Wednesday, March 19, 2003

Irony of life

Last night I had to talk to parents of a 39 year old woman with endstage ovarian cancer. Her son had just celebrated his 9th birthday, and despite the grim prognosis, she wanted everything to be done for the sake of her son. She was divorced, and didn’t have a husband to help with the child.
I had to tell her parents, especially her mother, that there was no hope. That the blood infection would take her life in 2-4 days and CPR and life support would do her more harm than good. It tore my heart to see her mother cry, to say “No parent should ever have to outlive their child.” In the circle of life, it’s true. But life isn’t always fair. Her mother was guilt-stricken as she had a cold just before her daughter was admitted, and felt that it was her who passed the infection over. No, I had to convince her. It was the cancer, and the chemo, that made her weak.
They decided to change her code status. Full code to DNR (Do not resuscitate). A legal issue, but also, an ethical, emotional and spiritual one. To let someone go peacefully, instead of cracking open the crashcart, pumping the chest, injecting epinephrine, shoving a tube down the throat and zapping someone’s chest with 360 joules.
You sometimes smell burnt flesh after the defibrillation.
Today, she passed on. I regret not being there with her parents, whom I’d gotten very close to. They were disappointed, and almost fearful when I told them it was my day off today. I suppose we all knew. I had to hide tears yesterday when I had that conversation with them about goals and futility of treatment.
She’s finally free. Free from the 2 IV lines, bladder tube, pulse oximeter, oxygen mask, central line, cardiac monitors. But most of all, free from the cancer.
She’s home.

You think about life. It’s fragility. You wonder if the spirit really lives on. Deep inside, I do believe so. The body, when alive, can be so vibrant. After the last heartbeat, so much changes. So empty. There must be a spirit, must there not? Something that lives on, be at one with the Creator. Something that remains with us after the body has passed on.
You wonder about the point of everything. Why am I here, if I fight a losing battle? Then you realize that if it’s a cure you’re fighting for, you’re bound to lose many. But if your aim is to heal the patient and her family, then even if she doesn’t survive, you often do win.
You appreciate life more. A simple touch of the hand. A smile. Embrace. Love. Friendship. Faith. You get encouraged seeing love that binds even through death.
When patients ask, I tell them that I believe. I believe that our loved ones are never far away even after they’re gone.
Our time is limited. Every breath we take brings us nearer to our last. Question is: What will I want to fill in the time between now and then? It then sometimes becomes ironic that when there is so much to live for out there, that you spend 90 hours a week working, and only 34 hours a week sleeping.