Kafeel Khan on the heartbreaking night the hospital in Gorakhpur ran out of oxygen for sick babies

It was almost midnight when my phone started buzzing. I picked it up instantly from my bedside table out of sheer habit and squinted at the screen. Someone had sent a message on the BRD Medical College’s AES WhatsApp group. It delivered such a jolt that I was fully awake in a second. The sender was Dr Satish Choubey, a senior resident at the Nehru hospital. “There is no oxygen supply in NICU,” his message read. “Cylinders out of stock.”

No oxygen? Immediately my mind was flooded with images of the children in the paediatrics ward of the large hospital attached to the college. Alarmed at the thought of what would happen to those young patients, I scrambled out of bed and groped for my formal clothes in the dark.

My wife, disturbed by the sound of my movements, asked in a sleepy whisper, “Where are you going at this hour?”

“I have to go, my love – it’s important.” I got dressed as fast as I could.

“Work, work and work. You think only of your hospital and the patients. Do remember that your own daughter is growing up. Try to spend some time with her!”

I did not want to argue with my wife or remind her that I had spent that whole day at home. Neither did I want to tell her about the situation at the hospital as it would only make her panic.

“It’s really urgent – a baby is very sick,” I said, offering a well-practised explanation that was not untrue.

“Okay, but come back soon.”

“Bas, abhi gaya, abhi wapas aaya (I will be back as soon as possible).”

Stepping into the night, I walked towards my car, preparing to drive the ten kilometres to the hospital. During such an emergency, I did not want to waste any time calling my driver and waiting for him to arrive. It would have taken him another half an hour to reach my place.

So I drove off in my car, my mind whirling with questions.

Why was it that I did not have any inkling about the oxygen shortage mentioned in that message? It was because I had been on leave on 10 August 2017. My sister had come home from Oman after a year. After being on duty during the chief minister’s visit to our hospital on the 9th, for which we had been preparing long and hard, I had taken a day’s leave to spend time with my family. I was surrounded by my loving wife, my caring mother, my eleven-month-old daughter Zab – the princess in our lives – and my brothers and their families.

I played for hours with my daughter, niece and nephews. After dinner, my sister Farro and I even found time for a long chat with each other. Later, I enjoyed putting Zab to sleep after trying to teach her how to say “Papa”, not that I minded her adorable childish gurgles.

While I had been thus engaged, away from the hospital for a single day, a crisis had got underway, threatening the lives of hundreds of our patients.

A shortage of oxygen could affect the life-saving processes in any hospital even during ordinary times. But what galvanised me into action at that late hour was the inopportune period in which this particular shortage had occurred. This was August, and it was peak AES season.

What could I do in such a situation? What could anyone do? What would I find when I reached the hospital? I frantically searched my mind for answers. All I knew was that I needed to be present to help save as many lives as we could. As my grip tightened on the steering wheel, my whole being gathered itself into a prayer for those helpless children.

Allah rehem kare!

Pressing hard on the accelerator as I zoomed through the dark, deserted streets, I began calling people at the hospital using my phone’s hands-free function. Before I left my house, Dr Satish Choubey, the senior resident who had sent the WhatsApp message, had told me that he had received panicked phone calls from the junior residents on duty. The hospital had run out of liquid oxygen, the fifty reserve cylinders were also exhausted and we had started to lose patients.

The conversations I had on the way to the hospital are seared into my memory. They were strange and surreal – most people I spoke to seemed not to have grasped the urgency of the crisis, except the junior doctors on duty in the wards.

Dr Sakshi and Dr Anil were the two junior residents on duty in the PICU that night.

“What happened?” I asked Dr Anil.

“Sir, there is no oxygen left at the hospital.”

“Did you inform anyone?”

“Yes, sir, I have informed everyone,” Dr Anil said. “The senior resident, the consultant on duty...”

“How did you realise that the liquid oxygen had run out?”

“Sir, the ventilators were not working and had begun beeping. I called Balwant Gupta, the central pipeline operator, who told me we have run out of liquid oxygen. He said the jumbo cylinders were not picking up enough pressure and those are also over now. Sir –” I could sense a tremor in his voice as he tried to convey the next piece of news.

“What is it?” I asked.

“Three babies have died.”

I pressed the accelerator harder.

After taking Balwant Gupta’s number from him, I ended the call.

Next, I called Balwant. My conversation with him was brief but enlightening.

“What happened, Balwant? Tell me in detail,” I asked.

“Sir, at 7:30 p.m. an alarm indicated that the liquid oxygen gas pressure was low. So I put fifty-two reserve cylinders on the alternative pipeline, but by 11:30 p.m. these, too, were exhausted. I informed everyone that the hospital now had no oxygen supply. I told the junior residents on duty, too. I wrote to Dr Mahima Mittal [the head of the Department of Paediatrics] as well as Dr Satish Kumar [the head of the Department of Anaesthesia], telling them about the impending oxygen shortage this morning itself. They had forwarded my letter to the principal.”

“Okay, so when is the next cylinder arriving?”

“Sir, Imperial Gas is sending a truck with jumbo cylinders from Faizabad. I don’t know when it will reach.”

“When did the truck leave? Do you know?”

“Sir, it must have left in the evening. I think Dr Rajiv Mishra sir [the principal] would have spoken to the suppliers, but they have not reached yet.”

As I tried to wrap my head around the communication channels and the chain of command, I fired a series of questions at him.

He repeated to me in a resigned but patient voice. “Yes, sir, I informed everyone. I gave them this information in writing during the day, and when the oxygen ran out at 7:30 in the evening, I told them that we have only fifty-two cylinders left which would also be empty soon. ‘Please do something,’ I said to them...”

“What did they tell you?”

“They said they will see.”

“Have they called you back?”

“No, sir, they have not called me back.”

“Has anyone come to the ward?”

“No, sir, nobody has turned up. Only the junior residents have been speaking to me.”

As a lecturer in the Department of Paediatrics at the BRD Medical College, I was very low in the pecking order, which began with the head of the department, under whom worked two senior professors and two associate professors. My status as a probationary employee gave me no administrative or financial powers.

There was a group of doctors working on contract who had also been given the designation of Lecturer or Assistant Professor. These included three senior resident doctors and a large number of junior residents who were in the process of securing an MD in paediatrics or a diploma in child health.

Out of this pool of doctors governed by professional rules as well as everyday hospital etiquette, I was going to have to stick my neck out, no matter what happened. In my mind’s eye, I could envision the tiny, naked bodies in the Neonatal Intensive Care Unit (NICU) and the gasping children in the PICU, and thoughts of designation and seniority vanished from my mind.

Excerpted with permission from The Gorakhpur Hospital Tragedy: A Doctor’s Memoir of a Deadly Medical Crisis, Kafeel Khan, Pan Books.