

didn't want to trouble him, but he had insisted. Seinna waited for him outside his examination

hall the next day with her blood test results in hand.

Her blood work was clean, eliminating eighty-eight possible causes.

'I never thought I would be the first person I would have to diagnose,' Seinna said on the

phone.

There were no tests left to be done. Blood tests ruled out pathogens and other common

diseases, breathing tests to check the lungs, MRIs to rule out any neck injury,

electromyography to check the nerves in her hand, a head MRI to eliminate other conditions

and nerve conduction studies to sum up the rest.

'You can never be too sure,' Sawyer said from the other side of the phone.

'I wish I didn't have to,'she whimpered and heard the rustling of pages. 'Are you still in

the library?'

'No, I am not.'

'You are. Go out, Saw-Saw! The exams just got over. Go out and party with the guys.'

'Not without you. I want you to be here,' he said.

'I don't think I am coming back,' Seinna responded

'You can't talk like that. You haven't even seen a doctor, yet. You have to be positive.'

'He must have read the same books that we have. I am sure of what I have, Saw-Saw. I can't

be in denial,'she lied.

'You mean to say that experience counts for nothing? See a doctor. It could still be

something else,' he argued.

Seinna didn't want to pursue it any more. She knew he was going through denial. A certain

part of her was going through the same. Except for this call, she had not stopped crying

since the time she discovered what she was afflicted with. She had cursed the unfair

balance of nature. What she had was not something she deserved. She had cried and pored

over the reports again and again, hoping there would be a mistake. She wished she was

wrong in her self-diagnosis. She could be. She was only a first-year medical student and she

wasn't supposed to diagnose it correctly in any case.

'Are you going to tell them?' he asked.

'I think I will let some doctor do it,'she said. Her eyes watered up. She heard the

flipping of papers from the other side. 'I will talk to you later. The signal is cracking up.'

She disconnected the call. I hope I am wrong about this. She sighed. The tears returned and

they never stopped during the three hours it took for her to reach her home from the college

hostel. All her dreams washed away in an instant.

Once home, she stood in front of her parents, complaining about the strange sensations in her

right arm. Her mother started to ask her about the examinations. Dad asked her if she was

eating right. It took her an hour to make them take the cramps and the loss of sensation in her

hand seriously. Her mom suggested stress. Dad suggested infection. Hostel's water is

riddled with parasites and germs. You're almost a doctor, you should know,' he said. She

insisted on seeing a doctor. Her dad smiled at the irony. Seinna knew what he was thinking

about. He had imagined her as a doctor. Something that Seinna knew would never happen. I

hope I am wrong, she sighed.

On the way to the hospital, she tried to be her chirpy self, even though all she wanted to

do was cry. Maybe she was wrong. The doctor in the hospital asked her a few questions and

prescribed her some blood tests.

'It could be anything. Let's wait for the blood test results,' he assured the worried

parents. 'Come back tomorrow and we will find out what's wrong with her.' He pushed the

bowl of candy in front of her. Out of habit, she stuffed a fistful of Éclairs in her pocket.

Seinna knew the doctor wouldn't find anything abnormal in the tests and would order some

more tests. Back home, she fished out every research paper and every document ever

written about the disease. Looking through various reports she found a research team in a

hospital in US which specialized in stem cell research and developing experimental new

drugs for the disease. She found the email ID of one of the doctors on the team—Alex

Boston, supposedly a genius, and shot across an email giving him the details of her

disease. She was desperate. She didn't want to die and she didn't deserve to.

That night, when she was done reading about her disease and had cried enough to make

herself tired, Sawyer called again. He had been texting her constantly. Seinna knew for sure

he had been doing some reading on the disease too.

'What did he say? Did he order all the blood tests? Did he guess anything? Any

alternative causes? Differential diagnosis?' he asked, the panic in his voice apparent.

'The reports come tomorrow. I know they will be clean. He hasn't guessed anything yet.'

'Maybe they will find something that we didn't. We did the tests just once. And these

government pathological labs make mistakes all the time. Where did you go? Apex

Hospital?' Sawyer blabbered, hoping against hope. This time he wasn't even convincing.

He had checked and rechecked the reports; Seinna was sure of that. They weren't incorrect.

'Let's wait for tomorrow.'

'Are you okay, Seinna?'

'Yes.'

'Are you scared?'

'Very,' Seinna said and started sobbing softly. She had promised herself that she would be

strong and not cry. She couldn't do it. She had read about the suffering of people who had

the same disease as hers, and she felt terrible. Having read horrendous accounts of how

patients lose control of their body as it slowly rots away, she started to question the fairness

of it all. Why me? Of all people! She cursed the mirror in front of her for it was lying. She

wasn't healthy. Her insides were rotting away, slowly, bit by bit.

'It's going to be okay,' he assured her.

'Nothing is going to be okay. You know that! I am dying, Sawyer …'

She cried a little more on the phone and eventually drifted off to sleep. She didn't know if

Sawyer had waited for long before he disconnected the call. It didn't matter. She was

alone in this. She had to get used to it.

Things only became worse the next morning. Her denial had given way to acceptance, and

the acceptance of her condition depressed her. With a heavy heart, she checked all the

websites she had bookmarked the day before, searched for cures on the Internet even when

she knew there weren't any, and checked if Dr Alex Boston from Methodlist Hospital had

replied to her long, ranting mail.

A little later, they were in the car, negotiating the early-morning traffic to the hospital.

Seinna sat on the back seat, wondering if the doctor had any inkling of what was wrong with

her. She hoped he would. And she hoped it wasn't what she thought it was. The anticipation

of the pain her parents would go through was getting unbearable.

'Good morning,' the doctor from the day before said. He was smiling. 'The blood reports

came clean.'

