A Walk to Remember

I finally finished my case report that was due the week before, last saturday. It wasnt exactly a big thing (and it isnt even completely over - i only submitted a draft) but somehow felt like something big was off my shoulders. N i also managed to finish some errands that were pending for weeks.So was chilling out at home in the evening after veena class.

My brother just happened to be back from the bookshop where he had bought two story books. My sister n bro haf been recently recommending some good books to read but i always find myself not being able to get through my medical reading, not to mention story books. Which is something that I felt was really sad cos reading is one of those things I've always loved doing. Nothing beats a quiet sunday afternoon spent in the comforts of your couch at home with a book in hand. Somehow such moments are a rareity these days. I think the last book that I read was Jody Piccoult's Handle with care. N even that was such interrupted reading during my trip to India.

Anyway, my brother had bought 2 books by Nicholas Sparks and that got my sister like really excited. I hadnt read any books of this author before. Since there was so much of excitement about his books n i finally felt like i had some time in hand, I asked my sis for her recommendation. And she told me to read 'A walk to remember'

So that was how I ended up with this book. I must say, the first page n first paragraph really got my interest n i started reading.....

At the end of it, I was lost for words..... The book was simply magical..... It's a very simple, plain love story that was written in a way that rocks you from within..... It was not one of those Daniel Steel kind of boisterous, passionate romance novels but a very very simple, plain but absolutely moving story.

The author mentioned in the first paragraph, 'First you will smile, then you will cry - dont say you haven't been warned.' N true enough, that's exactly what the book did to me. I continued reading it on sunday, whenever i had sometime in the midst of my very decent call. Everytime i went to see a new admission or to do some reviews, I couldnt wait to get back to the room to get on with the book..... I finally finished it today, post call before i went off to sleep..... And as i finished the book, I could feel the tears trickling down.....

I guess the book meant even more because of where I am right now. Where I see how short and how unpredictable life is on a daily basis. Where I see how people cling on to the thinnest ray of hope n hang on in spite of all the suffering that they go through. N where i see true love sometimes - couples who are there for each other, who go all out to ensure that their spouses, who in the medical point of view had reached a point of no return, are comfortable and not in pain or suffering. Spouses who are at the bedside of a comatose patient 24/7, talking n laughing n crying with their better halves as if they were right there listening to them, spouses who truly are around in sickness and in health, until death does them part.

A walk to remember - truly tugs at your heartstrings.....

Itz all about enjoying the Journey

I just had a very inspirational chat with a Palliative medicine consultant today. Being in Oncology, we do tend to work very closely with the Pall Med team. And they are extremely nice people, absolutely befitting the profession they have taken up. She came into the room after reviewing one of my patients and I was summarising a patient's notes for mortality presentation. N so we started discussing about the patient and eventually the conversation steered towards what I applied for in the next mopex and so on. I've always felt very comfortable with her hence told her about how I didnt get through to Paeds and how my decision to apply for BST was delayed by that. And she started talking about her experiences and how itz not the end that matters cos the end will come anyway but itz the journey and the experiences during the journey that matter more (of course, not forgetting the caveat that itz provided that there are no major commitments in life at this point in time). Which is so true..... To be very frank, I never really felt the urge to rush through exams n get on with specialty training. I've always believed that it is important to be ready and feel confident about your own capabilities before moving on to the next stage in the career. I was surprised at the breadth of postings that she had completed before making the final call. And the fact that she had enjoyed every bit of the journey, even in the midst of a competitive crowd of colleagues who were aiming to reach the end faster. I guess, to be exact, there is no real end..... N there shouldnt be an end, or else life will stagnate at one point or another.

So, moral of the story: No matter what the results may be tmr, just gotta take it as part of the wole learning journey ;) Haha

I dont know why I am letting this affect me so much but for some reason it has.....

So it was another one of those crazy days. Exit ended around 7 and after that I had to do a procedure for a patient. Called my boss for assistance and he said he was on his way. While waiting for him, another patient's daughter (in the bed opposite to the one i was doing the procedure for) approached me and asked if her mum could eat (the patient had just came back after a procedure n i had to review her n give the go ahead before she could eat). Initially I told her to hang on for a while as I was in the midst of this pt's procedure (and waiting for boss to come) but subsequently decided to go have a quick peek at the other lady's procedure report n give the go ahead as she had been fasting since morning. HOwever, as i went to the other pt's bedside to quickly eyeball her n give her the go ahead for dinner, her daughter started asking about her condition. Just then, from the corner of my eyes, caught my boss walking in to the other pt's bedside for the procedure. Hence tried to give a quick summary of that pt's condition to her daughter n headed back to assist my boss.

