The Accidental Apprentice (31 page)

Dr Mittal senses the palpable tension between us. ‘I know it is not an easy decision. That is why I want both of you to think about it carefully and come back to me in seventy-two hours. That's three full days.'

We walk home in silence, not knowing what to say or do next. It is a new challenge to both of us, something we have never faced before. The only ground rule we agree on is not to breathe a word about this to Ma.

*   *   *

That night, as I lie in the dark, I can hear Neha tossing and turning in her bed. And I know she is thinking the same thought as me. All our filial love and affection has eventually come down to this bizarre predicament: whom do you care for more – your mother or your kidney?

It is a question I wish no daughter should ever have to answer. For it has the potential of pitting sister against sister, laying bare the hidden weakness of the soul. Every anxiety, every doubt, every foible and pretence waylays me in the street of indecision. Every selfish desire sprouts in the garden of my fear.

I occupy myself by researching ESRD and kidney transplants. The kidney of an adult human, I learn, measures ten to twelve centimetres in length, contains one million nephrons and weighs approximately 150 grams. I trawl the Internet, seeking inspiration from those who have donated kidneys to their loved ones and are still leading happy, healthy lives.

Neha spends her time researching the opposite, marshalling arguments against donation. She holds whispered conversations with me when Ma has gone off to sleep. ‘Donating a kidney is not like giving your iPod to a friend,' she says. ‘It is a major surgical procedure and carries long-term health risks. After the operation you can forget about playing any more sports or doing physical activity. Besides, I don't even buy the argument that the second kidney is redundant. God forbid, but if something were to happen to me one day, say an accident or some serious disease, the second kidney would come in mighty handy.'

There is some truth to what she says. My research reveals that people with just one kidney tend to suffer from a few problems later in life. Some have high blood pressure, others a condition called proteinuria, which refers to excessive protein in the urine, and a third category has been known to suffer from a reduced glomerular filtration rate, which basically means that the single kidney is no longer as effective in removing wastes from the bloodstream.

‘After knowing all this, you still think we should go ahead with kidney donation?' Neha demands.

‘We don't have a choice. If Ma doesn't get a new kidney, she dies,' I respond. ‘Blood demands a price. Love demands sacrifice.'

‘Then you make it,' she says with characteristic bluntness. ‘I have to appear for the regionals of the Miss India contest. I can't go looking pale and unhealthy. Besides, you are the eldest in the family.'

Neha has hurt me before; now she is trying to backstab me. I can feel the knife of betrayal twisting up my insides. And it fills me with utter disgust. ‘Why? What special favours have you all done me?' I erupt in virtuous anger. ‘Where does it say that the eldest has to suffer for everyone else? I gave up my dreams, I cut short my studies, and now you are forcing me to even cut open my body?'

For once Neha is dumbfounded. She takes an involuntary step back, her eyes wide from disbelief. Then a gasp of contrition escapes her lips and she falls down at my feet. ‘Forgive me,
didi,
' she cries, clutching my legs. ‘I take back my words. After all that you've done for me, how could I be such an ingrate? I don't deserve to live.'

It is enough to make me break out in tears. I raise her up, mumbling, ‘We're in this together, stupid.'

We cling to each other, two scared souls trying desperately to gather the courage to do one brave thing.

*   *   *

When the moral instinct for filial love collides with the primal instinct for self-preservation, the first casualty is decision-making. We try to postpone the inevitable by immersing ourselves in the mundane routine of life. I religiously go to my job, Neha to her college. At night, closeted in the same bedroom, we hardly speak to each other, suffocated by our anxieties.

For forty-eight hours we remain in deadlock, tense with uncertainty, torn with irresolution, like a jury unable to agree upon its verdict.

It is Neha who suggests a way out of the impasse on the third morning. ‘Let's toss, like they do in cricket. Heads it is me. Tails it will be you. Okay?'

I nod. Perhaps it is the neatest way. Sometimes the big decisions in life have to be left to pure, cold chance.

