Tuesday, 10 December 2013

Heart's A Mess: Chapter Twenty Three Part I

Three Years Later. 

"Stop." The command came out, barely a whisper. Desperate, devastated and disbelieving all at once.
This was a conversation that she had prayed would never transpire. She had stared out the wall of windows for the past hour, the voices filtering in and out in muted waves. Sunlight trickled through the porous expanse of grey cloud hovering above the city, an occasional light shower painting the windows with liquid murals; dozens of droplets eddied upon the glass. Here, on the twentieth floor, Khushi felt that if she just stretched her fingers, just enough, just past the glass, she could reach the cloud.

"Khushi we need an answer." Danes pressed her, his demeanour tired and grave.

She stood beside the windows, staring straight ahead. Dread seeped under her skin, taking her nerves hostage. Slowly but surely it's creepers climbed up the cable like bundles, clawing their way up her throat, till finally its long bony extensions wrapped around her windpipe. She struggled to breathe; gasping, every breath short and sharp. There was an overwhelming need to purge her stomach of its contents as nausea staked its claim, constricting her chest. This wasn't supposed to be happening.

Not like this.

Not so soon.

"Dr. Gupta your presence here is simply a gesture of good will. We will proceed as we see fit."

Khushi felt empty inside. How long had she been fighting this? Life seemed nothing but a continuous struggle to scavenge time. Every month she had come into this boardroom with steely resolve; Arnav was not going to be placed into hospice. She had fought, debated, cajoled, convinced and begged for the board to look into new avenues: clinical trials, experimental drugs, holistic treatment.


But now, after this morning, she felt her strength leaving her. It was time to surrender to the inevitable and move forward with as much dignity as possible. She had been Arnav's shield this long and she wasn't going to stop now. Taking a deep breath, she squared her shoulders and addressed the clinical co-ordinator in a fractured voice.

"Actually it's Dr. Riazada now."

The severe woman blanched momentarily and answered in haste. "Regardless, we are here to make a decision that is in the best interest of the patient." 

"I'm sure we can all agree that Khushi has Mr. Raizada's best interest at heart." Oliver interjected politely yet forcibly.

The woman grit her teeth. "Her interests, whatever they maybe, are clouding her judgement. The LVAD has been sustaining him thus far but the incident this morning cannot be ignored. Correlations between ventricular arryhthmia and morbidity in CHF patients are still unclear."

"My position as a wife has not miraculously made me an incompetent doctor." Khushi bit back. "I beg you to remember that I am one of the youngest fellows on this board and remind you to address me with due regard."

The board held it breath as the tense atmosphere turned hostile. To the world Khushi looked worn. Frayed at the edges. Unravelling at the seams. And honestly no one knew how much longer she could keep it together. There was only so much a person could take. Today the entire transplant team was present, putting forward their professional assessment of the patient: transplant surgeons, transplant physicians, surgical nurses, psychologists, social workers, financial advisors and the two transplant co-ordinators.

"I think what we all need is some perspective." Timothy, the procurement co-oridnator, tried to diffuse the situation. "We are here to assess and rank the deteriorating health of the patient. We have a patient who is in chronic heart failure with Mitral valve insufficiency and a history of Rheumatic heart disease. 12 months ago he was inserted with a ventricular assist device that markedly improved his worsening symptoms. Leaving aside the episode of sudden cardiac arrest this morning we predict that the LVAD will continue to support him in the short to medium term."

Dr. Parker added to the assessment. "The sooner we can advise UNOS the better it is. This morning's episode will put him in a better position if there is a viable heart. Ambulatory care is no longer a viable option."

Hannah, the clinical co-ordinator, snorted. "Why are we pussy footing around? Anyone?"

"I would ask you to remain professional Ms. Rodriguez and watch your language." Danes, the most senior member on team flexed his authority.

She waved her hands, exasperated. "Look all I am saying is we can pretend that this morning didn't happen till the cows come home but it doesn't change the facts. Sure, the LVAD is doing great and he could have another year or two on it. But he still is on immunosuppressants increasing his risk for infection compounded by the fact that he has a history of Rheumatic Fever. Not to mention LVAD patients are at a high risk of developing infection with a high rate of mortality. So he is three times as likely to develop an infection than any other cardiac patient."

