Friday, January 04, 2019

Hope and despair

Scenario 1

Patient just woke up from her anaesthesia in recovery . The first thing that she did was looking at her previous stoma*  site. The operation planned was to rejoin the previously parted bowel due to an unexpected growth that caused sepsis.

*It is an artificial opening that allows faeces or urine either from the intestine or from the urinary tract to pass.The stoma is created of an end of the intestine, which is brought to the surface of your abdomen to form the stoma (opening)
"Eh, belum buat operation ke?" She asked. She was still dazy due to the anaesthetic effect.

The stoma was the cause of her depression. She was still young of child bearing age and was looking forward for this day. Gone will be the days when she does not have to see her stoma bag full with her faeces. She became withdrawn after the surgery because she felt embarrassed to the society. She felt herself dirty carrying the faeces back all over.

"Bila nak buat operation?" she asked again. Tears were slowly flowing.

Its tough to break the news to her for the failure of the intent operation today.

Scenario 2 

"Biopsi akan diambil terus dan di hantar ke makmal. Kami akan  dapat result dari pathologist dalam masa setengah jam. 
Kalau result negatif, kita akan buat lobectomy.
Kalau result positif, kita akan tutup"

The patient with her husband nodded. It must have been the umteenth time somebody is explaining the objective of the surgery today. I did see on the notes ; my surgeon and my respiratory physician detailed extensively the consent explanation.

That morning, the whole family waited outside the OT. With hope for a miracle. Based on the CT scan and PET scan, it did not look promising. Her father was in his wheelchair, her two children brought their toys to play with knowing how boring it can be waiting. Her husband was full of hope, requesting my nurse to keep the "yasin" in the pillow throughout the surgery.

We did not proceed with the surgery after receiving the call from the pathologist. 


Handling the family and patient's emotion is not easy. In my profession, I would be one of the first to witness the hope and expectations as soon as the bad news come around. Its an everyday story everywhere.

Seeing this all make me wonder how we should be thankful for whatever we have at the moment. The moment the crisis steps in, its a roller coaster ride. Its easy to think how we do not have enough but if we step back and look around us, we would be surprise how lucky we are to have what we already have. Its so easy to see our own misfortunes but when we compare, what we thought was bad is not as how people dealing with worst scenarios have to deal with. 

Arrogance, self mindedness is something i would pray to god to not me fall into the trap of declaring as such. That is why I appreciate my work, it reminds me a lot how lucky i am. 

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