Neha rummages through her clothes drawer and comes up with an old one rupee-coin, its surface tarnished by time. We gather in the middle of our bedroom, like two duellists about to meet their destiny. Neha shows me both sides, confirming that it is not a trick coin. Then, without further ado, she tosses it up. Though aged and well-worn, the coin catches the sunlight streaming through the open window as it spins in the air. Neha catches it expertly on the downward arc. She slaps it down on the back of her free hand, sheathing it. ‘Our decision is sealed. There will be no second chance, agreed?' she asks in a shaky voice.

‘Agreed. Heads or tails, it will be God's decision, not ours. Let's resolve to honour it.'

Neha nods. ‘I repeat: heads it will be me, tails it will be you.'

‘Now remove your hand.' I swallow hard. ‘Let's see our fate.'

Slowly, ever so slowly, like a plot twist being revealed on a soap opera, Neha slides away her hand. Sunlight bathes the coin, and the three lion heads from off our national emblem glint at me.

Neha's face crumples with shock. A sob catches in her throat at the terrible finality of the verdict. But she regains her poise equally quickly, displaying the same stoic resolve she showed in Mumbai. ‘If it is me, so be it. I will gladly give my kidney to Ma.'

We have finally reached closure, but instead of making me feel better it makes me miserable. I want to hug my sister and tell her, You will do no such thing. I will fulfil my duty as an elder. But what emerges from my throat is a gargled, ‘Sorry! Tough luck!'

We are shortly on our way to the hospital for our rendezvous with Dr Mittal. Today being a weekday, the hospital is less crowded. But it has the same smell of blood and antiseptic that makes me want to puke.

As we step onto the landing on the third floor, a dark, swarthy man accosts us. I recognise him as Tilak Raj, who works as a ward boy at the hospital. His son Raju is part of my Sunday English class.

‘Madam-ji, can I have a word with you?' he whispers, drawing us into a secluded corner.

‘Yes?' I say cautiously.

‘I am told your mother needs a new kidney.'

‘That is correct. How did you know?'

‘I overheard Dr Mittal tell the duty nurse. So how are you arranging the kidney?'

‘Neha is donating hers.'

‘Tch, tch.' He shakes his head. ‘What is this? Such a beautiful girl. You want to kill her future? After donating her kidney she will fade like a wilted flower. Take my advice, don't take this step.'

‘Then what can we do? We cannot afford permanent dialysis.'

‘There is another way.' He winks.

‘Tell me!' Neha almost clutches his arm.

‘You can buy a kidney.'

‘Buy? But that is illegal,' I remark. ‘The Transplantation Act does not allow it.'

‘Are you going to look at the law or the future of your sister? You want a kidney, I can get you a kidney, and dirt cheap too.'

‘How cheap?' asks Neha.

‘You will find out when you go to this address.' He takes out a slip of paper from his top pocket and passes it to me. It gives the contact particulars of a Dr J. K. Nath, a nephrologist working at the Unity Kidney Institute, a private hospital located in Sector 15 of Rohini.

‘Isn't the hospital owned by our local MLA, Anwar Noorani?' I ask, recalling the politician with the dyed hair and long sideburns I once encountered in the metro.

‘Exactly.' Tilak Raj nods. ‘MLA
sahib
is very helpful. It was he who got me this job here. He'll help your mother too. His hospital specialises in kidney transplants.'

‘And what about the cost?'

‘Tell Dr Nath I sent you. He will give you a good price.' Tilak Raj smiles knowingly and slinks silently down the stairs.

‘I didn't know Tilak Raj was a tout, running an illegal kidney racket,' I muse aloud as I watch his disappearing back.

‘I don't care if it's illegal or not,
didi,
' says Neha. ‘I would like to meet Dr Nath.'

‘I think that would be a mistake. We should first discuss with Dr Mittal.'

‘Because it's my kidney, not yours, isn't it?' Neha says with sudden vehemence. In that unguarded moment her mask of bravado slips. She sinks down to the floor and all her pent-up anxiety and frustration comes flooding out in uncontrollable sobs.

I feel a surge of compassion for her, accompanied by a flare of hope. Perhaps a miracle is about to take place. ‘I won't go to work today,' I tell Neha. ‘Come, let's go meet Dr Nath.'

We step out of the hospital and hail an auto-rickshaw for Sector 15. Thirty rupees and fifteen minutes later, we are at the gates of the Unity Kidney Institute.

