Its been quite some time since the last update from this blog. Well, I’m just being lazy. Keeping is so much easier than to type it out.
Being in this new posting for nearly 2 months, perhaps these recent 1 week makes me feel alive and touched. Her magical touch. I used to think about just to sail through this posting because it felt so much different as compared to the previous one. For now, apart from the new experiences, knowledges, I’ve started to ease away the numbness towards life and death.
From antenatal ward to gynae oncology ward, that transition from happiness in receiving newborns to sadness and despair from knowing your patient will eventually pass away or succumb to her illness. I’ve been taking care of her for the past few days. She came in with a grossly distended abdomen. It’s cancer. Cancer is eating away her day by day that you could see her maxillary bone so well. That cachexic appearance is like a reminder, the clock is ticking and it might be nearing the end or the beginning of more sufferings. She has advance carcinoma complicated with ascites (accumulation of fluid in the abdomen), Knowing it is a malignant ascites, she will be facing with a tough everyday life.
It’s like a balloon, when you keep pumping in the air, it’s getting so much distended until it outweigh its capacity, then it will give away. This is exactly what is happening to her. Stretching and stretching of peritoneum, nerves, causing her so much pain that despite daily tapping of the fluid, she stills experience that excruciating pain. We always assess her pain score, quantitatively measuring her pain, but we may never know the intensity and quality of the pain. Pain can be never be described so easily. Quality of her sleep deeply affected. She can only sit or stand in order to sleep. Can you imagine the long whole night, with the intense degree of pain, you can’t sleep?
I got exceptionally angry towards the surgeon who operated her at the first place in private setting. Being a doctor is not a money-earning industry, its to do no harm to your fellow human beings, to cure, care and comfort them. Her operation was not even an optimum surgery, leaving behinds all the tumour deposits leading to malignant ascites. So much of anger towards the surgeon. Ethical? Hipprocrates oath? Has she thought about it? Did she place herself in the patient’s and their family members’ shoes? Dealing with cancer is not about handling the patient, but her family members as well. Her mistakes, ignorance, taking a huge cost at the expense of this lovely patient, as well as causing a lost to the respective family members.
It’s not good for being too attached to patient, but somehow she touches my heart, probably because I’ve seen 2 of my relatives suffering and succumb to terminal illness. She never complaint of pain unless it’s so unbearable. The day when I tried to do a peritoneal tapping for her, I remember vividly that she was grabbing my hands so tight and begging for her life to be taken away. Living is so much suffering to her, she said. Standing there, I couldn’t do anything but only pat. I felt so much pain inside. Visual analogue scale for pain score, 8 over 10. Seeing her wriggling with pain, and there’s nothing I can do as a medical practitioner. It’s not professional to tears in front of your patient, but I’m sorry that I could not hold it back. I got so annoyed seeing pain experts kept pressing her on pain score.
Depression is a side effect from dying, dying from a terminal illness. Towards the end, religion is the only way I could resort to for comfort. I was once told that, towards the end of a suffering, that’s when miracles happen, just like dawn comes after the darkest. I pray so much that she can be release from this suffering. I shall end this post with a poem.
Wings of a jet plane provide steady flight
I pray you remain steady and strong through this fight
Butterflies have wings to fly playfully free
And free from this monster is what I pray you’ll soon be
Birds spread their wings as they may leave their nest
We’re spreading our prayers that you’ll always be Blessed
At the end of this, rainbows and colourful sky waiting for you