A smile shot across her parents' faces. Seinna remained expressionless as she looked at all

the branded merchandise—pens, diaries, clocks and notepads—from the big Pharmaceutical

companies. Her mom folded her arms as if to say, I know it's because of the stress. Her

father absent-mindedly played with a plastic model of the human brain.

'Are you still having some problem with your hands?'

She nodded.

'Any other problems? Difficulty in breathing? Anything?'

She nodded. Now he's getting it. Maybe. I would have made such a good doctor. She

tried not to buckle and weep. Her parents were still distracted. She felt sorry for them.

Again, she stuffed her pocket with a fistful of Candies

The doctor looked at her parents and started to ask them about their families. 'So Seinna's

grandparents? They are still alive?'

They let the doctors know whatever he needed and the doctor noted everything down on a

small pad. She knew he was yet to make any sense of it. But he had a hunch about what Seinna

had.

'We need to do some more tests,' he said, 'to check the nerve reactions. Nothing major.'

The doctor smiled. Seinna smiled back at him. Does he know? Why is he smiling?

'I am sure it's because of stress. She is a medical student, you know. Lots of pressure, big

books, late nights, you know? She is a brilliant student, topped the region in her board

examinations. She wants to be a surgeon.' Her mom's chest swelled with obvious pride. The

doctor nodded approvingly.

'Do you know what's wrong with her?' her father asked, keeping down the fake brain.

Please don't ask, Dad. I am dying. Slowly. Please don't ask.

'Let's wait for the results,' the doctor answered and whisked her away to the testing

room.

It took the doctor three hours, a battery of tests and consultations with other doctors to

come to the conclusion Seinna had reached days before. She had noticed the expressions of

shock on their faces while her doctor discussed the case with other doctors in her presence.

As they talked and looked in her direction, with pity on their faces, she was sure they didn't

know that she already knew. Some of them even called their counterparts in other hospitals

for a second opinion.

'Did you figure it out yet?'she asked the doctor, who shifted restlessly in his place.

'We are just getting a final confirmation from an expertdoctor in US,' he said. She

felt sorry for the doctor, too. Why should he be a part of the gloom that was about to engulf

her family?

'I know what I have, doctor,'she said, her head hung low.

'Excuse me?'

'I am a medical student. First year, Harvard Medical School. I did the tests myself.'

'What tests?' The shock on the doctor's face snowballed into concern and pity.

'I have ALS. I know there is no genetic history. I know there is no cure. I know that I am

slowly dying. I could be gone this year or the next. But I will die eventually. I have read all

there is to read about the disease. I know what's going to happen. I will not be able to eat on

my own, go to the bathroom or even breathe. You will cut a pipe into my throat to help me

breathe or I might choke on my own saliva,'she explained. She hadn't discussed her painful

future with Sawyer for she didn't have the strength to. It looked like it could never

happen to her. As she finally described her own death to the doctor, she came to terms with

it. The news finally sank in. In that moment, all her dreams, her aspirations, her visions of

herself as a doctor melted away and the morose faces of her parents stared back at her. Her

eyes glazed over and she resolved to not weep. There is some mistake! This shouldn't

happen to me. I have done nothing to deserve this. I am perfectly healthy! Her heart cried

out loud.

'There are treatments—'

'Riluzole, diazepam, amitriptyline. They will give me a few months more. A few days

more of breathing on my own. I have read all about it.'

She tried not to cry. The doctor didn't want to give her any false hope. She had to be

ready for what was coming next.

ALS is a cruel disease. It starts with the patient becoming clumsy. You drop things, get

tired easily, and the sensations in your limbs keep getting dimmer till paralysis sets in. After

that, you're at your helpers' mercy. You can't eat because your tongue and your jaw muscles

will be too weak to chew the food. You can't talk fast or for too long because your mouth

will become tired after the first minute or so. You will be on crutches … before the

wheelchair comes in. Soon, even that will be a problem because you won't have the

forearm strength to roll the chair. You will be paralysed and bedridden. There will be tubes

running in and out of your body to help you eat, breathe and defecate. Machines will keep

you alive. It's a sorry way to die.

'I am sorry,' he said. 'I wish I could do something. I can give you some books you can

read about people who have fought the disease. They didn't win, but they died happy. You

can't lose to the disease.'

'I would just wish for you to tell my parents. I don't have the courage,'she said and the

tears came again. She tried to stifle her sobs the best she could. Never had she thought her

parents would outlive her. What greater misfortune can there be for a parent?

'You're the most courageous patient I have seen in the longest time,' he said and added

with a pause, 'I have a daughter. She is seven.'

'Does she want to be a doctor too?'

'Yes. You remind me of her,' the doctor said, looked down at the reports in his hands and

closed his eyes. Seinna wondered if he was praying for them to be wrong. She wondered how

many death sentences the forty-year-old man had given before hers. The watery eyes of the

doctor told her that he was still not used to it.

'Let's tell my parents?' Seinna said, and clutched the doctor's hand and slipped in some

Candies. 'Give this to your daughter from my side.'

'Sure,' he nodded and took a deep breath.

Seinna took one too. The wails of her mother and silent groans of her father already

resonated in her head and she felt dizzy. They entered the doctor's chambers. Her parents'

eyes met hers and she knew they could see the horror. Their faces fell as if they knew what

the middle-aged doctor was about to tell them. She went and sat next to her mom and held

her hand. The doctor started to explain. The world blocked out. Her mind was blank. The

denial of her parents, their shouts, their screams, their accusations against the incompetent

doctor and the irresponsible hospital, their claims of their daughter being perfectly healthy nothing registered in her brain. She had just one image seared on her retina.

She was going to die, motionless on a hospital bed with a tube cut into her throat.