Taking a breath, she sighed. "We don't even know the chance of a repeat episode of v.fib." Scoffing, she continued on sarcastically. "Since everything is so obviously going in this man's favour let's just assume it's skyrocketed."

Matt ground his teeth, frustrated by the lack of empathy on display. "You could say things worked in his favour. Dr. Raizada was with him at the time."

Hannah raised an eyebrow at the territorial show of support for his female colleague. "Sure. But what about next time? Honestly, at this stage, the guy should be dead."

Everyone stilled and reflexively turned to look at the wife of said man. Khushi, it seemed had finally reached her limit as she turned from the window and ran out the room, her vision blurring.


"How long do you think I'll be stuck here this time round?" Arnav whined flopping back onto the bed. 

Khushi rolled her eyes, her back turned to him. Unpacking his night bag, she reached up on her tiptoes to put his shirts on the top shelf and threw a hospital gown blindly in his direction. "The same amount of time you are usually stuck Arnav. Stop asking me galactically stupid questions."

Arnav, in typical fashion, had a quick quip as she wandered in the bathroom. "You know ever since you became a wife you've become so critical. I preferred the old Gupta. Women. You're all the same. You only show your true colours after marriage." Shouting out, he craned his neck, trying to see her response from the ajar door. 

Khushi laughed softly, organising his toiletries. Her heart did a flip. It was little moments like these that she lived for; the witty banter between them. Two years and seven months. That's how long they had been married. Looking at herself in the mirror she swore she looked like a newlywed. Flushed cheeks, a shy smile and wide bright eyes. All it took were few words, a sly glance...a brush of the fingertips. The man could wield her emotions at will.  

Biting down on her lip, to stop a bubble of laughter she yelled back. "You know ever since you became a husba..."

A loud crash drowned her out.

She froze. 

Stumbling over her own feet Khushi ran out to the room. Arnav lay crumpled on the floor, his limbs rigid as he convulsed. His skin was deathly pale almost tinged blue; a superficial laceration on his forehead dripping blood onto the white lino. Her gaze lingered on the toppeled over meal trolley, silver cutlery splayed out on the floor. He must have hit it on his way down. Years of training clicked into gear and she moved with seamless grace. Hitting the button behind the bed Khushi activated the code blue alarm. 

The speaker system echoed around in a dulcet female voice. 

Code Blue. Code Blue. All medical personnel please report to the fifth floor. Code Blue. Code Blue. All medical medical pers.....

By the time she dropped down next to him the seizures had ceased. Her fingers searched for his pulse. 


She screamed out into the hall. "SOMEBODY GET ME A CRASH CART

Delivering three large precordial thumps, she frantically palpated his neck. Finding no pulse she began to resuscitate him. Fingers interlocking with one another she put her entire weight behind the compressions. 

"Come one baby. Come on." Khushi murmured willing him to open his eyes and look at her. Looking down at her hands she noticed just how small they were on his broad chest. How could such small hands possibly revive this giant? Several surgical nurses and an intern ran into the room. She barked out a series of well practised commands. " Jeff get a central line in. Susie take over compressions. Dom page anaesthesia now, I'll try and intubate him in the meantime."

Susie paused, unsure. Khushi looked up as she gloved herself. "What!? What the hell are you waiting for an invitation?"

"We can handle this. Dr. Parker is on his way. You shouldn't be doing this."

Khushi continued the intubation unphased. "Susie, I am currently the most senior member in this room and if you try and get in my way I will gut you. Are we clear?"Shocked at the unusually harsh outburst from her colleague, Susie took a second to gather her wits and resume compressions. Trying to find a clear passageway, she heard several other people entering the room and preparing equipment. Khushi kept mumbling. "You're so cold. So cold."

Somewhere in the chaos Khushi registered Danes voice booming. "Let's get him on to the body board and up on the bed. Parker monitor his vitals. Can someone tell me WHY is he not hooked up to the ECG yet?"

The heart monitor came to life and started beeping incessantly. Parker yelled out. "His sats are dropping. We're at 95." Paper spilled over from the ECG machine and Matt ran the strip in his hands analysing the electrical waveforms. "He's in V.FIB"

Danes looked to find Khushi struggling to find a clear passageway, her hands shaking as she mumbled to herself. He cursed. Addressing the anaesthesia fellow he quietly asked..."Take over intubation from Dr. Raizada."

