This is a real story of a doctor and a patient, and I have compared this real life incident to the rest of the world. Dr. Arjun (name changed) is a budding doctor doing his PG in Oncology, in his own words the story started "I was posted in casualty, my routine was to fix fractures, burns, bruises etc., While passing through the casualty ward, I am usually greeted by ward boys, nurse, patients and their families. On a normal day, as I came to work, I got the most loudest Good morning greet ever, and the most widest smile from who looked like an elderly lady. I had never met her, nor was she my patient. I felt good, I waved her back. And as a Doctor, its my general behavior to inspect the health visually even by distance. Thats a sort of a care I show to my patients and family. Instead of asking how are you, to an extent, I find it out myself. As I glanced at this lady, she looked pale, thin, dark circles, dressed in a green hospital suit, she was sitting on a chair and looked like she used up all her breath to just wish me the good morning. She had ran out of breath after the greet, and appeared struggling, still kept the smile for me till our eyes lost contact."
On a normal day for Dr. Arjun its bruises, blood, wounds, cuts, people in pain and cry. Facing life and death situations everyday. For the corporate world to which I belong, a problem without a ticket is not a problem at all. A customer calling for help is my life and death situation and not his. Customer for me sometimes is an all powerful, most precious person and nothing else unlike it is for a Doctor. We live in such different worlds.
Dr. Arjun continued " I came back to my ward. I found out that the patients name is Lakshmi, for no reason, call it an Oncologist's curiosity, I read her medical report. Lakshmi, aged 46, one lung completely obscured by cancer, and the other damaged by emphysema. Now I figured out why she was breathless. Her doctor said 'she is going to die' . I saw her blood tests and I realised why. Later that day, I introduced myself, sat next to her "thank you for your wishes today morning", she just nodded and smiled. She appeared sad although she was smiling. She looked pale, and looked 60 yrs old although she was years younger than that. I asked "what would you like me to do for you?" knowing its a difficult conversation, I asked it. I dont know why. She replied "I am probably in my last phase of life, you cant do anything to a dieing woman, can you?"
I found out that she was sent to chemotherapy which was not useful. The last doctor who kept her on stent to reinflate the nephron and ease her breathing did not bring a permanent relaxation. This lady was surely suffering a lot. I met her every now and then and someday learnt she was discharged. I decided to meet her again. I somehow wanted to help her, I consulted many specialists and seniors I know, with no progress, I met her at her residence. I asked a rare question I usually dont "How are you", she replied "I feel awful doctor, not good at all." I probed her for more, hoping I can help. I feel weak, handicapped and tired in everyway - mentally physically. I guess I am just waiting to die". She continued "The sad part of all this is none of the doctors tell me when could be my last. When I push, some say a month, some say a week. At this stage of my life, I want to see honesty" and her sister tried to ease her breathlessness by stroking her back and handed over a tissue.
A month ago, Lakshmi was a successful businesswoman. Her husband had left her when her daughter was a year old. She ran a Beauty parlor and had raised her daughter well. She turned out to be an intelligent woman, independant and now she terrible to be dependant on someone for the first time in her life. I added "Never mind what others say. What matters is how you feel?" . she responded "I know I am going to die, I just want someone to acknowledge it". I asked her "is that important to you? why?" Her sister answered to this, "she thinks she can get that last left over time to finish what can be finished, gives her a sort of a confidence" I get into such difficult discussions with patients. To tell someone directly on the face that he/she is going to die, and to predict that, oh its a inhuman task I am bound to do. I added "I have gone through your reports. By my predictions, you may have a week or 10 days." She leaned back on her chair, and said "Thank you" she looked relaxed."Thank you for confirming. you have done what no doctor could do. I am relieved that its not my paranoia that I am going to die".
I am much relieved and pleasantly surprised to her reaction. She didnt cry, break down or get upset. She told me how relieved she was now and ready to accept that her end is near, but she was happy that the she didnt have to suffer for long. "My only regret is that I will not get to see my daughter or my grandson. I dont want her to know just yet. I will write letters which I want her to read after I am gone. I will also write many bed time stories for my grandson" said the grief stricken lady accepting life practically.
Well, we think we can handle a tough situation, but as a doctor - what can be more challenging to see sorrow and pain everyday? and bloodshed? oh man, its so hard to even imagine.
Dr. Arjun continues - "its so unfair" says her sister. Lakshmi says "but the dying without pain and suffering sounds to be a good idea" and she smiles at that. She also said "I like the hospital staff, and the nurse who vists me for the injections. God bless her". . These days there are pills and injections to reduce the suffering unless the patient is mistreated or mismanaged. I said "I dont want to say I understand, but I want to say I know I cant resolve or refer you for any more treatment. I cant even say I will meet you again or ask you to see me again". I should not have made that sentence, I thought for a second. To that she said "you have been kind enough to answer my only question. what else will a dieing lady want". She knew she is going to die, her teenage smoking habit had caught up with her. She was in the same illusion like other smokers that smokers lead a normal life inspite of burning and choking their lungs. But, my job was to just sit and listen, and help her confront the fact. thats all.
I left from her home. That day she did not feel sad, sorrowed or unhappy. She had decided to spend the rest of her time smiling. The rest of the days she planned a farewell party, a picnic to a nearby place. She watched all her favorite Rajkumar and Rajesh Khanna movies, listend to songs, signed important documents, she also made peace with few gods. Her breathing progressively declined, she was later put in an ICU in our hospital. and when she could no longer bear the hunger, she agreed to be sedated. We sedated her and she took her last breath.