After the procedure, i walked out with boss n sister of the ward walked up to me to ask if i had any problems with the daughter. I said no but she went on to explain that the daughter had expressed unhappiness over my replies to her n was clearly unhappy. Boss was there. I didnt get reprimanded but he just dropped some tips n went off.

I just stood there feeling absolutely drained for a while. But after that picked up the phone and called the daughter up (she had left the ward by then). She said she was upset n felt that I tried to brush her away and not answering properly about her condition. APologised profusely, answered her queries and at the end of it she said thanks for calling her back.

I guess, admittedly I did sound rushed as I was talking to her because I was trying to get back to the procedure left halfway. N in the first place, the reason why I deviated from the procedure for a while was because the other patient had fasted the whole day n i just wanted to tell her if she could eat or not. Didnt expect to be ambushed by the whole list of qns esp since i had explained more than half of them the day before when I spoke to her.

This kind of situation is not uncommon in the sense that a lot of times patients do complain about doctors due to misunderstandings. I've had patients complaining to me about fellow colleagues and even bosses and im sure many others had similar experiences. But today in particular i was very disturbed by it. By the time I settled talking to her n trying to diffuse the situation, it was too late n i couldnt get a medicine for my sister n something my mum wanted (as pharmacy had closed. ANd this is not the first time it's happening. MAny a times I do realise that I neglect my family, friends, meals, sleep and rest for my patients. N hence it does get upsetting when people forget about everything else that has been done n focus on that 1 thing that goes wrong. Itz just a very crappy feeling. N In the very first place, it was out of empathy for an old lady who was starving the whole day that I attended to her first.

Just read my friend's blog yesterday where he was talking abt how healthcare is not and should not be seen as a service industry where people come in and demand things to be done. N worse still come in n demand that nothing be done to them (why come in then in the first place?) I certainly agree with friend's comments. Trying to do a 'service providing' job + dealing with the patient's health at the same time can just simply bbe very draining. I do not deny that being on the flip side of the coin, one can have a lot of anxiety n concern about their relatives' condition, n it is that very concern n anxiety that sometimes transforms into anger.Afterall, I have been on the flip side of the coin as well.....

However, there are many times when i have wondered why patients n families dont look at us doctors as fellow human beings too - human beings with the same blood n flesh n emotions just as much as each n everyone of them do.....

N i have not gotten an ans to that as yet.....

It feels like the year has just started but a month has already passed..... Itz really amazing as to how fast time flies.....

Welcome 2010!

MAy the beginning of this year be the beginning of many beautiful moments to come..... May it bring everyone lots of love and blessings! May it bring good health to all!

Happy New Year!

The dying process

Sometimes it's harder to deal with a dying patient than it is to deal with one who needs to be treated aggressively. Of course, the latter will require you to be on your toes and the whole process is just extremely intensive. Hence a lot of times, it seems easier to be dealing with the dying one - just write down BSC( Best supportive care) and adjust morphine and walk off - or at least that's what it looks like on the surface.

But after working for 2 months in the department, I've come to realise that treating a dying patient is not just about morphine alone. It's about looking at him as an individual, it's abt looking at the family's needs, expectations and so on.
The hardest questions to handle are ' you are not putting on the drip for him because he is dying right? you are making him dehydrated and it's like murdering him' How do you answer a relative who poses this qn? Even though you try to give a mini 'S.O.' lecture on how what actually matters is the feeling of hunger and thirst and that the drip is not gg to make much of a difference, or rather do him more harm than good, - not everyone can understand that. At the end of the day it boils down to the family's expectations and understanding of the patient's condition, which on the other hand also implies how much of effort we have put in as doctors to educate the families. It's certainly not the eaiset thing to do - not something you can spend 2 minutes in front of the family n walk off but it is extremely important.

A lot of people think that the hardest part of the job is dealing with the actual death of a person. I disagree. The harder part is dealing with the dying process and dealing with the people involved in the process. That's what is challenging. And that is also the satisfying bit - when you know that you have attempted to alleviate as much suffering as possible for this person in his last days and that he has left this world in peace - it is extremely satisfying - it makes you as the physician feel at peace as well. Especially when the family comes to thank you for making their loved one leave confortably - It is absolutely worth that extra time spent for that patient.

Un perai sollum pothe

I've not heard such a beautiful song in a long time.....Came across the song by chance..... Didnt realise i was tearing up on the bus as I listened to it.....