Every now and then we hear stories of miracle workers, Doctors who pull of miracles and bring back patients from the dead. God. That’s what people label them as. I differ. A doctor is not God. I want to share a few experiences from my Internship days that will shed more light on this.
During my rural posting in Karwar, I met this 29-year-old gentleman, full of life, who did not have any disease and had been perfectly healthy till he became increasingly lethargic over the prior 6 months. He also had a low persisting back pain. As an intern, I ordered the routine blood tests to rule out anemia and in addition, a bone marrow biopsy (I do not even recall why I did that, as it is not routinely advised).
Unfortunately for him, his blood revealed that all his blood cells, including the RBCs, WBCs and platelet counts were very low. The bone marrow picture revealed cells that shouldn’t be there, suggesting metastasis from elsewhere. He was 29! His hemoglobin was very low, 5-6 g (normal 13-18 in male), and we transfused him. I tried my best to help him, I stayed a bit late everyday to motivate him and his parents.
He had cancer elsewhere and that had spread to the bones. We referred him to a higher center as our hospital wasn’t equipped to deal with it. The source of the cancer couldn’t be identified though and he returned a week later. His kidneys kept failing and dialysis was done many times. I tried everything that I could do for a patient, I called my fellow intern at the referral hospital many times just to get his CT scan urgently. I annoyed the nursing staff, just that the patient will be pain-free. and without realizing, I too underwent the 5 stages of accepting death. Denial, Anger, Depression, Bargaining and Acceptance. And was clearly in the denial phase.
Things did not go as planned, the contrasted CT was postponed as his kidney function was bad, the radiologists would not risk it. The attending oncologist advised me never give false hope to the patient. But I wouldn’t give up, I tried to keep the patient motivated, even though deep inside, I already knew he was having an advanced cancer. There would be no treatment for him, except for pain management and supportive care. But I just can’t accept it at that moment.
And finally he succumbed. Only later I realized and remembered the quote “The doctor heals only if God wants you to”.
A few months later, after my rural posting, I shifted to the District hospital in Belgaum to complete the rest of the housemanship. One night during my casualty posting, I took charge of a 40-year-old man who had a road traffic accident, and admitted to ICU. He was doing very well in the ICU and on the 4th day of admission was extubated and transferred to the general ward. He was to be discharged a couple of days later, however,on the day of discharge, he suddenly collapsed as he was getting on to his car. He was pronounced dead 1 hour later.
I again remembered something I had once heard in a movie “Man can strive to reverse aging or avoid leaving this world in may ways, but ultimately, its God who decide whether to heal, or not to heal.”
Sometimes, as doctors, we become so obsessed in treating our patients. We try to play God. We easily get mad when something urgent or important is missed by our colleagues. We forget what we really are, until we learn such lessons.
We are doctors, not god. I thought if I worked hard enough, the patient can be saved, but no, that doesn’t always happen.
Steve Jobs once said “Live each day as if it was your last”. But as a medical professional, I’d rather change the quote to “Treat the patient as if it was his/her last day”. Another thing is never ever play god in treating the patient.
Some people experience death in front of their eyes too often. They form a shell around themselves, they avoid feeling, they hide their emotions to it all. They lose hope. But remember, take care of patient as if it was his/her last day in this world. Make them smile, make them comfortable, cheer them up, and even if that patient doesn’t make it, you will feel at least you’re contributing something to him/her on the last day of their life