Sunday, March 7, 2010

Life Is Uncertain - Smell The Roses

By Dr DANIEL WONG WAI YAN

Time is not always on our side and we can never predict the future with any level of certainty. So stop taking life for granted and live each day to the fullest.

SOME may consider oncology to be a rather depressing and morbid profession. However, in the midst of the apparent doom and gloom, I am grateful for the lessons about life and living gleaned from my patients.

I had a patient with advanced cancer who died recently. Let’s call him Tim. I got to know Tim over a period of almost one year while he battled this dreaded illness. He was in his mid-40s, never smoked, non-drinker, and a good husband.

As we struggle through our grief, we ask ourselves why Tim? Why was he cut off so cruelly and prematurely?

I was with him several hours before he died and memories of our many consultations flashed through my mind. I tried to analyse my management of his illness to see if there was something more I could have done to help him. There wasn’t.

It was an emotional moment for me as I explained to his family members that he did not have much time left. I said a quiet prayer with them and left the ward, hoping that he would be there when I came by for the ward round the next day. He wasn’t.

We had hoped that the treatment would extend Tim’s life for a further six months. I suppose I ended up as an oncologist because I am largely an optimist at heart. However, it is the hope that one might be the exception rather than the rule that sustains folks when they face the vagaries of cancer.

It is also this hope which sustains clinicians like me. I often tell my patients “widespread, advanced cancer means it cannot be cured by the conventional therapies at my disposal, but there is a God who heals”.

Perhaps more importantly, one who also offers true life beyond our stricken world.

Most cancer clinicians develop defence mechanisms to protect against emotional breakdown. I don’t shed a tear very frequently for my patients. I did in Tim’s case. Perhaps I felt that a bond had developed over the last few months. Perhaps it brought home my own mortality and the frailty of human life. I am not far off from the 5th decade of life myself.

On this occasion, I was reminded (again!) that time is not always on our side and we can never predict the future with any level of certainty. Patients often ask about their prognosis – their life expectancy and likelihood of responding to treatment. We can only provide information from past clinical trials and to a certain extent from personal experience. We talk about average survival and the percentage alive in one year. But we can never be sure in a specific individual.

So what have I learnt from Tim?

I am a bit of a hoarder. I have more than three weeks of annual leave that will be rolled over to the new year. I reserve these days just in case “something important crops up”.

The days of hoarding leave entitlement has come to an end. I have decided to carve a big slice of leave in 2010 for rest and recreation. For some quality time and meaningful fellowship with my wife, four children, parents, brother and sister and their families. Perhaps it’s even time to visit the many friends we left behind in the UK and Australia.

Several months ago, 228 people boarded a particular Air France Flight 447 from Rio de Janeiro to Paris, fully expecting to disembark the next day at the Charles De Gaulle airport at the French capital. But none of them arrived.

Thank you Tim. I would consider this episode a wake-up call – to stop taking life for granted and live life to the full each day with thanksgiving in my heart and a deep trust in God.

PS: We simply don’t know about tomorrow. Only God does.

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