Chapter 17: Nishita

# Chapter 17: Nishita

## The Medication

They came for me on a Wednesday morning, during the gap between breakfast and group therapy — the forty-five-minute interval that the schedule designated as "morning hygiene" but that was, in practice, the time when patients showered (cold water), brushed teeth (the Centre provided toothbrushes but not toothpaste; families supplied toothpaste, and families who could not afford toothpaste used neem sticks or salt, the dental care hierarchy of an underfunded institution), and waited.

Sunanda appeared at Room 4's door. She did not knock — the doors did not have the social contract that required knocking, because the doors locked from outside and the people inside had no authority over entry. She stood in the doorway and said my name with the flat intonation of a person delivering a message that was neither good nor bad but procedural.

"Nishita. Dr. Kamble's office. Now."

I went. Through the corridor, down the stairs, across the courtyard to the therapy wing — the walk that I had made every Tuesday and Friday for individual sessions and that I was now making on a Wednesday, which was outside the schedule, which meant that this was not a session. This was something else.

Dr. Kamble was at her desk. The mahogany surface held the usual objects — the file, the pen, the framed degrees on the wall behind her — and a new object: a small paper cup, the kind used in pharmacies to dispense tablets, the white cup containing two pills.

One white. One yellow.

"Sit, Nishita."

I sat. The plastic chair. The power differential. The leather on her side, the plastic on mine.

"I've completed your psychiatric evaluation," she said. "Based on my observations during our sessions, and based on the group therapy facilitator's notes, I'm recommending a course of pharmacological treatment to complement your therapeutic programme."

"I don't need medication."

"The evaluation indicates otherwise. You are presenting symptoms consistent with Paranoid Personality Disorder — specifically, the persistent belief that you are being persecuted by authority figures, the unwillingness to confide in others due to fear that information will be used against you, and the tendency to perceive benign situations as threatening. These are clinically significant symptoms that respond well to pharmacological intervention."

"Paranoid Personality Disorder." I repeated the words the way you repeat a sentence in a foreign language — each word individually comprehensible, the sentence collectively absurd. "You're diagnosing me with a personality disorder because I told you that your sister planted evidence in my car."

"I'm diagnosing you based on clinical observation."

"Your clinical observation is that I don't trust you. And you're right. I don't trust you. That's not paranoia. That's judgment."

Dr. Kamble's expression did not change. The wall. Always the wall. The professional surface that absorbed everything and reflected nothing, the face of a person who had practiced composure until composure was not a performance but a condition.

"The medication I'm prescribing is Olanzapine, 5 milligrams, once daily. It's a well-established medication with a strong safety profile. The side effects are mild — some drowsiness, possible weight gain. It will help stabilise your mood and reduce the anxiety that is driving the paranoid thinking."

"I'm not taking it."

"Nishita. The court order mandates that you participate in the treatment programme as prescribed by the treating psychiatrist. Refusal to participate in treatment constitutes non-compliance. Non-compliance is reported to the JJB. The JJB can extend your stay."

The threat was the same as before — delivered with warmth, packaged as care, the weapon disguised as medicine. The court order was the leash. The JJB was the hand on the leash. And Dr. Kamble was the person who could tighten the leash or loosen it, depending on whether the patient complied.

Gauri's advice played in my head: Accept the prescription. Take the pill at med time. Hold it under your tongue. Spit it out when the staff moves on. Forty seconds before the taste becomes unbearable.

"Fine," I said.

"Good." Dr. Kamble pushed the paper cup across the desk. "Take it now, please. With water."

The instruction was specific — take it now, in her presence, under her observation. Not at med time, not in the dormitory, not with the other patients. Now. Here. Where she could watch.

I picked up the cup. The two pills — the white Olanzapine, the yellow one that I did not recognise and that Dr. Kamble had not mentioned — sat on the paper's white surface like seeds. The yellow pill was unlabelled. The absence of a label was the absence of accountability — a labelled pill was traceable, a labelled pill had a manufacturer and a dosage and a paper trail. An unlabelled pill was anonymous. An unlabelled pill was the pharmaceutical equivalent of a whisper: deniable.

"What's the yellow one?" I asked.

"A vitamin supplement. B-complex. Standard for all patients."

The lie was smooth. The lie was the lie of a person who had prescribed unlabelled pills to dozens of patients and who had developed a cover story that was simple and plausible and that most patients — frightened, isolated, conditioned by weeks of institutional authority to accept what they were told — would accept without question.

