This morning i followed my usual routine of enjoying my morning cup of coffee and doing some studying in the hospital cafe before i headed up to the wards to see a few patients. I was with a few friends with similar aims in mind. Then we were joined by two others who rocked up to our table uninvited. I guess it was just socially appropriate to join a table when you see people you recognize but are not close to? Personally i would not because i did not want to intrude. Besides, my presence may be an inconvenience. And certainly if i did not extend an invitation; i would really prefer you to not join my table. You got to read between the lines – a skill that loads of people sorely lack these days. Perhaps being a numskull does confer a genetic advantage. (Don’t get me started…) I should also have noticed trouble was brewing when one of the two asked me rather sarcastically what i was doing even though my damn book was laid open in front of him. Without missing a beat, i told him exactly that lest he could not read the situation. Sorry dude, if you think it is rude for me to read and not interact with you; i think it is even worse for you to join my table and expect me to pander up to you. Uh ah.
Anyhow, my very wonderful friends unwittingly upped and left without letting me know, and i was stuck with the company of these two people. I am not a very friendly person and i do especially badly when it comes to social conversation with people i am not interested in meeting. But i obliged; because leaving suddenly when my friends just ditched me, would be incredibly rude. Anyway, the point is, there was a moment in our conversation when i was struggling to read through my textbook and attempting to engage in the conversation when suddenly one of them became quite rude. Not sure how, what or why it happened, but it did. I was taken aback. I just ignored the remark and moved on. Maybe it was a misunderstanding? After all i do have the tendency to be sensitive (actually i think it is more how insensitive people are and they do not even realize it). Somehow the conversation still managed to meander on. I was fuming. I could have told the guy off; but i did not, because i really did not want to create a scene. I was annoyed with my friends who just upped and left without telling me. They knew jolly well i was the last person on earth who had a social appetite, and yet they were completely impervious to the situation they had just created.
I was determined not to let the incident get me down and i stuck to my initial plans of going up to the wards. There i met a lovely patient. She has been hospital for over a month for dysphagia (problems swallowing). You know the statistics – elderly person with swallowing inability and no stroke issues? Cancer. She had none of the self-created risk factors – smoking and alcohol. In the middle of our conversation, a Catholic priest dropped by and administered Holy Communion to her. I have never seen a priest give Holy Communion unless it was serious. Anointing of the sick is not to be taken lightly; and i can only assume that this lady knew what was happening. I felt a little sad. I wonder exactly how deep my well of sadness when i encounter palliative care patients, run. Surely one day i will quit feeling sad whenever i meet someone dying and accept that death is part of life? Anyway, it is not that i get real upset. Ironically i like that i feel down when i meet such patients because it means i am still human and i have not hardened myself…yet. But it gets real tiring and mentally exhausting to be so serious contemplating life in general.
And so we ambled along with out examination and it really suddenly occurred to me what a privileged position i am in. I know this is very clique, but today this patient just exemplified the fact. Despite what she has been through (two surgeries and literally poor food intake for the last few months), she still patiently answered my innumerable tedious questions and allowed me to perform a top to toe examination. All without complaints, and all with the expectation that this was completely natural. To allow a complete stranger that was two decades younger than her youngest child to prod and probe her without any complaints. I was filled with respect and i knew i would follow her lead. When i am old and i am frail, i will let the future medical students learn what they need to know from me.
We were coming towards the end of our conversation when i asked about her social situation. Tears welled up in her eyes and spilled down her cheeks. She did not wail, did not make a sound. She only said she missed her husband whom she has not seen since she has been in hospital. Because they live too far away and he is not in the best health to commute the distance. She said it so matter-of-fact that i had to swallow hard and try not to feel sick. She dripped such many tears that i hastily pulled a tissue and gave it to her. How do i make her feel better? The only way i can alleviate her sadness is to arrange for a way to get her husband to her. Clearly i had no such means. So i did what i could. I explored the sadness and found out that she will be transferred to another hospital to receive chemotherapy, still a distance from her house. I think the other factor that was contributing to my sadness for this lady was because i was extrapolating – that this woman did not have long to live and of course she would want to live the rest of her life out with the man she spent more than 50 years of her life with, and yet even this was denied to her. Worse, she did nothing that contributed to her illness. In fact she had regular endoscopic surveillance for her Barrett’s and yet her cancer was detected too late. Sometimes, Life is indeed cruel and you really got to wonder why.
I spoke to her about her other concerns, found out about her dog, discovered her dog shared the same name as my dog (really remarkable), and whipped out my phone to show her a photo of my dog (an unprecedented move since i refrain from sharing any personal detail, no matter how insignificant, with patients). I chattered about her dog, about her grandchildren, about the job she loved; basically anything that made her happy and that took her mind off the sadness. I was successful only to a certain extent. She started smiling, laughing and then joking with me as she told me stories about her son and her grandchildren that clearly brought her immense pride. I was relieved. But when i left, the look of seriousness returned and i understood that there was no running away from the sadness. It will come back especially when one is alone. Unlike me, this patient was soldiering on and meeting it head to head.
I hope her doctors can work out something for her and her husband. And once again, i was reminded of why i chose this profession and that it was the right decision no matter the treacherous journey.