From outside, the hospital looks like an office building, with an all-glass façade. Inside, it resembles a hotel lobby, all marble and stone, spotlessly clean.

The reception area has the bustling efficiency of a military cantonment. I am surprised to see quite a few foreigners in the registration queue. A smart young receptionist beams at us. ‘Yes, what can I do for you?'

‘We are here to meet Dr J. K. Nath,' I say.

‘Do you have an appointment?'

‘No. Can you get us one?'

Dr Nath sees us after an hour's wait. He is a bald, diminutive man in his early fifties, with a fleshy, clean-shaven face and yellow teeth. Even though he is in his doctor's uniform, there is something about him that reminds me of Keemti Lal, that weaselly clerk in the subdivisional magistrate's office. He gives us a kindly smile, but the hungry glint in his eye betrays him, makes me wary.

‘We were referred to you by Tilak Raj from the government hospital in Sector 17,' I begin hesitantly.

‘Good.' He nods. ‘It means you need a kidney. Is it for her?' He jerks his thumb at Neha.

‘No. It is for our mother. She has ESRD.'

‘Well, you've come to the right place. I can arrange a replacement kidney for your mother once I know her blood profile.'

‘From a deceased donor?'

‘No, a living one. This is the great thing about the market economy of the twenty-first century. You can buy a kidney as easily as you can buy a car. It's all a matter of demand and supply.'

‘But won't that be illegal? I am told only close relatives can donate their kidney.'

‘You have obviously not read the 1994 Act fully. There is a clause for altruistic donation under which even unrelated persons can donate their kidney provided they feel emotionally attached to the recipient.'

‘But we don't know anyone like that.'

‘You leave that to me. I'll find the donor and it will all be perfectly legal. You'll be surprised to see how quickly emotional attachment can be formed once we bring money into the equation.'

‘So how much are we looking at?'

‘At UKI, we charge a flat rate of six lakhs for a kidney transplant package, all inclusive.'

‘Six lakhs? That's way beyond our budget.'

He passes a hand over his bald pate. ‘Then you better go somewhere else. Just know that more than a hundred and fifty thousand Indians need a kidney transplant every year, but only three thousand five hundred kidneys are available. That's why it's a bit expensive. And we have enough patients, both from India and abroad, who are willing to pay the price. Six lakhs is a steal. It's less than fifteen thousand dollars. In America you would have to pay more than ten times that for a kidney transplant.'

It is clear that we are dealing with a wheeler-dealer businessman rather than a principled physician. And there is no way we can afford his fancy prices. ‘Let's go.' I tug Neha's arm. ‘It's pointless wasting any more time here. Dr Mittal must be waiting for us.'

‘No,
didi,
' Neha says with a firm shake of the head. ‘Whatever happens, I am not going back to the government hospital.'

I am struck speechless at the sudden, insane idea that takes hold of Neha. She is desperate to buy a kidney, and cost be damned.

Neha takes over the negotiations from then on. ‘I'm just a student. Can't you give me a student discount?' she asks Dr Nath, her lips curving into a smile that is simultaneously pleading and teasing.

The doctor is instantly smitten. ‘Okay, just for you I will reduce the price by a lakh. How does five lakhs sound to you?'

‘That is also way too high.' Neha pouts.

I watch in silence as she trades figures with Dr Nath like an expert haggler. Finally, the kidney specialist throws up his hands. ‘What do you think this is, a grocery shop? My last price is two lakhs, and only because I take pity on you. Take it or leave it.'

‘We'll take it,' Neha says quickly.

I lean into Neha's ear. ‘How the hell are we going to rustle up so much money?' I demand, my voice a furious whisper. ‘Even Ma has no more jewellery left.'

‘You leave that to me,' she says confidently as she rises to shake Dr Nath's hand. ‘Thank you, Doctor. You'll get the money in less than a week.'

‘In that case let's begin the preliminary procedures right away. Bring in your mother tomorrow for a blood test,' says the doctor.

As we exit the hospital, Neha momentarily looks up at the heavens, searching the sky. I crane my neck too, squinting at the clouds floating across the blue expanse. I do not know what Neha saw, but I fail to glimpse any sign of a miracle.