Ashish Goel
Cell 2 Soul. 2005 Spring; 1(1):a8
I walked a mile with sorrow;
And never a word said she,
But oh... the things I learned from her
When sorrow walked with me!
They say that a priest without temptation and a doctor without suffering can never do justice to their chosen fields because they can never understand the psychology of sin or the despair of the disease. Most doctors are like the four blind men; seemingly knowledgeable about the sunny side of their profession and yet blissfully ignorant of the view from the patients' bed.
I consider myself fortunate to have had a brush with destiny in the very first week of my 26th year when, on a fateful day in July, riding pillion on a motor cycle, I came face to face with death; and then she looked the other way. Something we doctors dryly describe as NDE — a Near Death Experience.
I had landed in the strange city of Bangalore in the middle of the night, thanks to a delayed flight. I had come in with a hurriedly put together, chaotic schedule to see the ailing sister of a childhood friend. This little girl was fighting acute lymphoblastic leukemia, having recently lost her previously healthy father to a hospital acquired infection following a routine procedure.
At the airport I was picked up by a cousin. Thinking that it was too late in the night to visit the sick girl, we decided to go back home and catch some sleep. Little did we know that none of this was going to happen.
A few meters from the airport, we managed to drive into a car speeding from the opposite direction. The vehicle disappeared into oblivion, the driver seemingly unaware of the fact that he had left two fellow men unconscious on the road. One of them, I, had succeeded in breaking a few of his delicate bones and lay in a rapidly enlarging pool of blood. As described later by an onlooker, "there was blood all around and an unconscious, unknown, unidentified body in the pool. A huge crowd had gathered to watch the fall, but no one stepped up to help." Then some other considerate and humane humans took upon themselves the unenviable task of carrying the bag of bones to the nearest accident room.
My cousin, who quickly regained consciousness and miraculously escaped any physical trauma, helped those angelic souls in their Herculean mission. They forced a passing car to stop even as scores of others looked on. With great difficulty they loaded me into the car. One of these angels said afterwards, "When I stuffed you into the car, your calf, attached to the rest of the leg by a flap of skin was dangling out
of the window. I did not have the courage to manipulate or touch the leg or the projecting bones for the fear that it would detach. When the car drove away towards the hospital I did not know if your leg was going to reach the hospital with the rest of the body or was going to
fall down on the way. Yet I could not do more!"
The two beatific souls who tended me on the road must have descended from the heavens above, for they demonstrated more sense and courage, despite being under the influence of alcohol, than the scores of teetotalers who had gathered to watch the fun.
I was carried to a doctor who demonstrated immense patience and compassion in the thick of the night when he decided to immediately embark upon the task of setting right my broken bones and crumpled mind. This was the first and the only time in my short medical career, to date, that I have seen a senior orthopedic surgeon come to the emergency room, accompany an unknown patient to the radiology department of the hospital, and give position to the broken limbs for each x-ray to be taken, all this in the middle of a hot summer night. While the x-rays were being taken, he stood by my side, assisting the technician and assuring that the radiographs were taken to his satisfaction. After one such x-ray film, he walked up to me confused. The question in his mind was whether another x-ray of my leg was needed and if the particular bone in my thigh was actually fractured. I had been consistently denying any sensation of pain in this region and I did not believe that anything was wrong. But, his clinical acumen told him that there was something wrong. Once again, squeezing my thigh, he asked me, "Does this hurt?"
In my semi-comatose, drowsy state, I instantly burst into a volley of abuse, informing him of my opinion of orthopedic surgeons in particular and doctors in general, adding for the first time for his benefit that since I was a doctor myself, I knew very well how the system worked. I told him to leave my thigh alone and get on with the broken bones, rather than getting x-rays for all the unbroken bones in my body, to insure that they were in fact intact.
He quickly retreated, only to tell the technician to proceed with the x-ray of my thigh. Soon he brought the film back for my perusal. The sight of my shattered femur left me dumbstruck, and marked a turning point in my relationship with him. I soon passed into a dreamy state only to regain senses when I was being wheeled into the operating theatre. The angel who had lifted me from the site of the accident was there next to me, though I did not know this fact or his identity then. I insisted that he hold my unbroken hand until the moment I entered the theater gate. He did, and this eased my pain considerably.
