Deluge: Agasthya Secrets

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Prologue

"O Yudhishthira, in the country of the Pandyas are

The tirthas named Agasthya and Varuna!

And, O bull among men, there, amongst the

Pandyas is the tirtha called the Kumaris.

Listen, O son of Kunti,

I shall now describe Tamraparni.

In that asylum the Devas had undergone penances

Impelled by the desire of obtaining salvation.

In that region also is the lake of Gokarna

Which is celebrated over the three worlds,

That lake is extremely difficult of access

To men of unpurified souls.

Mahabharatha 3:88[17]

Sojourn at Hotel Samurai Ashok

14th March 2016; 4 pm., New Delhi

There was a knock on the ornamental door of room number 1102. ‘It must be room service’ Swathi got up and opened the door.

The hotel server placed three coffee cups and some sugar cubes on a tray. Ashwin was wondering what took Jennings so long. He thought it was prudent to wait for his host before they started drinking the coffee he had ordered. However it was getting cold.

Suddenly they all heard a noise.

THUD

‘What happened?’ All three of them rushed into the bed room. Jennings was on the floor throwing a fit. There was obvious froth coming from his mouth. The insulin syringe, novo pen was still clasped in his hand. His entire body had gone rigid.

‘Do something’ Ashwin hoped, being a doctor, Swathi could do some CPR. The hotel server was standing frozen at a corner of the room.

Having worked in the ICU, Swathi had been exposed to such situations. However she did not have any resuscitation gadgets handy at the five star hotel rooms. She showed Ashwin how to give chest compressions and asked the server to give Jennings mouth to mouth breathing. Although they were not trained at it, Swathi’s crash course enabled them to give their best shot at resuscitation.

What could have happened? Swathi took a second to think it over. Jennings took the insulin jab and after a second, had gone crashing on the floor throwing a fit. She remembered Jennings telling them, that he had forgotten his insulin jab and it was quite a while since his lunch.

‘It must be low sugar levels’. Swathi thought and immediately rushed to get the sugar cubes that came along with the coffee.

Putting sugar under his tongue should do the trick, she felt. Often such quick steps had saved diabetics from going into hypoglycemia and coma, she thought.

However, unfortunately in the case of Jennings, it did not work. His pulse was feeble and his pupils were not responding to light. Swathi knew that he needed to be hospitalized.

The hotel manager, a short well–dressed young man, was there by that time. He had sensed a medical emergency and had asked the hotel ambulance to be ready.

Although the hotel server and Ashwin had been doing a wonderful job, they had already started showing signs of tiredness. Swathi decided it was best to hospitalize Jennings to resuscitate further.

Swathi and Ashwin accompanied him in the ambulance to the hospital. Swathi took the novo pen away from Jennings’ hand to prevent others from getting injured during transport. She however kept it safe in a plastic bag to send it for analysis at the hospital lab later.

She noticed an odd black discoloration at the site of insulin injection on his tummy, just next to the navel. Insulin very rarely caused such a color change, Swathi thought.

The nearest medical facility from hotel Samurai Ashok was Pristine super specialty hospital, which was only 2.5 km away. However it took more than 45 minutes to reach there, as they had to go past the heavily barricaded US embassy and other foreign offices. In addition, the early morning traffic of the high–end Lutyens population of New Delhi had slowed down their pace at several points.

The Embassy had to be informed anyway, she thought. Time was running out and Swathi was losing hope. She could not feel his pulse anymore and Jennings’ body had gone cold.

Thankfully the emergency ward was relatively free at that point of time and the team immediately started attending. The hospital ER team took over the resuscitation and Ashwin felt relieved.

On hearing Swathi’s suspicion, the doctor at emergency checked Jennings’ capillary blood glucose. However to her surprise the glucose levels were normal with no evidence of hypoglycemia. Swathi was astonished as to what could have caused his condition.

Jennings’s blood pressure was not recordable and the nurse attached all the monitors. The ECG showed a flat trace and Swathi knew it was not going to be a good news. The doctor administered some emergency intra–venous medicines to revive the heart. But it was of no use.

As a last resort an AED was connected. ‘All clear’ shouted the doctor and administered the shock. Jennings’ body recoiled a bit and a faint activity appeared on the monitor. However it did not sustain. Further two shocks also did not make much difference and finally they gave up.

The doctor at the emergency did not have much to do apart from filling the paperwork. ‘Dead on Arrival’ he wrote in the case records. Cause of death was declared as ‘hypoglycemia and cardio respiratory failure’ and the case was a closed one.

The emergency team started attending to another case of road traffic accident, they had received by then. Ashwin was not used to the hospital surroundings and the course of events over the day had left him in a state of shock.

Swathi was not convinced about their diagnosis. Hypoglycemia did not cause such rapid deterioration and she had given the first aid of giving him sugar. In addition the lab results of blood sugar did not support their diagnosis.

Swathi knew Dr. Harsha, a pathologist there, from her earlier acquaintance at a conference. She asked him to analyze the insulin syringe discretely and get back to her.

The hotel manager waited to complete the formalities and informed the embassy while Ashwin and Swathi headed back to collect their belongings they had left at Jennings’ room.

Acquaintance at Adyar

12th March 2016 (Two days ago)

It was half past seven in the morning.

