“Siguro manhid na kayo pag may namamatay at madami na rin kasi kayong nakita.” As doctors, we are presumed to be immune to feelings in the face of a patient’s impending death. Please allow me to correct that impression.
Most of us still go through an intricate unchoreographed dance of emotions that sometimes leaves us in a state that is beyond just being physically tired. Just a few days ago, we lost a patient, an only child of middle-aged parents. Her case, though uncommon, was not the first that we have seen or handled. Upon her transfer from another institution, her team of doctors was well aware that the chances of recovery were slim, but we chose to keep our worst fears unspoken, as we had to be focused on trying to help reverse the situation.
Having gone through this route numerous times before, we were guarded but totally and extremely hopeful. Her parents had been apprised of their daughter’s critical condition and had permitted us to exhaust all measures. A few days ago, our little girl decided that it was time to go to a better place. Personal recovery has been a little bit slow maybe because for this month, I am in charge of the hematology-oncology and nephrology services and a repeat was not an impossibility.
“Ma’am would you like to visit our new admission before we proceed with the other patients in the ward?” The fellow-in-charge had several late-night referrals and wanted me to see a patient who was rapidly deteriorating from a possible malignancy and a concomitant infection. About to enter the room, I saw the father lying on his side and holding on to his son’s pale hand very tightly while gently speaking to him. His son was on oxygen support and occasionally nodded to acknowledge what could have been reassuring words from his father. One can only imagine the panic that the child was feeling and the father’s desperation. We decided to temporarily postpone the visit and give them time alone. The next day, he was transferred to the intensive care unit, and under such circumstances, parents are not allowed to be with them. I learned that he is the youngest of five children.
One may wonder why we choose to stay in a profession that constantly leaves us wide open and at risk of being under attack from emotions that can affect us on a very personal level. The answer? While there may be defeats, to be in a position and instrumental in saving even just one life brings an unexplainable feeling of fulfillment, and markedly obliterates the sadness and the occasional feelings of doubt if we have done enough in the face of a loss. Coming to this realization took considerable time, remembering how it felt as a young physician training in the field of infectious disease, thrust into an environment where poverty is overwhelming. The attacks of self-doubt would frequently creep in whenever a patient died. A mentor had this to say when I verbalized these thoughts along with the question if it was normal to feel that way, “We should learn to accept that not everything is under our control and if you know you did your best, God knows. Learn to include your patients in your prayers.“
A few days while given an unexpected break in the middle of the day, I happened to run into a highly respected obstetrician-gynecologist who knew me as a young pediatric resident with a reputation for being toxic. Reminiscing about the time when she had delivered five out of the seven babies on one duty night, I asked her why she chose her specialty.
She shared that she initially wanted to become a psychiatrist but this all changed when she had the chance to deliver a baby as a clerk in medical school. The privilege to be given the opportunity to help nurture a life and bring a child into this world is a precious gift from above. Listening to her easily brought back precious memories of a time when we were tasked with the responsibility to allow the fathers a first glimpse of their newborns and how they just lit from within. That brief exchange was a mood-lifter and I walked away feeling a lot lighter.
He must have seen how I badly needed resuscitation and provided a chance meeting to remind me that even though death is inevitable, there is always the promise of new life. How could I forget? Maybe this Holy Week is an opportune time to work on how I can better understand what he is trying to tell me. Yes Father Orbos, we all need to just believe and trust in, and surrender to the promise of fresh beginnings.
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