Inevitable

As a doctor it is inevitable that I will face death, as a new doctor I have not dealt with that inevitablity until now. This week had been a good week for me, I rode on a private jet for a transplant case, I got into the operating room FOUR times and have actually been able to do things, my hours were manageable, overall it was a good week. I imagined that this post would be about one of those big things until I arrived to work on Friday and my patient was dying. Out of respect for him I will write very little about what actually happened or the details of his death, but instead about what I feel as a result.

Choosing death
The stories are countess. A person tells family that he has had enough, says goodbye...just changes, and shortly thereafter he dies. Amazing our own internal power to sustain life - just highlighting that doctors and medicine will always be limited by the human spirit. My patient did the same thing, although I realized it only in retrospect. On Thursday, I only wanted to encourage him more and planned to do the same thing on Friday. I didn't realize then that it was out of our hands. After weeks of losing control to disease, this was his last statement of independence.

Two sides
I chose surgery because of the ability of a surgeon to immediately affect the process of disease. Cancers removed can yield instant cure. Today I realize that there are two sides to that argument.  What surgeons do is step into the natural process of disease and change its course. The hope is always that the disruption of nature prolongs life, but nothing is without consequence.  The results of surgery can also hasten death.  No statistic regarding human life is 100% good, and 0% bad.  Some will not be saved.

Life leaves
There is a point at which life leaves the body.  As I said goodbye on my way out on Friday I realized that the man I had taken care of for a month was gone.  As I left and held his hand telling him I'd see him on Sunday, I knew in my heart that time would likely never come to pass.  I prayed a prayer without words or request.

Grace
My patient made it through the first day with maximal support, he died when I was away from the hospital.  I originally though I'd want to rush back to say goodbye, to be there.  But, when it actually happened, I was standing in my beautiful sunny kitchen, and I wept alone, with the comfort of quiet.  It was grace that ended his suffering and gave him peace.  It was grace that allowed me to have this moment in the stillness of my own space to grieve for my patient, and his wife and his children and his sisters and brothers and his family and friends and the space he will leave behind.

Selah