16 January, 2012

Just How Much Is Too Much?

Petikan ini diambil dari Star Online untuk tatapan kita bersama.

Dr Chan, Star Monday 16 January 2012

WHEN we were discussing a patient’s CT scan findings, the professor paused and told me: “You cannot be too emotionally attached to patients, as you’ll get depressed and lose your energy one day.”

“Shall I stay away then?” I asked.

“Just stay cool...” was his reply. I swallowed my next question.

How can I not be emotionally attached to patients but yet still care? And how much is too much?

Yesterday, I was crying in the bathroom thinking about my patient, a Mr N, who passed away the day before.

A few days ago he was admitted in a very late stage of disease. I interviewed and examined him upon admission and got to know his brother and sister-in-law.

Throughout the stay, he was my responsibility. He was such a gentleman and was the kind of patient I would like to stop by for a short chat.

That morning, he started vomiting non-stop. The team reviewed and decided to put him on anti-vomiting medication. It didn’t help much.

That night I was on duty and he wasn’t doing very well. Together with the medical officer oncall, we started him on supportive treatment and informed his nephew, who was the only relatives around, that his time is near.

His brother and sister-in-law rushed back to hospital, but all his children were still overseas.

“We’re truly sorry about this, but his condition is very critical. We hope you understand, even if we perform aggressive resuscitation, it might be futile and will only prolong his suffering.”

They cried. The brother said: “Ya, it is better to let him go...He has been suffering for too long.”

“He might not be able to talk, but he still can hear what all of you say. Let his children talk to him over phone,” I told them.

They wept, and nodded.

Later as we were reviewing another patient’s X-ray, Mr. N’s sister-in-law came to see me, “Doctor, is it almost the time”. I nodded, and somehow felt I should go with her.

The last rites were administered. We stood silently, witnessing the process of dying. He regurgitated out few mouthful of blood, and not long after, there was a straight line on cardiac monitoring machine.

I looked around, trying to understand what death brought to people around the deceased.

His brother was holding his hand, whispering into his ear. I saw tears in sister-in-law’s eyes and sadness on his nephew’s face. And I looked at myself and felt guilty and sorry.

Was there anything else I should’ve done? Was there any issue I missed or overlooked? Was everything possible done?

It is a human beneath the white coat after all. I was greatly impacted by the patient’s death. I also once again thought what life truly meant, what death always wanted to teach us.

Sometimes I can’t stop wondering, if we’re fighting a losing battle?

That night, before the patient’s family members left, they took our hands and thanked us sincerely for what we had done for him.

Maybe it is not just about the ultimate outcome of a patient that only matters.

Maybe it is also the little things we do for them, each human touch that we provide.

How wide we open our heart to our patients’ suffering, will be a life-long learning exploration.

Johor Baru.