SELF-AWARENESS
Death — A Finality, and a Beginning
Each life lost is many more transformed
I lost a patient today.
I am a resident — a trainee in Surgical oncology and often deal with patients diagnosed with cancer at different stages. Some are curable. Each patient who decides to embark on this journey with our team, allows us by trust, to guide them. As a result, a bond forms that stays throughout his treatment. It continues during the regular follow-up visits.
Luck and the limits of medical science aside, my decisions mark the course of my patients like landmarks on a long and arduous journey; and losing a patient towards the end of such a journey, makes me question everything. Until a plausible and modifiable cause is deciphered in that meticulous search for answers, the mind does not rest. Regret looms around the corners without any mercy. I am left with asking myself what I could have done differently.
To the close relatives of the patient (spouse, sibling, children), regret comes as a self-reflection of their decisions, as well as in the knowledge of those unsaid and unexpressed emotions that someday, could have been. “If only”, is what keeps on rolling in their minds, long after grief has passed through them from its inception to its acceptance.
To the patient, I am unsure whether a sudden death is better than the realization of the inevitable over a few hours to days before. The suddenness doesn’t give a patient any chance of a goodbye. Every man going through its ups and downs in his life, looks at some form of closure, to mark the end of a chapter and turn a new page. The final page of his life, should it come suddenly, robs him of this final closure. But then, after death, how does it matter? I don’t know, yet I feel uneasy with this realization, perhaps because I am alive.
Should death come slowly to a man, giving him and his family time to accept, and say those unsaid words and feelings, make promises, and re-live moments — then perhaps the closure is complete, although in that final moment, it still hits everyone else like a splash of cold water on a sleepy face. Yet, for the soul that departed, was the journey of his final moments and those last few labored breaths he gasped easier than if it would have come suddenly?
I, as part of his treating team, am probably the most secluded person in this trio of the patient, the relatives, and the physician, because I have a connection with the patient that is limited to his disease. Anything beyond that is definitely human. Two people going on a journey together brings them closer. And we doctors are humans as well — touching a life forges a bond that cannot be described.
But my regret on losing a patient, however profound in its acute stage, is in all practicality, limited. It makes me aspire to learn what went wrong and what could have been different and make the necessary corrections — from being extra cautious to over-diagnosing “early” signs to sometimes counting on my guide’s lifetime of experience to help me not make over-zealous decisions. My boss has a working experience in the field of oncology of at least 34 years, which is more than my current age.
I am still a novice, a resident under training. But as I step out on my own a few months from now, I will be where my boss is right now — the one with the whole burden to bear, of a life lost, just like he has the honor of each life saved. The burden is still mine to bear or rather, share because I am as much involved with a patient as my boss, but being a trainee, my regrets are different than my boss’.
That is where the following thought comes from — death brings with it a wave of regret that sweeps everyone. Besides picking ourselves up, we cannot do anything more because death is a finality that even time cannot reverse.
For those alive, as time moves on, we have the opportunity to not put ourselves in such a situation again.
I don’t want to regret not saying how much I love my daughter, my wife, and my family. I don’t want to regret not fulfilling the dreams I once had but never fulfilled them because I lost my focus. I don’t want to think of a life not lived well as I lie on my deathbed.
Each life lost, as a doctor, creates the path for a better tomorrow for someone else — by teaching me lessons regarding disease, death, and life.
The lessons that one chooses to keep, however — as a doctor or as a close relative of the departed soul, add to the legacy of the life lost.
For even in his final moments, a man leaves us with hope — hope that the regret morphs into a lesson that adds value to life. For the departed soul, life has no more meaning, yet his death leaves an imprint on all those he touched. Such is the irony of death — for every life lost, many more are transformed. We get to choose our transformation.
The patient our team lost today was an elderly gentleman with an otherwise smooth recovery until his sudden collapse. His relatives thanked us for doing everything we could, with tears in their eyes. Perhaps that is why I write this.
Even as I sit and ponder what could have been different, I cannot slide away the image of this gentleman telling us on our evening rounds, not 2 days back, how thankful he was that we supported him so well throughout his treatment. It’s what we are here for, we told him with a smile. Today, he left the world, leaving behind all the lives he transformed whilst alive, even in his last moments.
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