After the eighth ring, the phone call finally picked up.

“Hello, Rani Ambulance,” a groggy and sullen voice said. It was four in the morning, and the pitter patter of the winter rain lacquered the dry walls of the Rural Allapuram Emergency Room in a glistening whitewashed glow. I replied in my best Tamil, “Hello, Arcot anna. Heart attack patient. Needs transfer now. Come fast.”

I put the phone down as the nurse handed me the ECG of the patient— as suspected, the ST segment reaching for the skies in three different leads. “Heavens,” I heard myself whisper under my breath—more so a cry of my jaded mind than of empathy—it was the third STEMI of the day. When the ambulance rolled up the muddied road with more mudlakes than road to the emergency room, the patient was packed and ready to go—three hundred milligrams of Aspirin and Clopidogrel with eighty of statins holding the miracle window period open till the gates of the tertiary hospital in Ranipet, where miracles had chances of happening. Arcot jumped out of the driver’s seat and walked barefoot into the room, trailing his muddy prints behind. He quickly took the patient in the trolley and pushed it into the back of the ambulance, while I made a call to the Ranipet hospital, roughly thirty-two miles away, that we were to reach in fifteen minutes, though I knew it took thirty even at breakneck speeds. Since I was the only doctor presently in the hospital, I asked the nurse, Mrs. Krishnan, to defer any coming patients to other nearby clinics till I was back.

♤

It had been almost three months since I had taken up the job at the Rural Hospital in Allapuram, and exactly six after I had attained my medical license from the Madras Medical College. With my tenure at college ending, and the harrowing prospect of going back to my hometown of Aizawl, I must admit it was a stroke of luck that the recent bombings on Guwahati by the NDFB and the shutting down of the railway station happened following the week after my graduation. I had tried to convince my parents I had no means of going back home. “I need some time before I see you or shiver in the cold again,” I had written in my letter with my graduation photo attached. But when my father, the district magistrate, sent a reply letter to the dean of the college to arrange for an escort home, I had gone to the administration office to seek out any job offers, and had picked the first available opening posted at the front desk.

Three months later there I was, in the back of the makeshift ambulance of a minivan donated by the Denmark Trust Foundation to the Melkavanur Hospital, who later sold it to Arcot when it closed down due to financial hardships. I had a stethoscope on the patient’s chest every five minutes to check for the heartbeat and the patient’s relatives praying to Mother Mary and all who would listen. Arcot had tactfully placed four vomit bags in the back by the oxygen cylinder, one for the patient, one for the relative and the other two for me—the doctor with uncontrollable motion sickness. In my first month, a relative of a patient had complained (rightfully so) to the superintendent of the hospital, Dr. Kiruba, as I had thrown up on his father in the ambulance while he was mid-seizure. In my defence, I had given the dose of antiepileptic successfully, but it was Arcot who stopped me in front of the office before meeting him, advising me not to raise my voice under any circumstance. “Thambi, ‘sorry’ should be the only thing you say inside. Keep head down always,” he said, hands on my shoulder, “Be happy. Patient survived because of you.” I had smiled throughout the meeting, regrettably so, as Dr. Kiruba, irritated by it, at the end of his harangue ordered a pay cut from my salary to pay for the patient’s soiled linen.

♤

The ride to Ranipet was uneventful. I handed the referral letter to Dr. Thomas whom I had talked to on the phone, and who I then saw was comically bald, though he couldn’t have been five years older than me. On the way, I had filled up one of the vomit bags that Arcot gave me, and I was still feeling immensely queasy and nauseated so I asked the Ranipet triage nurse for a shot of an antiemetic. “This is a very busy hospital, and we will not give you a shot unless you get triaged,” she said. And it was after five minutes of heated argument that she allowed me to take a few tablets I had to pay double the amount for.

I got into the ambulance and hesitantly woke Arcot from his deep slumber, and we left the hospital with a worse mood than I had entered, but grateful for the antiemetic that had begun to do its job. I told Arcot to drive slowly on the way back. It was January, when all the festivities had died down and only the cold remained. A few houses still had their Christmas lights up, and in Katpadi village a family was preparing for a funeral march, smoke rising in the breezeless morning. “Ayo yo,” Arcot muttered, making a sign of the Cross like he always does even though he was a Hindu. We stopped for breakfast halfway to the hospital, the rain having reduced to only a slight inconvenience. As we dug into our piping hot idlis I couldn’t help but ask him why he made the sign earlier, to which he simply said, “Because Christian heaven seems nicer than my heaven.” When we got back into the ambulance, he jerked the old radio, cranking it till it hit the spot when The Fool on the Hill blasted in full volume.  I learned, as he later told me while we got back in the ambulance, that he was born into a Baptist family in the town of Arcot, his namesake, where the missionary Scudder family had served the region. “Here, have an apple,” he said as he handed me an ancient-looking apple and evicted the fruit flies circumnavigating it, probably looking for lost treasure. “Fruit flies see future. Only dead things. Eat apple soon,” he said.