An interesting piece of conversation ensued in the theater, though I am completely unaware of any dialogue and was informed about it only after I awoke the next morning. On the operating table before being given anesthesia, I asked the doctor to hold my hand.
"But your hand is broken, how can I hold it?" he asked.
"Please hold my other hand, then." I replied.
"There is an intravenous line running in that hand. How can I hold it?" He queried, slightly amused.
"Then please put your hand on my forehead," I said quietly closing my eyes.
The next morning when he narrated this little story to me, I asked him only one question, "Then did you?"
"Yes," he replied softly.
I then learned a very important lesson: there is something far more important than any first aid, something more soothing and something more comforting — the warmth of a human touch!
In the subsequent days I stayed on a hospital bed, and for the first time I had a glimpse of my profession from the other side of the stethoscope. I had a chance to observe doctors from the eyes of a patient. I spent the next few weeks nursing my open wounds, salvaging my broken bones, nourishing my shattered ego and caressing my disturbed mind, punctuated only by a string of life wrenching surgeries. For the next fortnight I had unexpected visitors and unknown well-wishers. A group of nuns traveled every day a distance of 50 kilometers on a road riddled by potholes, just to visit me. They would sit by me, talk to me, touch my wounds over the protective dressings, and pray for me. Never before had I seen them or heard of their names, nor had they ever heard of me. But the love and compassion I received from them, is unparalleled. Those few weeks brought me much more enrichment than any accumulated knowledge from my previous life experience.
The agony of despair and the distress of dependence have only these antidotes: the compassion of your doctor, the kindness of your nurse and the courtesy of your attendants. Yet for many patients trying to come to terms with the horrors of illness, a gentle doctor, a helping nurse and obliging ward attendants are nothing more than a fantasy. Perhaps, because I am a physician, I have been uncharacteristically lucky for I have been given care that remains elusive for many others. Each day I imagined myself in the place of the doctor, the nurse or the attendant, and I wondered how I would have cared for an unknown patient admitted under my care and completely dependent on me for his daily needs. Each time my care givers undressed me, I felt a portion of my dignity go with my clothes. I felt miserable, exposed, fragile, vulnerable and helpless. Life seemed to be so simple from the other side of the bed. The process of examining a patient seemed so clinical and detached. Somehow, when I was the object of the procedure, things were unusual, indeed very unusual.
I may never fully understand how an orthopedist could be so gentle and humble, or the nurses so humane and patient, or the ward boys so polite and so obliging. Nor may I ever comprehend how more analgesic power can be held in a few tender words from one's doctor than from the most potent of pain killers. I had read books that talk about vocal anesthesia, but this was the first time I experienced its power. Now, if asked to make a choice between a visit from the doctor and a shot of pethidine (a pain killing drug), I would choose the former without hesitation. In the first 25 years of my life, I never had any occasion to believe (or to disbelieve) in God, but in those 25 minutes of trauma, I found a new faith to hold on to. I had been brought unspeakably close to the jaws of death and then been generously allowed to drink again from the cup of life. I had been given the pain and also the strength to grin and bear it.
There are things that money cannot buy and there are things that books cannot teach. Books may sprinkle upon you a treasury of knowledge but they can never bring you the showers of wisdom of experience. They will tell you how to set a fracture but they cannot teach you how to heal a broken bone. They will tell you the science that you need to cure a disease but they cannot teach you the art to ease the pain.
I only wish that I had broken my bones years earlier, and thus would have sooner gained the wisdom that came to me in the millennial year! If I can write this story today, it is only because I have cried each day of my suffering. If I can walk straight and upright today, it is only because my doctor cried with me. Every doctor is as human as her patient. Every doctor cries. Some cry with patients and some cry for patients. Sometimes there are no more tears to shed, but the grief is profound and the experience immense.