Advancements?

I saw something cool the other day when I was on rotations in a doctor's office and that got me thinking about how advanced our world has become.  We are able to quickly see inside the human body, make a diagnosis, and prescribe appropriate treatment.  Recently, the Curiosity rover landed on Mars and is sending back photos from another planet. Another planet.  When we were young, we would never have thought that we'd have Skype and Facetime, things that allow us to see and talk to people as far away as the other side of the world, on our phones that are small enough to carry in our pockets.  Pause and think for a moment about how amazing all of this is and how far we have come.

But then I remembered that there are whole groups of people in this world dying of starvation.  They constantly feel the stabbing pangs of hunger and are dying.  This happens every single day.  People are killing each other over meaningless "differences" or because their thoughts, values, and what they think is right are not what someone else thinks is right.  We continue to discriminate and even hate others over these differences, whether they be race, religion, sexuality, political beliefs, disabilities, or anything else.  We have the nerve to possess ego and consider ourselves superior to other individuals and groups of people.  We hate our fellow humans.  We are blind and we ignore the pain, suffering, and deaths around the world.  I will say this again--we ignore our brothers and sisters who are dying of hunger or of differences in thought.  Pause and think about this now for a moment.  What justice is this?  What progress is this?

No, we are not advanced.  No matter how quickly and easily we are able to treat/cure those of us blessed to be born in this society, no matter how many planets we explore and discoveries we make, no matter how technological we get, we are not advanced.  We are a failure as a species.

Young folks, old folks

I love med school now.  You may have noticed a change in my tone over these past few years.  The only way to describe my first two years of med school is by a feeling of drowning.  I know others feel the same.  I slowly started to breathe as I progressed.  I’m only partly through my third year now and I am loving it.  The things I see and do every day reinforces why I decided to become a doctor in the first place.  I have also learned a simple truth about life:  really old and really young people are funny, happy, and great to be around.  Everyone else in between is just “blah”.

I have written before about how I love babies and little kids.  This is the first time in my life that I’ve spent several weeks interacting with the elderly, though.

The old and the young are similar in a lot of respects.  They both seem to live in a sort of timeless zone.  There is no past.  There is no future.  They may have completely or partially forgotten about the past.  Thus, it does not bother them.  They also have no worries about the future.  When was the last time you saw a ninety-year-old regretful and in agony for something they had done when they were thirty years old?  When was the last time you saw a four-year-old worrying about what they were going to do in a few weeks?

How often do we regret the things we’ve done in our past?  How many of us are worried about what we will be doing in the future or about our upcoming deadlines?

Both the old and the young have very simple needs:  they need food, they need shelter, they need love.  They are careless and they are content.  What happened to us?

Somewhere along the way while “growing up” and become “mature”, we strayed from this track and became lost.  We started “needing” many different things that really were not vital.  We started needing attention.  We started having pride.  We started getting our self-worth from what other people think.

One thing you may also notice about these two groups is that their mouths usually do not have a filter.  They are honest and say whatever comes to their mind.

There are many things we can learn from the very young and very old.  Firstly, the past does not matter.  It does not matter who you were before or what you have done.  Those things have past.  Forget about them.  Save the good memories that make you smile for when you’re sitting on a balcony and watching the sun rise or talking to your loved ones, but do not worry about the rest.  You cannot change those things.  I cannot change the fact that I have experienced things that I wouldn't wish upon anyone.  Also, the future isn’t that big of a deal.  It will come when it comes.  My future was pretty well laid out before but after my accident, I do not know what to expect and now I am very uncertain about my future.  Who will I become?  What will I do?  Will I have a "normal" life like I always thought I would?  It’s humbling to meet elderly individuals who know they may pass away any day or even any hour, yet have accepted it and take things lightly and are always smiling.  They do not miss an opportunity to help someone else.  And children live so much without care for the future that they can hardly think passed what they want to do when they go to the park that afternoon.

The young and the old are not superficial.  They do not have many preconceived notions about other people or things.  They have been superficial or had biases at certain points in their lives, but now they usually do not care.

