In learning the art and science of medicine, we are privileged with countless "Aha!" moments - when embryology explains a congenital defect, when etymology helps decipher conditions and anatomy, when biochemistry demystifies the symptoms of a disease.
But, with each "Eureka!" comes at least as many "You’ve got to be kidding me’s" and "Oh no’s.”
Today’s was: "I have to bisect and clean the rectum in order to dismember my cadaver? You have got to be kidding." After a momentary freak out, I suppressed my gag reflex, came back to my tank, told myself to suck it up and got the job done. Yuck!
Last week it was worse. It was an "Oh no."
I’m sure many of you saw Barbara Walters' interview with Patrick Swayze, who was diagnosed with pancreatic cancer, the same terrible disease that killed the man whose body I’ve learned so much from this year. This is one disease I have seen with my own eyes, and the understanding that comes with seeing something so destructive first hand is incredible heavy.
As Swayze spoke of hope, my heart sunk, and so many questions rushed to mind. Does he understand how pernicious, rapid and incurable this disease is? Does he know how advanced it must be to be diagnosed? Does his family? Does he really think there will be a cure before his time is up?
I recalled the sutures throughout my cadaver’s abdomen combining portions of the bowel that were never meant to be together, his cirrhotic liver, the cancer’s penetration of organ after organ, and I imagined the pain he must have endured. For the first time in my life, I felt that hope was a waste. I momentarily equated hope with denial.
Then I caught myself. My perspective was perfectly incorrect.
The future looks grim for him, however, right now, Patrick Swayze is alive. And, I realize now that the extent of his medical understanding may be irrelevant, especially if hope is driving him to really live the rest of his life.
In a terminal case a physician’s role is to help manage pain and disease progression, to provide support and to maintain quality of the patient’s life to the best of their means. Yes, physicians must deliver the truth to patients and their loved ones, but that does not mean we should be a constant negative reminder of impending doom.
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3 comments:
You are a wonderful writer- I had no idea you were in med. school! Good for you and good luck!!
-Alana
Arti-
I didn't realize you had been leaving more frequent posts here -- I'll have to add you to my rss.
This is a great post -- I am struck by how you kind of repeat the historical process of the discovery of human anatomy through that course of study. I also find it interesting that entering such a high-tech and knowledge-intensive profession begins with something that I find so macabre.
I saw the Patrick Swayze interview as well, and I guess I had a different perspective. I had a friend who died from pancreatic cancer a few years ago and watched everyone learn just how dire the disease was. That was really my only experience of it, but I can understand how he could have such hope in the face of a terrible prognosis - even if he has little chance to survive it, it will make the end of his time better.
Scott -
Thanks for commenting. Macabre is such an interesting word to describe the human anatomy course. I think we go through all kinds of mixed emotions as medical students in lab - from "Ew, gross" to "Wow, there is just no better way to learn this" to "Oh no, what am I doing to another human being." But, now that it is over, I'm so grateful to those people who donate their bodies, because I have learned such a great deal from them. At this point, I just don't think that there is a better way to understand the body and anatomical relationships than to actually see things first hand, gruesome as it may be. I guess as science progresses we can't forget the basics. To qualify this, I'm generally a very visual learner.
In terms of Swayze, I completely agree that hope may be the best thing for him at this point. He is still alive, after all, and what is life without hope?
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