8.6
The Heavy Toll
Managing Death with Dignity in the Time of Chaos
By late April 2021, the second wave had reached a peak so relentless that death had become a constant companion in the halls of MGIMS. There is no administrative manual for losing a patient nearly every hour. In normal times, a death in the ICU is a singular tragedy that stops the clock. In the summer of 2021, the clock didn’t just stop; it seemed to shatter.
I remember April 6, 2021, with a clarity that still brings a chill. Within twenty-four hours, we lost twenty-six patients. The hospital was suspended in a state of stunned motion. ICU doctors moved swiftly, filling out death certificates until their hands cramped. Nurses worked without pause, completing the overwhelming administrative formalities that follow a passing. Each death set off a frantic chain of communication: the nurse informed the supervisor; the supervisor tracked down the family; the nodal officer coordinated with the district administration for the hearse van.
The Ritual of the Hearse
In March 2020, the government had issued strict guidelines for handling bodies. It was a sterile, uncompromising process: body bags, 1% hypochlorite decontamination, and leak-proof plastic. Families were permitted to view the body from a distance, but the rites were performed by hospital attendants at the crematorium. The body was never handed over.
During that peak in 2021, the heat in Wardha touched forty-five degrees Celsius. Our hospital attendants, dressed in full, non-breathable PPE, worked for six hours at a stretch without a drop of water. They would carry as many as six bodies at a time in a single hearse van to the cremation grounds. It was a brutal, grueling service. We tried, within these impossible constraints, to ensure that every life ended with some semblance of dignity, but the sheer volume of loss pushed our systems to the breaking point.
The Horror of the Wrong Call
In such an atmosphere of exhaustion and alarm, errors—however painful—became inevitable. On that same evening of April 6, our nodal officer received word that a patient named Gajanan (name changed) had died. Following protocol, we informed the son.
The response was immediate and furious. “I spoke to my father just a minute ago,” the son shouted over the phone. “He is alive! Let me speak to him again!”
He called his father’s mobile. The phone rang. The old man answered. He was, indeed, alive.
It emerged that another patient—Ganpat—had passed away. In the cacophony of monitor alarms, muffled speech through N95 masks, and hurried handovers, a supervisor had misheard the name. By the time we realized the mistake, some relatives had already traveled five kilometers to the cremation ground, only to discover that the body awaiting rites was not their father.
Later that day, a similar mistake occurred at the cremation ground where attendants unpacked four bodies from a hearse, only to find that none matched the families waiting there. The scene was one of pure, unadulterated distress. It was a moment of deep administrative shame and human heartbreak.
Anchoring Compassion in Discipline
The volume of death had overwhelmed our existing checks. Goodwill was no longer enough. That night, despite my own exhaustion, I instituted a new, rigid rule: The Rule of Dual Verification. No body would be moved from a ward unless two independent supervisors verified the patient’s identity, thumbprints, and destination. Only after this dual confirmation would the nodal officer be informed.
We apologized repeatedly to the families. It took hours of patient listening for the anger to subside. We learned a painful lesson: when compassion is stretched to its absolute limit, it must be anchored in even stricter discipline.
As the last body was taken away that night, a heavy quiet descended on Sevagram. There was no sense of “victory” in having fixed the process—only a profound sorrow and a fragile sense of order restored. We learned that even in the midst of a once-in-a-century plague, care demands meticulous attention until the very last moment. Dignity did not come easily; it had to be defended, mistake by mistake, process by process.