Silent together

Moving.

Aliya, this is something, the awkwardness that one feels when telling parents that their child has a terrible incurable disease, is a feeling that no amount of ``practice`` can cure. It is an utterly terrifying experience - relived over and over again - forever marks on the heart.

I read this and thought of all who have died on my watch - all those who went with a smile, braving it to the end, knowing it all, but still smiling. And the parents left behind.

Anita

even though stories about doctors and dying patients are getting hackneyed..i just LOVED this last line of yours

``So I gave up trying , and just sat next to her until it became so dark that I couldn`t see her anymore.``

the line hit me very strongly..so kudos on your strenght of expressing emotions that cant be expressed.

rizvi.

The loss of a child is the greatest devastation that any individual can face. Its a wound that festers forever. The only thing worse is the knowledge that a parent`s own action was ultimately responsible for the loss.

I sure hope you fully assured the grieving mother that her refusal to allow innoculations to her child had nothing whatsoever to do with, nor could it have possibly had anything to do with the horrible tragedy. She didn`t need any guilt on top of her sorrow.

...SR

Re: Zehra

``...even though stories about doctors and dying patients are getting hackneyed..``

That`s just it Zehra. These are not stories. These tragedies happen to thousands of children and parents every day.

You might think that Dr. Chekov`s work, for example is fictional, but in fact, much of it is based in reality and is drawn from his own medical experiences.

If you refer to the television show ER, a lot that is on there is also based on real events, just that the events that may unfold over days are compacted into an hour, so they appear over-dramatized.

Anita

Thanx everyone.

SR: We may disagree on the need for immunization, but we agree on one thing, it would have been cruel and thoughtless to have blamed the mother that evening.
I wrote it just as I remembered, I really do not remember what I said to her.

Re; Anita
As a pediatrician, you`ve dealt with it much more frequently than I have.

Don`t you think medical schools teach us next to nothing about what to do, and more importantly what not to do when we are powerless to heal .

Would like to hear from docs and patients/ families.

Re:Aliya

nicely written!!

As Anita very rightly pointed out that no amount of practice can prepare you for breaking the bad news.....its a difficult thing regardless of the age of the patient .

As for medical schools teaching us next to nothing...well I think its nothing that can be taught....there are no set of things to do or not to do,all one needs is some compassion and understanding and common sense given the cultural and social setting....I think you would agree that the best way that med students can be ``taught`` is by watching the attendings....who unfortunately can be very deficient in that area despite being excellent clinicians.At AKU I personally thought that Farhat Moazam was good at interacting with her patient`s parents...she did not do anything extraordinary just spent 5 mins talking to them and listening to their queries....I paticularly remember one patient of hers a five year old who was not only battling lymphoma but also bearing the burden of repeated chemos and surgeries for many months...nobody thought he would make it out of the hospital this time including the parents....this was their only child,conceived after 15 yrs. Despite all that all three would greet us with smiles when we visited them during rounds and the boy would eagerly shake hands with the whole team everyday. One night when he took a turn for the worse we spent half an hour in the room with his parents and watching him in pain I suddenly realized I was crying and the boys father was looking straight at me(a crying white coat and steth...didn`t make a very professional sight)I just excused myself and left...(Coward!) The boy died in the night and the next day I ran into the parents leaving the hospital red eyed,strained but very erect....the father paused next to me said ``Jo khuda kee marzee`` and walked on with his wife.

That day was a big reality check for me.

There is nothing one can learn to say or do, I think for physicians its important not to develop a God complex because that brings out arrogance and callousness and death is no longer loss of a human life but a bad statistic...but on the other hand getting too involved with patients can be insane ...so you just imbibe from your surroundings and learn along the way...there can be no set rules I guess you just have to strike a balance for yourself.

During my first year at AKU one night I was eagerly running to bag a patient (those were the over enthusiastic days)when I ran into a final year student oozing self importance and cynicism. He said ``o why bother he`s going to die anyway``..I was shocked at his attempt to rob me of my enthusiasm about being a part in saving someones life. I just said ``but what if he lives?`` the caustic reply I got was ``you first yr students are so bloody optimistic``.....well 5 yrs later I still have optimism though mixed with a healthy dose of reality.....but whatever he got in 5 yrs I hope med school doesn`t teach that to anyone.

Aliya:

I was awed speechless, by your article, into a realization of our own, human beings, insignificance to alter the events that shape our reality.

Your article reminded me of a few lines from King Lear: we are like wanton flies to the gods they kill us for their amusement.

Looking forward to more of your work.

Sincerely

You make my heart cry.

ok!!!