Emmanuel tried to pry the laryngoscope and tracheal tube from her hands. She pulled back violently. "I've GOT it!"

"Step back from the patient Dr.Raizada." Danes ordered.

"No." Khushi continued to try and put the tube down the trachea. "Damn it! It keeps getting stuck." she cursed.

"Dr. Raizada you are harming the patient's wellbeing. STEP BACK."

Khushi ignored him and continued to peer down the laryngoscope. Danes nodded to the two security guards at the door. With as much gentility as they could manage, they pulled her back from Arnav.  She looked up in shock. "What....what are you doing? LET ME GO! I said... LET ME GO!" They continued to drag her from the room as the doctors and nurses focussed on reviving the patient. Oliver tried not to look as his mentee screamed in desperation. "NOOOO! NO! LET ME IN!" Khushi banged against the glass. "I NEED TO BE THERE! LET ME IN!" She sobbed and wailed, begging to be let back in.

Her screams pierced the heart of everyone in the room. It was not easy witnessing her pain. Khushi pressed her face and hands against the glass windows of the room looking in from the hallway; her chest wracking from sobs she no longer noticed. Every statistic and paper she had ever read came back to her and she imagined the worst possible scenarios. The odds were not in their favour. 

"Sat's are stable." Parker called out. Emmanuel had managed to intubate him in seconds and stood compressing a large blue bag on the end of the tube. 

"How long since we began compressions?" Danes asked.

Susie looked at the wall clock. "Six minutes."

Danes watched the amplitude of the heart's waveform decrease with every passing minute. "Charge to 200J. Shock him."

Parker yelled out "CLEAR!" Pressing the button he delivered the electric charge to the heart. Khushi watched as Arnav's lifeless body raised a few cm from the bed and landed back down with a thud. She watched as her peers delivered cycle after cycle of CPR followed by electric shocks. She watched as the love of her life slipped away from her with every passing minute. Then without warning the small amplitude waves ceased all together. 

"We have asystole. He's in cardiac arrest!" Parker yelled out to Danes.

"Push another round of epi and atropine."

Suddenly it dawned on Khushi, as she stood pressed up against the glass, that Arnav was dead. From that moment Arnav was quite literally dead. He was gone. In a panicked frenzy she began to bang at the glass screaming. "WAKE UP! WAKE UP! YOU PROMISED ME CHILDREN YOU BASTARD. WAKE UP!"

Emmanuel pushed in the extra epinephrine. Everyone watched as Susie continued compressions. They could only wait now. 

Questions of science, science and progress
Do not speak as loud as my heart

Tell me you love me, come back and haunt me
Oh and I rush to the start
Running in circles, chasing our tails
Coming back as we are

Nobody said it was easy
Oh it's such a shame for us to part
Nobody said it was easy
No one ever said it would be so hard

Thirty seconds later Matt held his hands in his head. "We have normal sinus rhythm."

Author's Note.

Hey guys! As usual let me know what you think. I really appreciate your feedback. It's going to be heart wrenching from here on. There will be some happy moments. Only two more updates then the epilogue. I will tell you that NOBODY has actually guessed the ending. A couple of people have come really close. Only half right though. 

So hold on tight. 

I really would appreciate if you could take out two minutes to view this video. It was what inspired me to become a doctor and the scene form 22.42 to 26.00 minutes will show you what really happens in a situation like Arnav's. I tried to portray it the best I could. 



  1. Wow...this update itself is quite heart wrenching .... Thank god he came back...but he is in such a situation ...can get worse anytime....
    As per ending...I guess he might just get a heart for transplant ...but maybe pRioR to surgery he might have another arrest... Or may be during surgery...and may not come back...
    Khushi might become pregnant in meantime...epiplogue showing khushis kid n Anjali Aman forming close knit family...

  2. You almost killed me you know?? I nearly lost breath when they took Khushi out...and when the shock was not working and her scream reminding him of his promise...God lady you killed me....I am going to call my friend who told me about the update and scream at her...I need to let this pain I felt for Khushi out...it was truly heart wrenching....You made me feel as if I was Khushi, hanging on to her husband's life, acting as his shield...