A few months passed, and summer was knocking at the door with marigold in hand and jasmine braided in rows down her hair. Emergency services ran as usual under the forty-degree Celsius heat I could never get used to. The day was peaceful, and the hearts took a day off from arresting and laid in the sun. I quickly settled the usual patients—a family of gastritis from eating rotten piasam at a wedding, two ammas—one Catholic and another Muslim hit by their booze-fueled husbands who needed stitches across their nape and right shoulder respectively, children with cold brought by their hypochondriac mothers. I went to the chapel to meditate after my shift, the sun still up, frolicking in the sky dusting the winter coats off the leaves. When I entered, I saw Arcot in front of the altar, kneeling in front of the statue of Jesus and Mary, chanting ‘Om Namah Shivaye.’ When I asked him a few days later about it as he was washing his ambulance, he said, “My God and your God same, just different names.” His hypermetropic eyes brimmed with tears when I gave him my King James Bible with gold rims—the only gift my family had given me in lieu of everything else.

One day, upon returning to the hospital for the tenth time, we decided to park the ambulance in a field and sleep for an hour or two. I woke up suddenly to him thrashing about, limbs flailing and hitting the windshield with loud thumps. I thought he was having a seizure, but while scrounging around my pocket for a vial of midazolam, I heard his raspy voice, “Appa, Amma, why have you forsaken me?” I held onto the midazolam, and prayed to anything and everything and waited for him to wake up. When he did, with pockets of sweat on his thick brow, I helped him to the back of the ambulance. I drove the rest of the way back in silence.

♤

The following week on my day off, I was helping him wash the ambulance. As we unwrapped our idlis and golden sambar, he told me, “You know, I was born, what do you call… ah yes, breech. That's why my mind is so upside down.” He told me how it was a Scudder who had delivered him, despite his mother’s Hindu family’s protests. The midwife shrieked when she tickled Arcot’s feet as they slid out. “She ran away and so Amma brought me to the younger John Scudder sir,” he said. “He twisted me so hard Amma thought my head would fall out.” His mother, overjoyed with her little twisted baby sucking at her teat, agreed then and there to be baptized. “That’s why Amma and Appa separated,” he said. Mother and son lived together in the Christian colony in Arcot, until his mother’s death from yellow fever when he was five.

♤

It was the day before Christmas Eve when I got a letter from my family, the first after my graduation. When I had told them I wanted to stay in the South, my father, deeply traditionalist and patriotic, had taken a vow of silence against me for the blasphemy I had committed against my family and state. "We wanted you to become a doctor here and not there," they had previously written, to which I had responded by writing ‘Luke 4:24.’ A new letter had come, telling me I would not be inheriting anything from my father after his death, and no more contact would be made if I did not return. I burned the letter that night in the biochemistry lab, next to a boiling test tube of a diabetic patient’s urine checking for proteins.

♤

I believe there exists a certain tragedy and a hint of romance in the inexplicable loss of their loved ones, more so when the loss precedes death. When the night of Christmas Eve passed and Christmas came, melancholia had strung me by the neck and tied me to the kitchen chair. I sat by myself, vowing I would drink till I dropped dead in the morning, when Nurse Grace came banging at my door saying there was a patient who came with a stroke. I snapped back to the chair, turned off Hallelujah on the radio and trudged up the hill to the ER to find the patient already in the ambulance, Arcot was honking at me and shouting in English, “Moia thambi, already fruit flies are there. Not a good sign.” I saw him swat them away as they scattered wayward into the fading twilight. I watched, through the booze-soaked lens of my eyes as some landed on the walls of the ambulance. Some I saw made their way to the now-dried mudlakes where they tried to swim. I saw a lone crow pick the ones on the footpath. The ones which landed on the dried lakes taunted me of how fair my skin looked and how the south summer sun would leave it bruised. As the ambulance revved past the road and squashed them, the flies on the wall echoed their taunt.

I handed the referral letter to Dr. Thomas. Afterwards, we stood there in the Ranipet hallway outside the ER, comforting the parents of the poor girl till the Christmas sun came up. She was declared dead at six in the morning. She was only twenty-six.

♤

On the way back, Arcot turned the sirens off. Halfway through the journey when the leaves lay golden on the ground, he asked, “Do you know why I became Hindu again?” I told him I did not have a clue.

Sometime later we passed a CSI church where people had started to flock for the morning service. Not long after did I see flecks of black smoke rising steadily behind the rows of casuarina trees.

Arcot clutched his rosary as the church bells rang. “For your answer, ten thousand gods in Hindu. Christian only one. More chances of god hearing me, no?” he said. He turned on the radio, and April Come She Will by Simon and Garfunkel came on, Paul’s words carried in the wind by Simon’s voice years after their inevitable separation.  I braced myself against the chilly winds, wondering how cold it would be back home at this time. “Maybe I ask Jesus for bigger ambulance for both of us to sleep,” he said, grinning, eyes focused on the road far ahead. He hummed along to the song, occasionally chanting something in Tamil I couldn’t understand. As the smoke continued to rise, I lowered my head and averted my eyes to the bare cassia trees which would be ripe with gold in summer. I wanted to know if Arcot saw the smoke and wondered, too, if anyone died.

♤

May 7, 2026