I went to her funeral, there were lot of people who admired her strength, courage and determination to fight. She was fine example to many. And her Obituary read the next day that "We all will come across death. In life, death is inevitable, and the only person who can face death with grace is the person himself facing death. The last adventure we all take."
Day after day, dispels the dark
Flowing our time away
Absorbed into the world we fail to mark
How swift our years fade, how quick they decay
Ignorants we are, maddening wants drugged our souls
Dreams, love, hope and the vital breath
Respect the time what we have today
Cuz you took a birth, certain is disease and definite is death
On a normal day for Dr. Arjun its bruises, blood, wounds, cuts, people in pain and cry. Facing life and death situations everyday. For the corporate world to which I belong, a problem without a ticket is not a problem at all. A customer calling for help is my life and death situation and not his. Customer for me sometimes is an all powerful, most precious person and nothing else unlike it is for a Doctor. We live in such different worlds.
Dr. Arjun continued " I came back to my ward. I found out that the patients name is Lakshmi, for no reason, call it an Oncologist's curiosity, I read her medical report. Lakshmi, aged 46, one lung completely obscured by cancer, and the other damaged by emphysema. Now I figured out why she was breathless. Her doctor said 'she is going to die' . I saw her blood tests and I realised why. Later that day, I introduced myself, sat next to her "thank you for your wishes today morning", she just nodded and smiled. She appeared sad although she was smiling. She looked pale, and looked 60 yrs old although she was years younger than that. I asked "what would you like me to do for you?" knowing its a difficult conversation, I asked it. I dont know why. She replied "I am probably in my last phase of life, you cant do anything to a dieing woman, can you?"
I found out that she was sent to chemotherapy which was not useful. The last doctor who kept her on stent to reinflate the nephron and ease her breathing did not bring a permanent relaxation. This lady was surely suffering a lot. I met her every now and then and someday learnt she was discharged. I decided to meet her again. I somehow wanted to help her, I consulted many specialists and seniors I know, with no progress, I met her at her residence. I asked a rare question I usually dont "How are you", she replied "I feel awful doctor, not good at all." I probed her for more, hoping I can help. I feel weak, handicapped and tired in everyway - mentally physically. I guess I am just waiting to die". She continued "The sad part of all this is none of the doctors tell me when could be my last. When I push, some say a month, some say a week. At this stage of my life, I want to see honesty" and her sister tried to ease her breathlessness by stroking her back and handed over a tissue.
A month ago, Lakshmi was a successful businesswoman. Her husband had left her when her daughter was a year old. She ran a Beauty parlor and had raised her daughter well. She turned out to be an intelligent woman, independant and now she terrible to be dependant on someone for the first time in her life. I added "Never mind what others say. What matters is how you feel?" . she responded "I know I am going to die, I just want someone to acknowledge it". I asked her "is that important to you? why?" Her sister answered to this, "she thinks she can get that last left over time to finish what can be finished, gives her a sort of a confidence" I get into such difficult discussions with patients. To tell someone directly on the face that he/she is going to die, and to predict that, oh its a inhuman task I am bound to do. I added "I have gone through your reports. By my predictions, you may have a week or 10 days." She leaned back on her chair, and said "Thank you" she looked relaxed."Thank you for confirming. you have done what no doctor could do. I am relieved that its not my paranoia that I am going to die".
I am much relieved and pleasantly surprised to her reaction. She didnt cry, break down or get upset. She told me how relieved she was now and ready to accept that her end is near, but she was happy that the she didnt have to suffer for long. "My only regret is that I will not get to see my daughter or my grandson. I dont want her to know just yet. I will write letters which I want her to read after I am gone. I will also write many bed time stories for my grandson" said the grief stricken lady accepting life practically.
Well, we think we can handle a tough situation, but as a doctor - what can be more challenging to see sorrow and pain everyday? and bloodshed? oh man, its so hard to even imagine.
Dr. Arjun continues - "its so unfair" says her sister. Lakshmi says "but the dying without pain and suffering sounds to be a good idea" and she smiles at that. She also said "I like the hospital staff, and the nurse who vists me for the injections. God bless her". . These days there are pills and injections to reduce the suffering unless the patient is mistreated or mismanaged. I said "I dont want to say I understand, but I want to say I know I cant resolve or refer you for any more treatment. I cant even say I will meet you again or ask you to see me again". I should not have made that sentence, I thought for a second. To that she said "you have been kind enough to answer my only question. what else will a dieing lady want". She knew she is going to die, her teenage smoking habit had caught up with her. She was in the same illusion like other smokers that smokers lead a normal life inspite of burning and choking their lungs. But, my job was to just sit and listen, and help her confront the fact. thats all.
I left from her home. That day she did not feel sad, sorrowed or unhappy. She had decided to spend the rest of her time smiling. The rest of the days she planned a farewell party, a picnic to a nearby place. She watched all her favorite Rajkumar and Rajesh Khanna movies, listend to songs, signed important documents, she also made peace with few gods. Her breathing progressively declined, she was later put in an ICU in our hospital. and when she could no longer bear the hunger, she agreed to be sedated. We sedated her and she took her last breath.
I went to her funeral, there were lot of people who admired her strength, courage and determination to fight. She was fine example to many. And her Obituary read the next day that "We all will come across death. In life, death is inevitable, and the only person who can face death with grace is the person himself facing death. The last adventure we all take."
Day after day, dispels the dark
Flowing our time away
Absorbed into the world we fail to mark
How swift our years fade, how quick they decay
Ignorants we are, maddening wants drugged our souls
Dreams, love, hope and the vital breath
Respect the time what we have today
Cuz you took a birth, certain is disease and definite is death