  3. OMG I thought he is dead this time around. ... phew loved loved thd update. ..!!!

  4. oh! this update itself is heart wrenching, not sure how i will take the future updates. Beautiful writing though i had to google for some medical terms. Waiting for the next update. Would appreciate if you don't kill Arnav in the end and leave it to reader's imagination.

  5. I recently came across your blog. Read all 22 updates in one go and was waiting for the 23rd one. I have not commented on your blog before. I was so excited to see the update today. I don't know any of the medical terms you mentioned, but I really understand the feelings and emotions of Khushi. This update is really heart wrenching. I'm preparing myself for more as you have mentioned in the post. Would appreciate if Arnav is saved. You got a very appealing way of writing. Keep writing and we would look forward for more.

  6. I'm guessing here.. Won't an artificial heart work here? Is the impression that Arnav is going to die? But the ending is about Khushi?

    P.s last line, a typo? "held his hands in his head. "

  7. Omg I am actually gonna go into cardiac arrest ok that's not funny but seriously it was HEART WRENCHING to say the least I loved it and as for the ending well they could use like embryonic cells to produce an organ or sommat but then he wod have an cardiac arrest but he would be ok and get to see his chilldren be born please let it be a good ending (I don't know much about science hence the unsure answer of embrionic cells)

  8. I was worrying and crying with Khushi..gave a heart attack to me I should say ��...good job sasak!

  9. oh GOD........it sooo heart wrenching...i hope Arnav survives...plsssssssssss.........if he didnt survive then the pain and suffering they both and anjali had gone through will be for nothing....please let them fight....taking one day at a time.....both arnav n khushi deserves happy ending.....i usually stay away from emotional stories but this one caught my attention......the last bit was a flashback so that means arnav is still alive right???? i hope he get a heart transplant......my dad is a heart patient past 19 years...he has AICD planted since 7 yrs as well.......maybe thats why i felt like reading this story......a very good job Sasak....best wishes.......

  10. normal sinus rhythm means normal heart beat on ECG rite????? so he's alive!!!!!!!!!!!!!

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  12. Very touchy update... Feeling really bad the way things are going on with arnav and khushi. I am actually eager to know how they moved on to their marriage and how they were doing after the marriage.. Hope you will give us some glimpses! even flash backs will do!

    However, the only difficulty i had was with all these medical science terms and situations... I felt like sitting with my secondary school biology book.. haven't been in touch with science for so may years!

    Looking forward to the next update!

  13. Soul wrenching....i cud imagine myself in the ER

    Sarahjac *IF

  14. Hey there !!;
    i am a new reader ..
    you make me cry like hell yarr .. I simply loved this story .. It was so emotional update .. Loved it to the core ..Eagerly waiting .. ��

  15. hey!!!
    i don't know what should i say after reading this update. i was literally shaking with fear while i was reading the flashback. a happy moment turning into one of the deadliest in matter of nano-seconds!! i an totally unable to make any guesses but will just hope for a happy ending.
    i didn't understand much of the medical terms that you have mentioned over there, but over all summery is too intense.
    you made me cry with anticipation....

  16. I just read this whole story in a go and I am speechless! I laughed at arnav's attempt to woo khushi, cried every time arnav got sick, and was touched by the strength of their love. This story was absolutely perfect.I absolutely can not wait to read more! :)

  17. hey, you are an amazing writer! not everyone is lucky to be gifted with creativity as well as the language skills but you definitely have them. i just read all the chapters of this as well as ylme's n loved it :) waiting for more now :)

  18. You've a way with words, nice update. Waiting for the next update, hope Arnav will be alive till the end

  19. i have read the whole story in one go it's so emotional and heart touching ff i have read.plz keep arnav alive.update the story waiting for it eagerly

  20. youre a b#$%^. I hate you!! FOR WRITING THE BEST STORY EVER!!!LOLOL i mean no offense! :D you rock!! reading this story makes me soo like why isnt this an oscar worth movie?!? i absolutely love this!! I DEMAND AN UPDATE IF YOU DONT WANT ME TO CURSE! LOLOL update soon! and once again sorry if that was mean! :D lol love you times infinity :) :) :)

  21. Are kidding me i finished all the chapters in one go and looking like crazy for the update where the hell is it?

  22. hey dear,

    I did not know what to tell. I am speachless. This is the begining or the ending what can i say after i commented on the first few episode i wanted to read the rest in one go. so i did that.