All of this not only got me thinking about how I look at the world, but also how the world looks at me.  Older people never make a big deal out of my wheelchair.  Neither do little kids.  Well, they sometimes run up to it and start playing with it, but they do not see how it could be a hindrance to anything.  You may say that they are simply ignorant.  But I contend that they are just not worried about what other people will think.  They do not get their self-worth from others; they get it from themselves.  They only judge something based on the criteria that it makes them happy and makes them smile.

When you are worried about that upcoming exam or deadline, about what you plan on doing for the rest of your life, or about what the girl you met last night thought of you, talk to a small child or an elderly individual.  Ask them what’s on their mind and what they are worried about.

Love before you lose.

I feel like I should first explain what I have been doing these past few months, because many of my friends haven’t seen me in a while and I have not written any new blog posts recently.  This summer, I was busy studying and taking the first and most important of our three medical licensing exams, the USMLE Step 1.  A mere few days after taking the exam, I started my third year clinical rotations.  I have thought and seen many things over these past couple of months that I have wanted to write about, but I have not had the time.  I usually just ended up discussing those things with friends.

I am currently on a palliative care rotation, which focuses on relieving and preventing the suffering of patients.  I mostly see patients who are at the end of their lives.

Let me share a little story with you (with a few details modified for privacy purposes, of course):

     You are asked to consult on a 72-year-old woman in the ICU who was recently brought to the ER after suffering her second stroke.  She has end-stage dementia and is now unable to speak due to her stroke.  Her two sons are both present with her in the hospital.  As you flip through her chart, you notice that she does not have an advance directive, meaning that she has not specified what she wishes her care to be and who she wants to make health care decisions for her in case she is incapacitated—either physically or mentally.  Her lab values and tests show that it is unlikely that she will live much longer.
     Since she does not have an advance directive and is currently unable to make her own medical decisions, the health care power of attorney (the power to make health care decisions) is now legally with the widowed patient’s adult children.  You decide to bring up the difficult topic of their mother dying and what should be done.
     You explain the situation to her two sons.  One son listens calmly, is quiet for a few minutes, and then states that since their mother is in pain and will not live more than a few days, he wishes that she is kept pain-free, comfortable, and that she passes peacefully.  The other son is angered by this.  He states that there is no way his mother is dying and that everything must be done to keep her alive.  You explain to him that doing some things will only further her suffering without prolonging her life, but he does not listen.
      The two sons argue with each other all night while you are away.  When you return and see this, you decide to take the angrier son aside to your office to have a talk with him.  After about thirty minutes and plenty of tears, the son leaves your office and states that he too now wants his mother to be kept comfortable and free of pain, and that he will sit and pray for her as she passes.

Why was one son unable to accept his mother’s death?  Why did he argue and insist that she was not dying?

When he entered your office, you asked him these questions.  He burst out crying and explained to you that he did not feel like he had done enough for his mother.  While the other son lived with his mother and cared for her, this son lived in another state and hardly saw or spoke to his mother.  He initially felt that if he let her pass away now without doing everything medically possible, even if it meant more pain and suffering for her, he would be ridden with guilt.

Friends, do not let this situation happen to you.

Often times, it is not the patient who has trouble accepting their situation; it is their family members and friends.  I have both experienced this myself and seen this in other patients.  I was fine whenever something happened to  me.  When hit by life, I'm briefly frustrated, and then I do my best to be done with it.  There are some things we just have to accept and realize that we can't change, so we do our best to change everything else that we have the ability to do so.  I have noticed, though, that others cannot let it go.  Sometimes it is family members.  Sometimes it is friends who regret doing or not doing things to/for me.  I feel sorry for them.

We have a tendency to delay things.  We get so caught up in our own lives and our own desires that we push other things and other people aside.  We consider ourselves too important.  We are ungrateful.

Think about all the people who have done so much for us, including our parents, our siblings, our children if we have any, our other family members, our teachers, and our friends.  We cannot let opportunities to reach out to them and be kind pass by us.  We do not want to be left thinking after it is too late that we wish we could have done more for someone when we had the opportunity, but we were too blind to see it.

Love before it’s too late.  Love before you lose.