Bitter Water

Kuttanad, late monsoon. The rain had thinned into a steady thread, like someone pulling a white cotton wick through the sky. At the cooperative hospital, the backwater slapped the mossy steps and brought with it the smell of silt and coconut husk. Dr Ajayan reached for the metal gate and felt it cold against his palm.

He had been on duty for sixteen hours. The ward slept in uneven breaths. From the postnatal room came the hiccuping cry of a new baby and the soft persuasion of a tired nurse. A feral cat stared in from the verandah, eyes narrowed, tail writing things in the damp air.

Just before dawn, a woman came in with a breathless boy. The boy’s face was pale and tight at the lips. The woman had tied her hair in a knot that had loosened into a tail of frizz. Rainwater clung to the end of her sari like a shadow.

Asthma, Ajayan thought. He did not look at the file first. He crouched near the boy and spoke in a simple way. Tell me where it is tight. The boy pointed to his chest with two fingers. A quiet wheeze answered the stethoscope. The nebulizer purred, the boy’s shoulders softened, and the nurse’s eyes unclenched.

Only when the boy was dozing in his mother’s lap did Ajayan pull the file closer. The surname made his stomach cramp for a second. Sajeev. He felt the old stitch under the ribs. He pressed his thumb hard into the paper until the nail bed whitened.

The mother thanked him as if he had handed her a glass of water in a dry season. She paid what she could. Ajayan signed a small slip and told the pharmacist to write off the rest. The woman hesitated, then handed him a note. The letters had the slow care of someone who writes only when she must.

Please, she had written. My son’s school is three ferry stops away. Without the inhaler he misses class. If you know any fund, tell me.

She had signed it, Malathi Sajeev.

When they left, the corridor felt longer. Ajayan stood there a moment with the note in his hand as if it might burn. Then he folded it once, put it in his coat pocket, and went back to the ward.

He kept his guilt organized. One would think that guilt is a wild animal, but he had trained his well. He fed it small portions, on time, and it lay quiet most days behind the shelves in his consulting room, where a file of laminated certificates would block its view. On some nights it came out and looked at him from the steel sink, from the rim of the white enamel mug where tea had left a brown tide line. On those nights he arranged the instruments again and again until the tray shone.

Years back, in a medical college far from these fields, there had been a boy. He had come from a small town with a bag of tender letters from home. The letters were written in blue ink by a father who was proud and a mother who measured worry in half teaspoons. In the first week, the senior students had gathered the juniors in a room that smelled of phenyl and wet dust. There were jokes. There was a bottle. There was a dare made in laughter that had in it the hardness of stone. In the late night, under a tubelight that hummed like a trapped bee, the boy’s head had tipped back at the wrong angle. Someone said he would be fine by morning. Morning came like a hand that does not knock. They carried him to the emergency with their heartbeats jumping at the throat. The boy did not wake up.

That was a long time ago. Time does not turn soil over and bury things. It only appraises the ground and says carry on.

Ajayan left the city after he qualified. He came to this hospital by the water, where the paddy fields lie low and the sky stoops to listen. He told himself that work is a stubborn broom. If you sweep enough floors, the dust in the lungs will thin. It did not thin. It only settled in different corners.

A week after Malathi’s visit, a young woman walked into the hospital office in a crisp, inexpensive salwar. Her hair was braided with too much care. She was there for a trainee nurse position. The office clerk nodded her toward the matron. As she waited, she stood by the window and looked at the canal the way one looks at something that refuses to explain itself.

Her name badge read Anitha S. Another small stitch under the ribs for Ajayan. The letters settled together. Sister to the boy he had seen. Daughter to the mother who had written him that note. He avoided looking at her for long. He signed her training schedule, wrote a small recommendation for the charitable trust that funded nursing students, and pushed the file back to the matron.

That year the rains came late and left early. By Onam, the hospital’s oxygen cylinders had developed a wheeze of their own. Ajayan ran a camp in a school verandah where the benches had knife marks on them from who knows when. He found himself watching Anitha’s work. She leaned into people when she spoke to them. She started IV lines with odd patience. She remembered to tuck the blanket at patients’ feet in the same way a mother tucks in a child. Some nights she sat on the steps with her face lifted to the rain as if it were a radio playing a language she could almost understand.