    How appropriate is the name that you have for this story. I really feel that he shoudl not die.

    Khushi should be given her share of happiness. She is always on a watch out and shouldn't she be given a rest. A life with happiness. I am clueless what will happen in the end.

    She is an amazing person. I loved all her colleague in the hospital.

    I cried when i read this chapter. All my emotions were drenched out i wanted to hug khushi, i want to know the ending please will you update.

    Are you a doctor because all your medical terms are and the way you write about it has a medical touch to it. But the references you give and the way you convey your thought process to the readers is amazing.

  23. Omg, injust read this chapter, my tissue box is empty, but normal sinus rhythm. Please let him live, give them a chance, I know in reality it might not be so but thus is fiction we canmake it happen. And please, I see you have notupdated in the longest time. Hope all is well!

  24. Please dont leave this incomplete... Re read atleast 4 times and waiting for updates and busy with ylme

  25. Hi Sasak! :)

    Hope all is fine at your end.

    It's been very long since you updated. Waiting for the updates..

    Have been waiting HAM to have its perfect end, so that you begin with updating YLME again.

    I know I'm being greedy. But can't help.

  26. why havent you completed it?? r u leaving it incomplete??:( please update yaar.. seems like its been so long since you have updated.. please dont leave it incompleted yaar :(

  27. oops i forgot to tell ... i have finished it one go .. its wonderfull .. really loved it!! pleasee please update ..

  28. Wow!!! We r waiting patiently for your update since December 2013!!! C'mon update please!!!

  29. hi. i came across your story and read the entire thing in one stretch. the way you have crafted the story line and created the characters of arnav and khushi is absolutely beautiful. the emotions portrayed are so real that they brought tears in my eyes many-a-times. kudos!
    being a sucker for happy endings, i can only request you to give it one. after all the pain arnav and khushi have gone through, the least they deserve is a life together that's full of happiness.
    also, i noticed that you haven't updated in quite a while. hope you do so soon. eagerly eagerly waiting for the next chapter, and for a miracle to happen in the lives of arnav and khushi.

  30. Where are you? Hope everything is okay with you. Waiting eagerly for updates, on ham and ylmetm

  31. One Year Later... I still await an update here...

    Hadn't check the blog for a while . But dont know why, I really thought I would find an update here today..

    Hope everything is okay at your end..


  32. hi...

    I don't know if you remember me, but I've been one of your craziest fans. I've always loved your work, if it were sorrow you wrote, it'd make me sad, if a chapter was sad, it'd make me cry, if you wrote about romance, I'd want to be the subject of such romance (and that when I don't even practically believe in the concept of romance - it's all romantic in books and movies only), most importantly, any character you created for arnav, I fell in love with your idea of arnav. and I fell so hard, every single time. I fell in love with his little nuances, like how he called khushi, gupta, I could hear it in my ears. like how he would smile, it was like I could imagine him, like how he would have those content but sad eyes, I could sense his emotions, it was like I could feelwhat you made him feel... why did you stop writing then? this story was and still is especially close to me, because of very personal reasons... but I still want to know how it ends, I worry about khushi, can you always just give me a small summary for the ending?


    lots of love and best wishes,

  33. I read last few chapters again and almost cried when Arnav wishes Khusi to have a family - his family But then this last update my heart literally skipped a beat when Khusi was thrown out and she thinks him as dead. There are so many ways the story can go and I would like to wait for your vision to unfold though as a reader I do wish for Arnav to have a transplant and for both of them to have children so that Arnav's wish of giving a family to Khusi is fulfilled and She has had her share of misery and should have some happiness now.
    Also could you please give us snapshot of their married life... good and the bad one.
    looking forward to reading more....mentally preparing for the roller coaster ride of emotions.
    take care
    IF paaskhanna

  34. My heart's a mess too after reading this Sasak! What happened? What made you give up on updating and completing the story. You are a fabulous writer, come on, come back and continue with it. Love and hugs for all th chapters that you penned down.

