Car­ni­val is sup­posed to be joy.

It is colour and mu­sic and rhythm and re­lease. It is sweat on skin, feath­ers in mo­tion and the col­lec­tive per­mis­sion to for­get who we are for a mo­ment. Car­ni­val, we say, is cul­ture. Car­ni­val is free­dom. Car­ni­val is who we are.

And yet, an­nu­al­ly, just be­neath the se­quins and so­ca, there is an­oth­er Car­ni­val un­fold­ing qui­et­ly. One that does not make it to In­sta­gram. One that ends with a phone call, a siren or a stunned si­lence.

This year, a young man died at a fete. That sen­tence should stop us cold.

While Car­ni­val plays, hos­pi­tals brace.

Ac­cord­ing to Con­sul­tant in Emer­gency Med­i­cine Dr Dar­ren Dookeer­am, the ca­su­al­ties ar­rive in waves. De­hy­drat­ed mas­quer­aders vom­it­ing un­con­trol­lably. Young men with head in­juries who can­not re­mem­ber what hap­pened. Women with dan­ger­ous­ly low blood pres­sure who sim­ply want­ed to en­joy them­selves. Pa­tients who ar­rive too late be­cause no one want­ed to be the one to “spoil the fun” by call­ing for help.

The heart does not care if the mu­sic is sweet.

The brain does not know it is J’ou­vert.

The kid­neys do not un­der­stand fete cul­ture.

They fail all the same.

Al­co­hol is not new to Car­ni­val. But its role has changed.

Once, it was rum shared slow­ly or beer sipped in shade. Now, it is ex­cess pack­aged as ex­pe­ri­ence. All-in­clu­sive bands. End­less re­fills. Drink­ing com­pe­ti­tions mas­querad­ing as vibes. Bot­tles pa­rad­ed like tro­phies.

The dan­ger is not just in­tox­i­ca­tion. It is what al­co­hol does qui­et­ly: sup­press­es judge­ment, de­lays re­ac­tion time, masks pain and con­vinces peo­ple they are fine when they are not.

Then there is the oth­er ele­phant in the fete.

Stim­u­lants. Pills. Pow­ders. Drinks spiked with things no one can pro­nounce. Sub­stances passed ca­su­al­ly with the as­sur­ance that “it’s safe” or “every­one tak­ing it.”

Car­ni­val drugs are par­tic­u­lar­ly dan­ger­ous be­cause they are rarely pure, rarely dosed cor­rect­ly and al­most al­ways com­bined with al­co­hol. The re­sult is over­heat­ing, heart rhythm dis­tur­bances, seizures and sud­den col­lapse.

The body keeps score.

Car­ni­val just ac­cel­er­ates the reck­on­ing.

Every Car­ni­val sea­son stretch­es emer­gency ser­vices to break­ing point. Am­bu­lances di­vert­ed. Staff ex­haust­ed. Blood banks strained. Op­er­at­ing the­atres filled with pre­ventable trau­ma. This is not ab­stract. It means de­layed care for heart at­tacks, strokes, chil­dren with asth­ma and preg­nant women in labour. The health sys­tem ab­sorbs the cost of ex­cess long af­ter the last fete fly­er is for­got­ten. Car­ni­val is free on­ly if you ig­nore who pays af­ter­wards.

When some­one dies, we mourn briefly, post con­do­lences, then re­turn to the same be­hav­iours. The cy­cle con­tin­ues be­cause we refuse to in­ter­ro­gate it.

Car­ni­val cul­ture glo­ri­fies ex­haus­tion. Fete all night. Work all day. Re­peat. Sleep de­pri­va­tion is not be­nign. It in­creas­es the risk of ac­ci­dents, wors­ens judge­ment, rais­es blood pres­sure and desta­bilis­es heart rhythms.

