Medical mondays – Richard, ‘omas’ and end of life

A seemingly obvious part of being a medical student it having to deal with death. In the pre-clinical years, at least, death is …death is a lecture, no,a statistic in a lecture, a likely event of a poor prognosis, a cervical fracture between C2-5, a challenge for research, the morning after the night before. We learn a lot of things, and death is just one of those things that are constantly competing for synaptic connections in our brains as we cram for exams. 

In our society, we’re less exposed to death than most people around the world. The death we see is often through the television at 6:00 where we witness untold numbers die in global disasters and civil unrest. To an extent, this happens so much that we are almost desensitised to death on such a large scale, that is, until some horrible thing comes and pushes our thresholds for what we think as every day further into the morbid heights. So what about closer to home? Now you’re on to something. 

Acquaintances, friends, relatives, siblings, family. Deaths in these spheres probably affect us the most and bring us closest to death. I’m lucky to say I haven’t really experienced much of this. My grandfather died when I was quite young. The other, a year or so ago. I knew neither very well due to language barriers, which upsets me deeply, but keeps the emotional struggles of my parents at arms length as I can’t quite empathise on the same level. Richard, a friend of mine, is currently in palliative care for an aggressive cancer, and is staring death in the face. 

When I say good friend, I knew him for a week when I was a camper. He and his wife and, then, five kids were all there as leaders. He had a smile for everyone and was deeply passionate about all he did. He taught me some great life lessons, both as a camper, listening to him speak, and as a slightly older person watching him live out those principles in the hardest of times. His wife keeps a blog, and this morning a couple of people shared their latest entry and it was just, wow. Despite him being in the outer circles of my life, the blog allows us to share in their pain and rejoice in the little things like him being able to leave the hospice to go to the waterfront with the family. 

I guess, what really impacts me as I read the entries of the blog is what is pretty straightforward to most people: I’m training to be a doctor, I’m going to have to work with real people and sometimes those people will die. Death isn’t just a thing that happens, it affects so many people as it takes its twisted course through their lives. As we try and approach the cancer with antibodies here and cytotoxics there, the patient person and their families are in the middle of it all having to deal with the consequences of what can become a game of doctor vs. cancer. 

I guess we can’t really change much, there needs to be that aspect of challenge in order for innovations to arise. There needs to be a driving force behind research that involves looking at medicine from a quantitative point of view, one which quantises lives into binary 1s and 0s, alive or dead. However, we shouldn’t’ look at it as such a fixed dichotomy. I think, I hope, that when I become a doctor, I’ll try and look at the whole person behind the case, which may involve some really tough decisions regarding treatment in order to preserve their quality of life, because I know the difference it can make myself when the doctor takes an interest in me, rather than my symptoms alone. 

But I’ll have to pass to find out! 




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