Final call
#Gentle giant
Early in the week, a young colleague passed peacefully to a better place. His mission was most probably accomplished. Our whole community is in mourning. He was well-loved. We saw him metamorphose from a pediatric resident to a fellow in hematology-oncology, to a junior consultant and an authority on palliative care. At 40, as any physician knows, your career is just about to blossom. His chosen area of expertise was warmly welcomed by many and his future was looking particularly bright and promising. In our farewell visit, what caught everyone’s attention were his stethoscope, his glasses, and the personalized hospital coat embroidered with our institution’s emblem, strategically placed beside his coffin. As I passed a hand through the arm of one sleeve, I felt such a deep sense of loss. He was a dedicated physician and a man whose kindness and gentle ways were constant reminders of how we should strive or learn to be, as expected of decent human beings.
Simple, and unassuming, he was such a light and gentle presence who oozed calm amidst the uncertainties that dealing with sickness brings. This April, for our pediatric convention, the scientific committee unanimously chose him to be a speaker. As a member, I was tasked to remind him to submit the needed requirements for his talk, clueless that he had been hospitalized and recovering from surgery. Reviewing our Viber exchange, I was overtaken by a sense of disbelief, closely followed by a heightened respect for his commitment. He had sent his apologies a day before he lapsed into unconsciousness. His co-resident later relayed that he was looking forward and excited to deliver his lecture and had attempted to even record it. His condition was unknown to most of us, as we would still be seeing him report for work. A month prior, he was still accepting referrals and was our service consultant in another hospital.
#Cookies
“Are you sure? You must be tired from work and it’s perfectly okay if you don’t have the energy.” I was her designated driver on those days she would have cookie cravings, usually around 9 or 10 p.m. Knowing how the most basic and simple things such as food made her happy, those trips to the coffee shop were hopefully the highlights of her week. In her wake, I sat with her caregiver and was surprised to learn that in most of our close-to-midnight sessions, she would pass out the food that she ingested upon reaching her home. This was usually accompanied by extreme pain but no one was allowed to know, especially her family members. She was 40 when she passed on, exactly a year and a half after her advanced diagnosis.
#Twenty one
They had welcomed me into their home as I didn’t have family in Texas and my observership training would entail a two-month rotation. She must have been around seven at that time and shared that she also wanted to be a doctor. Three weeks ago, I learned from her uncle, that she did pursue a premedical course but midway, had to pause when she was diagnosed with a malignancy that eventually became resistant to treatment. She finished her degree, but never made it to medical school.
One wonders why they were taken away when they still had dreams to fulfill and roles to play. As harsh as it may sound, I have come up with an answer. Maybe they had to go prematurely so that the lessons that they imparted from the choices they had made, as exemplified by how they lived their lives, could be better appreciated and savored by those who have been left behind. I could only imagine what might have gone through their minds upon receiving a termination notice. There must have been considerable time spent going through the process of denial, anger, bargaining, and finally, acceptance of things that could not be changed. From my end, what was exceptional was the path they took, silently going through their days keeping things as normal as possible. It takes courage, sensitivity, and selflessness to ensure that the lives of the people who love and care for you will not be disrupted.
You must assume that as physicians, we must be well-versed in conversations about mortality or have even talked about our own. I look back on my earlier days with my cousin and wonder if I have done enough to encourage her to speak about the inevitable. While our conversations did not lack depth, admittedly, there was reluctance and cowardice to dissect reality, coming more from my end rather than hers. Did I come up short? I was not brave enough to discuss her prognosis at length, fearful to erase the one thing that was left … our hope that a miracle would happen.
It has been close to two decades and a lot of lessons have been learned in the art of disclosure. It would be helpful to bear in mind that each and everyone has the right to know the truth and be given credit for having the ability to take hold of a situation before that one and final call.
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timgim_67@yahoo.com