I was not most patients.

I put both pills in my mouth. Took the water glass. Drank. The pills sat on my tongue — the Olanzapine dissolving slightly, its chemical bitterness starting at the edges, the yellow pill hard and smooth and resistant to saliva. I swallowed the water. Opened my mouth for the inspection that I knew would come.

Dr. Kamble leaned forward. Looked at my mouth. The open mouth, the tongue raised — the inspection of a person checking that the medication had been swallowed, the same inspection that prison guards conducted, the same inspection that psychiatric facilities conducted, the procedure that confirmed compliance and that confirmed, also, the power relationship: I am the person who checks. You are the person who is checked.

She nodded. "Good. You'll take this daily. Morning, after breakfast. Sunanda will administer."

I left the office. Walked through the therapy wing. Into the courtyard. Behind the neem tree, where the courtyard's angle created a blind spot — the one spot in the compound where the dormitory windows and the admin office windows and the therapy wing windows could not see, the spot that I had identified in my first week as the compound's only unsurveilled space.

I put my finger down my throat.

The pills came up. Both of them — the Olanzapine and the yellow pill, swimming in water and stomach acid on the gravel behind the neem tree. I spat. Rinsed my mouth with the water from the courtyard tap — the tap that was meant for washing hands and that I was now using for the specific purpose of removing the chemical taste of a medication I had not consented to and would not take.

The yellow pill sat on the gravel. Undissolved. Hard. I picked it up. Wiped it on my salwar. Examined it — the surface smooth, the colour even, no markings, no scoring, no manufacturer's imprint. An anonymous pill. A pill that could be anything.

I pocketed it. Evidence. One more piece of the puzzle that my mother and Sushma-mavshi were assembling, one more stone in the wall that we were building against the wall that confined me.

---

The side effects came anyway.

Not from the pills — I had expelled those. But from the fear. The fear was its own medication, its own chemistry, producing symptoms that mimicked the drugs I had refused: the racing heart at 3 AM, the dry mouth during group therapy, the particular heaviness in the limbs that came not from Olanzapine but from the knowledge that I was inside a system that could medicate me against my will and that the only thing standing between me and the restraint beds in the third building was my ability to perform compliance while practicing resistance.

The performance became my daily work. I attended group therapy and said the right things — "I'm feeling calmer today," "I understand why I'm here," "I appreciate the structure." I attended individual sessions with Dr. Kamble and answered questions with the mix of vulnerability and progress that the treatment plan expected — enough vulnerability to seem authentic, enough progress to seem responsive to treatment, the performance of a patient who was "getting better" because getting better was the script that kept me in the dormitory and out of the third building.

I took the morning pills in front of Sunanda — who administered them at the med station in the dining hall, a folding table with paper cups and water glasses and a clipboard — and held them under my tongue while Sunanda checked the next patient, and spat them into my hand and flushed them in the bathroom within forty seconds, Gauri's technique executed with the precision of a person whose liberty depended on her tongue's ability to shelter a pill.

The yellow pills I saved. Each one pocketed, each one wrapped in a piece of paper torn from the library's textbooks, each one added to the growing collection under the mattress — the evidence cache that was becoming a pharmacy of anonymity, a collection of unlabelled pills that a forensic laboratory could identify and that a court could present as proof that the Centre was administering medication that was not what it claimed to be.

Two weeks of this. Fourteen mornings of theatre. Fourteen pills held and spat and saved. Fourteen individual sessions with Dr. Kamble where I performed the slow arc of recovery — the script that psychiatric institutions expected, the patient moving from denial to acceptance to insight to wellness, the narrative that looked like therapy and was actually survival.

On the fifteenth day, Mehak collapsed.

It happened during morning group therapy. Sonal was leading the session — "Today we're going to talk about coping strategies" — and Mehak, who sat in the circle with the glazed stillness of a girl who had been on medication for seven months and who had not refused a single pill, stood up. Or tried to stand up. Her body attempted the vertical and failed — the legs gave way, the torso folded, the girl who had been sleeping fourteen hours a day and who had been getting thinner and who had been, week by week, disappearing into the medication's fog, hit the floor with the specific sound of a body that had no strength to break its own fall.