Three months later, Malathi came in as a patient. One side of her neck was swollen, the skin stretched shiny. She kept holding it like something that might drop if she let go. The biopsy jar arrived sealed in a world of brown glass. The report followed with its usual politeness. Malignant, it said. The word sat on the paper as if it were a guest refusing to leave.

The treatment plan needed money that was made of numbers their lives did not have. Ajayan went to his old alumni chat group, the one where people sent pictures of children in red ties and their new SUVs. He wrote a short message. Patient in need. He did not explain more. He knew exactly which handful would respond without questions. The small transfers came in like shy rain that begins as a smear on dust.

He walked to the panchayat office where the clerk, a man with a measured voice and clean nails, nodded and stamped the hospital letter with an air of civic duty completed. He visited a toddy shop owner who sometimes paid the ward’s electricity arrears in exchange for advice about his father’s blood pressure. A little here, a little there. Somehow the first cycle began.

Malathi tolerated the chemo like a person climbs a steep path with borrowed chappals. When the nausea rose, she closed her eyes and breathed slow. On the days she felt a little human, she picked at her food and asked about the other patients. She did not speak about the past, but she watched Ajayan sometimes with a look like a person standing before a locked room whose key must be somewhere nearby.

One afternoon, as wind rushed in from the backwater and flipped a stack of forms like a deck of cards, Malathi asked her question.

You studied at St. Joseph Medical College, doctor?

Ajayan took a second longer than he should have to answer. I did my internship there.

She looked away and nodded. My son wanted that college. He got admission. He died in the first week. Heart failure, they said. Some accident in the hostel. She said the words without hooking them to anyone. When the silence did not bite, she continued. We filed complaints. It became like shouting into a well. The well returned our voices, and nothing else.

She did not weep. Some griefs are tidy. They sit with their back straight and drink tea. He wanted to ask her to forgive someone without saying who. He matched her tidiness. He adjusted her drip rate and told her that the next cycle would be gentler. This was not true.

That evening, after the ward quieted, Ajayan took out a thin notebook from the last drawer of his desk. It had a cover with a faded picture of a temple lamp. He wrote a letter to a name he never said aloud. He did not write Dear. He wrote only the name, a boy’s name that made his throat tight. He said what should have been said long ago. He apologized without pretending that the apology had weight. He described the room, the tubelight, the bad jokes. He wrote about the boy’s chin tipping back, about the good intentions that came too late. He wrote about every patient he had since held by the wrist as if a pulse could be a confession. When he finished, he folded the paper once and placed it inside the notebook. He did not sign it.

Malathi’s illness walked faster after that. It took one thing a week. Taste first. Then sleep. Then the quiet ease of sitting and looking at the light on the wall. The charitable fund kept up for a while, then thinned. Anitha took extra shifts. On Sundays she ironed her uniforms with a cheap iron that tripped the ward’s breaker if anyone else boiled water at the same time.

One night the sky was loud. The backwater rose to lick the top step. The ward smelled of Dettol and wet cloth. Around midnight, Malathi’s breathing developed an edge. Ajayan stood by her head and counted the chisel marks of breath. He adjusted the mask and spoke to her as if she were slightly awake. He told her small ordinary things. The rain will ease by morning. The banana tree by the lab window is heavy with fruit. The road to the temple floods first.

She opened her eyes once and looked past him toward the door. Anitha stood there and did not step in. She held the jamb as if the wood could take some of the weight off her. Malathi’s gaze moved back to Ajayan. She said his name without sound. He understood the shape of it. Then the chest rose twice more, obedient, and then refused. He felt for a pulse out of old habit. A minute later, he did the formal thing. He signed the time.

The next day, the hospital hall grew smaller with people and murmurs. The men brought a garland that smelled of jasmine and diesel. Women rubbed their eyes and cooed to the child that did not want to be cooed. Anitha stood with a fixed mouth and accepted the shoulders that leaned into her with condolences. Ajayan kept to the side. He wrote out papers that make the state acknowledge that one more life has been counted and closed.

After the funeral, at the edge of evening, Anitha walked into his room without knocking. Her hair was loose and damp. She placed a plastic cover on his table. Inside was a small blue book. His notebook. You left this in the ward, she said. Her voice was even. It had the steadiness of someone who has used up her allowance for shaking.