  35. Read this beauty again. Yar i hope everything is Okay with you. And i really hope you update this again. every month or two i come back and see if there's an update but alas.
    Intehaa ho gai Intezaar ki
    Ayi naa kuch khabar, meray yaar ki ;P

  36. Its been three years since you started this story. It's weird, when you first started the story, I remember reading updates in the evening after shadowing a cardiologist in the day so at the time it felt oddly relevant (other than ipk, that is) and now when rereading, I'm prepping for med school.
    I really hope whatever issues you were going through have been resolved and also just wanted to let you know there's still people waiting for the ending because a story like this truly deserves to be completed. What started out as a lighthearted story full of witty banter turned into a heartwrenching tale where every update just leaves you crying and imagining the raw emotions that must be going through Khushi. Can't believe some people can be as blunt or insensitive as that clinical coordinator, especially knowing they're married.
    It's just the last stretch of HAM I imagine, 2-3 chapters, but please please complete it at some point, no matter how much time's passed because it really needs closure and this is one of the best pieces of fan fiction written.

  37. Totally agree with the above comment please please come back

  38. Hi Sasak. Will you be updating. Read this ff in a few days. It's beautiful! Please continue and update us. Will Arnav live, will they have a family. Please have pity on Kushi. Do let him live and happily ever after. Are you a full fledged doctor now? Very busy? Thanks love.

  39. Your last chapter starts off by saying 3 years later, and its been 3 years since an update. Still hoping that one day you might come back and finish this. Please? It's an amazing ff that shouldn't be left incomplete.

    Hope everything okay on your end! If you ever see these, there's still a lot of people hoping you'll come back to finish it. And YLME too.

  40. I do, t have access to last chapters of heart a mess not your love means everything to me . Can you give access plz😓

  41. Dear Author, 

    How are you doing? Hopefully all is good in your world. Please let us know everything's going good - sometimes we worry.  Are you a doctor now? Very busy (Thats a given!) Do you sometimes visit this site? Reading comments? I thought to write you a little something - just perhaps seeing another notification of this blog make you visit this place again. 

    It has been years since you last wrote to us - years have passed in between but I can tell you for sure - it hasn't been years since we last read. Many of us visit this site, we come to cherish this beautiful story, we shed (many) tears in silence and then close away the tab for another day. We miss you - the emotions you weaved years ago still have their magic - they still captivate us, they still make us want for more and more and ... more. 

    We indulge in the lives of our favorite characters, re-read to interact with them again and all of those characters have so much life, its hard to choose favorites. They make us cry and then a beat later laugh too. We are always pulled into the vortex of myriad emotions - such is your talent, dearest author.  

    Do you know we love this story? Do you know we would buy it in a heartbeat if you decide to publish it, do you know we want more - closure we didn't get, you said few chapters are remaining of this beautifully illustrated tale - you said the ending will be nothing like we have imagined. And we have imagined a ton in this passing years. Do you know we will always welcome you with open arms without even asking about your absence? Do you know that many still waits, hoping against hope that perhaps one day a new chapter will be waiting for them when they open this site again? Such is our love for this tale. 

    It has been many years since you last wrote, do you narrow your eyes at your writing - thinking of it as awfully (I know many authors do that to their previous works) But that's natural and only in your head because you have grown as a writer in these years. Please know that this is one of the best stories I ever had the privilege to read (one of the very best from all the published stories I have ever read) This story defines why I love reading and why I believe that storytelling is nothing short of art - the hues you painted still marks us.

    I wish I had your email so I could send you this and more, which perhaps has more chance of being read - but then maybe if one day you ever visit this place, you will see this - My love for the beautiful tale in few words.

    Last, I just want to say - if you ever decide to come back to it (even 30 years later, Do you know it will be a crime to leave something so beautiful unfinished?) Just know We will be here. Always. Ready to be part of this unforgettable journey again. We waited and we are waiting.

    Our hearts more than a little mess. Just please someday come back. Please.

    We hope and wish for you all the very best in everything and anything you do.

    Take care,

  42. Dear Author,
    Just came to check if you have updated the story. Please...Please update. If you can't post lengthy two chapters and epilogue please at least give us brief ending. Thanks.

  43. This comment has been removed by the author.

  44. Please come back, dearest Author. The story begs completion and we, the beautiful reading experience. Warm regards.