Car­ni­val does not sus­pend crime; it dis­guis­es it. Crowds cre­ate anonymi­ty. Mu­sic drowns out warn­ing in­stincts. Pick­pock­et­ing es­ca­lates in­to as­sault. Mi­nor dis­putes ig­nite in­to vi­o­lence. Stab­bings, shoot­ings and rob­beries do not pause be­cause it is Car­ni­val Mon­day. They in­crease.

Med­ical stu­dents wish­ing to learn how to su­ture should vis­it any Ca­su­al­ty dur­ing this time. Trau­ma does not re­spect cul­ture and the knife does not care whether the vic­tim was wear­ing beads or busi­ness at­tire. When we flood the streets with­out ad­e­quate safe­ty, we turn cel­e­bra­tion in­to op­por­tu­ni­ty.

Car­ni­val in­juries are of­ten treat­ed as badges of ho­n­our. Falls from trucks. Twist­ed an­kles ig­nored. Head in­juries laughed off. But blunt trau­ma does not an­nounce its dan­ger im­me­di­ate­ly. Con­cus­sions evolve qui­et­ly. In­ter­nal bleed­ing does not post warn­ings. A per­son who “just took a lit­tle knock” can de­te­ri­o­rate hours lat­er. The body does not care that the mo­ment felt mi­nor. Car­ni­val med­i­cine is filled with peo­ple who un­der­es­ti­mat­ed in­juries be­cause the mu­sic was loud­er than pain.

Car­ni­val al­so brings a pre­dictable spike in sex­u­al­ly trans­mit­ted in­fec­tions. Al­co­hol low­ers in­hi­bi­tions. Fa­tigue erodes judge­ment. Pro­tec­tion be­comes op­tion­al in the mo­ment and re­gret­ted lat­er. Clin­ics see the af­ter­math weeks lat­er: new HIV di­ag­noses, syphilis resurg­ing, gon­or­rhoea re­sis­tant to treat­ment and un­planned preg­nan­cies that per­ma­nent­ly al­ter lives. We do not talk about this loud­ly be­cause it makes peo­ple un­com­fort­able.

And then there is the noise — re­lent­less, un­apolo­getic and of­ten thought­less. Mu­sic trucks thun­der past hos­pi­tals while pa­tients strug­gle to sleep, to heal, to breathe. Noise is not harm­less back­ground; it rais­es blood pres­sure, wors­ens anx­i­ety, dis­rupts re­cov­ery and strips the sick of rest. A so­ci­ety that cel­e­brates out­side a hos­pi­tal with­out pause must ask it­self who, in that mo­ment, tru­ly mat­ters.

This is not an at­tack on Car­ni­val. Car­ni­val is not the en­e­my. Car­ni­val is a mir­ror. It re­flects both our joy and our reck­less­ness.

We can cel­e­brate with­out self-de­struc­tion. We can fete with­out flirt­ing with death. Oth­er cul­tures do it. We can too.

But that re­quires hon­esty. It re­quires ac­knowl­edg­ing that some as­pects of mod­ern Car­ni­val are med­ical­ly un­safe. It re­quires or­gan­is­ers to pri­ori­tise wa­ter over prof­it, shade over spec­ta­cle, med­ical ac­cess over aes­thet­ics. It re­quires par­ty­go­ers to look out for each oth­er rather than film­ing a col­lapse for con­tent.

It re­quires us to grow up.

Car­ni­val will come again, as it al­ways does. The mu­sic will swell, the cos­tumes will daz­zle and we will once more de­clare that this is who we are. A sea­son that pro­duces joy should not rou­tine­ly de­liv­er grief.

A fes­ti­val meant to af­firm life should not re­peat­ed­ly flirt with death. If we are se­ri­ous about lov­ing Car­ni­val, then lov­ing our­selves must be part of the mas­quer­ade: safer roads, sober choic­es, hon­est con­ver­sa­tions about sex, drugs and vi­o­lence, and the courage to in­ter­vene be­fore tragedy be­comes tra­di­tion.

When the last song fades and the streets grow qui­et, the true test of Car­ni­val is sim­ple — not how loud­ly we danced, but how many of us made it home alive.