He did not remember leaving it. She kept her eyes on the notebook. Sir, I do not know what you have written in it. I do not want to know more than I already do. Her hands were open at her sides. Appa died long back wanting answers. Amma also wanted them. It is probably late. Her mouth trembled once and stopped. You have been kind. You arranged money. You sat nights for her. You kept this place running when even light did not want to come here. But kindness is not a coin that pays off everything.

He nodded. The wet in his eyes surprised him. He wanted to ask her to sit, to breathe, to drink water, to leave, all at once. She did not sit.

If there is a confession in that book, keep it for yourself. Do not hand it to the police now, when there is no body to protect with truth. Do not set the backwater talking again. She swallowed and looked at him properly for the first time. Live with it. That is your work. Mine is to come tomorrow morning at eight and begin the dressing on bed three.

She left. The cat from the verandah slid across his doorway, tail erect like the mast of a small boat.

That night he did not go home. He slept on the narrow couch in his consulting room, on his side, as if he were guarding something with his back. At four, he woke, washed his face at the sink, and walked out to the steps where the water tapped the stone. He took out the notebook.

The sky in the east had a narrow brightness like a blade. He held the book over the water. The first drop fell and broke the surface into a flower that closed at once. He thought about letting it fall whole, letting the water take the pages and soften them into pulp, letting the letters run off their lines and become harmless ink like a bruise fading. Then he pulled it back.

He did not want the water to hold his words. The water held enough already. He opened the book. He tore the letter out along its fold. He tore it again and again until his hands ached. He lit a match. The flame climbed and paused to consider. The pieces became a brief bright thing and then ordinary ash. He blew the ash into the backwater. It spread and disappeared as if it had always been part of the silt.

The morning brought cases. A fisherman with a palm sliced by a net hook. A schoolteacher with a pressure he had been ignoring since Vishu. A pregnant girl with vomiting that looked simple but did not feel simple. Work is a broom, he thought again. It moves the dust, but the house is the same size.

Anitha came at eight. Her hair was oiled and neat. She did not look at him. She did the dressing on bed three. She spoke to the old man on bed six about his granddaughter’s exams. When she passed Ajayan near the nurses’ desk, she paused.

Sir, there is a boy waiting outside. He says he is from Sajeev’s old village. He has a letter for you.

Ajayan took the envelope. The paper smelled faintly of camphor and damp cupboard. Inside was a single sheet, torn from a school pad. The handwriting was a careful child’s, but the words had been dictated.

Doctor, thank you for the inhaler. I can run half field now. Teacher says if I run more I will get prize. My mother slept in peace. Please give medicine to others also. That will be good.

It was signed with a name he did not know. Maybe a cousin. Maybe no one.

He folded the letter and tucked it in the pocket where Malathi’s note had lived for months. The pocket lining had frayed. A corner of his thumb caught a thread. He pulled gently. The thread came away like the tail of a small weakness.

At noon the rain eased. The hospital boatman shouted from the canal. The smell of frying chillies came from the staff kitchen. Somewhere a conch blew once and stopped.

In the afternoon, he took a break and stood at the window. The cat lay on the sill with one paw bent under its chest, pretending not to watch him. The backwater had turned the color of strong tea. A boy paddled a coracle slowly, each stroke silent as a held breath.

Ajayan thought of the tidy griefs and the untidy ones. He thought of what a life can and cannot pay for. He adjusted the stethoscope around his neck. The rubber smelled of powder and skin. The call bell rang in the ward with a sound that had no patience. He turned and walked toward it.

Some debts do not close. They travel with you like a familiar. You learn to carry them without spilling. That evening, as the light thinned and the ceiling fans hummed and the ward settled into the measured rhythm of surviving, Dr Ajayan kept moving among the beds. He had a list in his pocket and a letter next to the list. He touched neither. He counted the breaths of those who were asleep and those who were pretending to be. He spoke to the shy ones and the angry ones. He did not search for forgiveness in their faces. He listened for breath. He gave water. He wrote the night orders.

When he finally sat down, the window showed him only his own reflection in the glass. It looked like a man leaning forward in a chair. The cat hopped onto the sill behind the reflection and yawned. The backwater kept its small, important secrets. The rain returned as if it had remembered something. And the bell rang again.

NB: This is an original work written in the spirit of M. T. Vasudevan Nair’s storytelling, another master storyteller whom I admire. It is a respectful homage that adapts only the mood, moral weight, and silences of that tradition, not any particular plot or characters. Any resemblance to specific works, including Amritham Gamaya, is limited to tone and theme.