The posh Adyar locality in south Chennai was essentially quiet with most inhabitants still asleep or just trying to wake up. The leaves of the lush green trees overlooking the bungalows were wet with morning dew and the birds were trying hard, with their chirping and squeaking, to wake everyone up.

However for Swathi, life was different. Being a doctor, she had to report at 8 am and it took a good thirty minutes to drive to her hospital.

Swathi hated to rush after waking up late. She wanted to be there on time, it being the last day of her internship.

She grabbed a quick toast and dashed out with her car key after a hasty make–up.

Adyar traffic was acceptable at that point of time. The traffic signals were only delaying her progress.

‘Woosh’ overtook a bike on the wrong side and parked in front of her at the signal. ‘What is wrong with the guys? They always have to overtake if a lady is driving’ Swathi thought.

‘Asshole!’ she shouted opening the power window next to the driver seat.

‘It’s Ashwin. Not asshole. You can call me Ash.’ He smiled back. He actually looked smart in his jeans and T–shirt. He was wearing a small backpack and his black Honda bike was ready to speed away when the signals went green.

Without waiting for any reply he cut across the vehicles and turned left into the I.T highway.

Swathi thought for a minute, ‘Had I been a bit harsh to swear at him? He actually looked like a decent guy but in a hurry’. Her thoughts were interrupted by the horns from the cars behind. The signal had turned green.

Her last day of internship in ICU would be over and soon she would be a fully qualified doctor. Her memories went back to the previous day.

She was attending to a patient with multiple organ failure. He had developed it after a serious infection and was already on the highest spectrum antibiotic. The infection had spread into his blood stream and his organs were losing function one by one.

Swathi parked her car and rushed into the hospital. After entering the ICU, as a first priority she collected the blood culture report. Unfortunately, the bug he was infected with was resistant to all antibiotics known to mankind. ‘What else could I do?’ she knew she was stuck.

It was another stressful day. Swathi generally loved her work especially when they could revive people from tough situations and give them new life. But she hated it when their hands were tied. Unfortunately it was one of those days; she had to struggle with no success.

After finishing her days work, Swathi went to meet Professor Raj, her mentor. She had already booked her appointment with him for career counseling.

‘Hope your day was good. You must be proud to have finally made it’ welcomed Professor Raj. He was a tall lean man with a great sense of humor and amazing simplicity for a person with multiple degrees.

‘Yes and no’ replied Swathi. ‘It had been a bad day’ Swathi narrated her futile struggle with a patient in ICU. ‘I never thought we will run out of all antibiotics. Our patient had one of the rarest multi resistant bug and we were helpless.’

Raj listened to her story with empathy. He wanted to change the topic and cheer her up. ‘Don’t worry. Let us talk about your future. How do you want to proceed with your career from now on? There are several opportunities available now and you should keep your mind open’ he waited for her to come out with her own views.

‘I was thinking about it today. I want to do something different. I am fed up doing the same stuff everyone is doing. I want to do research. Find new antibiotics. See today we lost some one as he had multi resistant infection. We could have saved him, had we invented more antibiotics.’

Raj liked interns who were interested in research. Of late very few had spent enough time doing something new and most ended up practicing routine medicine which had become stagnant over the years. He only wished more interns came forward to take up challenges and innovations like her.

‘Microbiology? A very good choice! And research in that field has so much potential. Do you want to take it up further?’ Raj was keen to encourage her.

Swathi thought for a while and said, ‘Yes definitely. How do I go about it? I would really appreciate any help in that direction.’

‘I have a friend Professor Gordon Jennings, coming from New York in a couple of days. He is giving a lecture at an international microbiology conference happening in New Delhi. Do you want to go and meet him?’

‘Yes of course. I like travelling and I would really love to take up some research assignments. In fact I was thinking seriously about going abroad to take it up further’ Swathi was excited.

‘Very well then, I will get you an appointment to meet him in the evening after his lecture. Who knows, you might get a grant to do some path breaking research with him.’ Prof Raj smiled.

‘Thank you, professor. I shall try my best to make it.’ Swathi left with some hope and relief after her tiring day.

She was clueless on how her future would shape up and she literally had no time to think about it during her busy stint at ICU.

Although her last day had been full of struggle, towards the end, some hope had dawned upon her regarding her future. As soon as she reached home, she booked the flight tickets on the internet and registered online for the event.

Seeking help from Syria

11th March 2016, IS Head quarters

The IS headquarters located at the huge mansion along the Euphrates river was buzzing with activity. Guards equipped with machine guns were pacing up and down the corridors. Haneef Yazidi was waiting eagerly to meet the new chief of IS, ‘The Invisible Sheikh’ also known as Caliph.

As a founder of Lashkar–e–Azadi, a major network based in Karachi, Haneef was not used to waiting. He had been mastermind of several large scale terrorist activities in India and was one of the most wanted fugitives worldwide. He was getting impatient.

There was a time when people used to queue up and wait to meet him. However things had changed over the years and finances at Pakistan had dried up to wage any more large scale activity. The only way was to team up.

Finally the Caliph was free, and a security led Haneef into the secret chambers after a brief frisking. Caliph was a tall, emaciated figure who could easily be mistaken for a common man but for