The sound was a thud. Not a crash — Mehak was too light for a crash. Fifty kilograms at admission. I estimated she was forty now. The weight loss was visible — the cheekbones sharp, the wrists narrow, the grey salwar kameez hanging on a frame that was shrinking inside it.

Sonal panicked. The panic was the panic of a counsellor who had been trained for feelings, not emergencies — the textbook had chapters on emotional regulation and cognitive behavioral techniques and active listening, but no chapter on what to do when a patient collapsed in front of you and the patient's pulse was rapid and the patient's skin was grey and the patient's eyes were open but seeing nothing.

"Get Dr. Kamble," Sonal said to nobody in particular.

I knelt next to Mehak. Took her wrist. The pulse was fast — too fast, the heartbeat of a small bird rather than a fifteen-year-old girl, the rhythm thin and racing, the blood pushing through vessels that were carrying too much chemistry and not enough nutrition. Her skin was cold. The cold of a body that was not managing its temperature, the cold that was a symptom of something that was beyond my medical knowledge but that was, I was certain, the product of seven months of medication that had been prescribed for a condition she did not have by a doctor whose primary concern was not Mehak's health but Mehak's contribution to the monthly billing.

Dr. Kamble arrived. The professional mask was on — the doctor's face, the competent face, the face that assessed and decided and acted with the efficiency of a person who had spent years managing bodies. She checked Mehak's pulse. Checked her eyes. Called for Bharat — the orderly — and Mehak was lifted and carried out of the group room and down the corridor and toward the therapy wing, the small body in the orderly's arms like a child being carried to bed, except this child was not going to bed.

She was going to the third building.

I watched from the group room door. Bharat carried Mehak across the courtyard, Dr. Kamble walking beside him, the white coat flapping in the monsoon wind, the procession moving toward the neem tree and then past it and then to the door of the third building — the door with the hasp and the padlock, the door that opened and swallowed them and closed.

Gauri was next to me. Her hand found mine. The grip was tight — the grip of a girl who had watched this before, who knew what the third building meant, and who was holding my hand not for comfort but for confirmation: you see this. Remember it. Tell someone.

"She'll be on the IV now," Gauri whispered. "The drip. The straps. For two, three days. When she comes out, she won't remember. They never remember."

I stood in the doorway of the group room in the Sahyadri Centre for Behavioural Wellness and watched the third building's tin roof glint in the monsoon light and felt the anger that is not hot but cold — the cold anger, the anger that does not explode but crystallizes, the anger that becomes structure rather than heat, the anger that builds things rather than destroys them.

The thing I would build was a case. The thing I would build was a testimony. The thing I would build was the specific, documented, evidenced destruction of a system that took girls like Mehak and medicated them into silence and billed the government for the silence and called the silence "treatment."

Saturday was three days away. Aarav would come. The evidence under the mattress — the billing figures, the drug names, the patient list, the yellow pills — would travel from the compound to the cottage, from the cottage to the lawyer, from the lawyer to the court.

Three days.

Mehak had three days too. Three days in the third building. Three days strapped to a bed. Three days on the IV drip that Gauri said erased memory.

I could not save Mehak in three days. I could not break down the third building's door and carry her out and drive her to a hospital where real doctors would prescribe real medicine and treat real symptoms rather than manufactured ones.

I could not save her today.

But I could save her testimony. I could save the evidence of what was being done to her. I could add her name — Mehak Ansari, fifteen, admitted for Oppositional Defiant Disorder that she did not have, medicated for seven months, collapsed in group therapy, taken to the restraint room — to the file that Sushma-mavshi was building, the file that would become a PIL, the PIL that would become a hearing, the hearing that would become an order, the order that would close the third building's door forever.

The chain was long. The chain was slow. The chain was the specific, frustrating, necessary machinery of Indian justice, the machinery that worked not with speed but with weight, the weight of evidence and testimony and law and the accumulated fury of mothers and daughters and lawyers who refused to stop.

I went to my room. Sat on Bed 2. Looked at the window — the wall, the wire, the sky.

The sky was grey. Monsoon grey. The grey that preceded rain.

Three days.

The evidence was under the mattress. The yellow pills were wrapped in paper. The billing figures were memorised. The patient list was complete.

Three days until Saturday. Three days until Aarav. Three days until the evidence left the compound.

I waited. The way you wait when waiting is the only weapon you have — not passively, not patiently, but with the active, coiled waiting of a person who is gathering force.

The rain began.

I waited.