Phillip Hughes : Too Soon?

When a person dies before the ripe old age of 60 years, it's called an early, untimely death. It doesn't matter what the cause may be - myocardial infarction, stroke, accident, cancer, or murder. An untimely death is always associated with "he didn't deserve it", "he was so young", "how could this happen?", "miss you forever", "in our hearts forever" and so many of these phrases.

That is exactly what is happening today since the breaking news that Australian Cricketer Phillip Hughes could not survive the injury he received from a bouncer. For a better part of today, I've been confused. First there was a "No!! NO!!" moment, followed by a "but it's simply not true" moment followed by a big lecture to God for ignoring my prayers since Tuesday (yes, I am arrogant enough to believe that God does what I ask him to). Then, after all that, came this confusion. Confusion because I still can't digest the fact that I will never see his name in the national team batting line-up; confusion because I almost expect him to walk out on the Gabba pitch next week; confusion because he's just 25; confusion because I don't consider cricket a fatal game - you may lose an eye, but a life?; confusion because I have watched this player bat since his international debut and I find it hard to believe that I will not be able to see how his career shapes up; confusion because the completeness of death makes me wonder whether all these "you're forever in our hearts" phrases are just empty or face-saving or soul-saving.

I feel that saying all this is our way of saying, "I'm guilty I never thought more about you during your lifetime. Trust me, now that you're gone, I'm so going to do it." I shall be the first to admit that I never thought about Hughes unless and until he actually played in the international team. I am a fan, but I shall not follow the careers of players day in and day out. So hearing the news of his injury made me feel guilty. Maybe if I had paid more attention, this wouldn't have happened. Crazy thought, but something to think about. Then, when he was battling for his life yesterday, I prayed that he survive. Because that was the least I could do. Amongst, the absolute dread of a news like today, I felt guilty for sending up a prayer only when it was the only thing that could save him. I felt guilty for not appreciating this wonderful cricketer as much as I should have before. That got me thinking, is this what is actually the message in peoples' "RIP" thoughts that plaster all the social networks? When a life is cut short, do we feel guilty because we thought we had all the time in the world to appreciate and thank that life? After all, I probably would've said stuff like," You're an amazing cricketer, a fantastic batsman and have been a great part of the team that I love, hope the new path you choose be as successful as the one you're leaving", when he retired. But, who knew, it would never reach that stage.

I've always been a little sensitive about the issue of death. I simply cannot understand why it has to happen. So when somebody so young (just 2 years older than me!) dies, I question nature and it's ways. He did not even get to say good-bye. And, that right there, would hurt his near ones more. He left in the morning to play the game he loves, was probably delighted when he reached his 50 and thought he could even reach the 100. And then out of nowhere, this bouncer decides to trick him. Next thing you know, he's down and gone, and all he must've realised is that he got hit. That's it. No life flashing in his eyes, no last words, just nothing at all. You almost wish he'd regained consciousness to at least let him know that he would be missed, loved, prayed for and thanked for being who he was.

Let's thank him and his talent for those 3 amazing international test centuries to his name, for being a part of the national team, for being such an amazing talent, for his contributions to his state and club, for being the person he was to his family, friends and team mates, for giving fans like me something to cheer about. I wish you hadn't gone away. I wish you were going to play next week. I wish I could watch you open the innings for eternity. I wish the only reason I never got to see you bat again, was because you weren't selected into the final 11. Now, that option seems so much easier to deal with than what we've been given.

Our only solace is that the last thing you ever did was play the game you love and score that 63. That number will never ever be the same again.

  That's how you'll always be....a great life, a great career :-)

Reflection

I’m not a social person. I have very strict ideas about the kind of parties I like and the kind I don’t. I have my own circle of close friends whom I regularly meet. We talk a LOT and catch up on each other’s lives. There is no drinking involved, no needless gossip, no dressing up…just some good old friends having a good time, laughing and sharing their desires and thoughts.

I met a couple of my school friends day before yesterday for dinner. They are both doing Engineering. One of them has a dual degree with Economics, and the other has a dual degree with Biology. So, practically speaking, each of us is in our own world professionally. They say, don’t they, the grass is always greener on the other side. However, having conversations with them, has made me wonder whether it is really worth it to do what I am doing.

Frankly speaking, the only reason I decided that Medicine was my field was because I sucked at Physics and Mathematics decided to abandon me during the year I needed it the most. By mid-12^th grade, my prophecy from 10^th grade (I want to do Chemical Engineering from IIT Powai) had all but eaten dust. My strength was Chemistry and Biology. I decided to do the practical thing, choose the lesser of the two evils. Instead of forcing myself to succeed in two subjects I sucked at (Physics and Maths), I forced myself to manage just Physics and enjoy Chemistry and Biology. I ended up making the right decision, since I got into BJMC in my first attempt itself, in the first round itself. I could not have asked for more.

Today, however, I wonder whether I have done what I had thought I would do as a medical student or not? I wonder whether it really is worth it to put in as much of effort and pressure as we do. Medicine is a tough choice for a profession. You need to have the push and the desire to give. You need to feel that insane urge to serve people. You need to feel that you just have to make your patients ok. I agree that in the past 3.5 years, I have formed an idea of what I will be doing in the future. I do want to give back to people. I want to make this world a better place. I just wonder why it is so difficult to want to do such things.

Final year is supposed to be crazy. It is crazy. It hasn’t treated me very well either. I am not particularly enjoying it. But, even then, I’m not a sulky sort of person. I love myself and life too much to really sulk about it. The fact that I am sulking about this year, means there is something wrong. Maybe I am taking that project too much to heart. But, even then, the rest of the year isn’t all that great.

I am wondering today whether I really want to get out into the world and treat patients. Do I really want to put myself through all the torture that being a doctor brings with itself? This year will get over. Then there shall be the internship, the PG entrance, the residency, the super-specialisation, the start of my private practice. I’m already tired thinking about it. On the other hand, my friends are excited about their internships and have nothing to really worry about. Work from Monday-Friday…weekends off…a good pay…their life is pretty much set.

I’m just a little disillusioned, I guess, by the working of my college and our lives as medical students. I know I am being extreme in my reaction…but life could be so much better for us, even with all the studying. Lectures, teachers, patients…it all sounds so interesting from an onlooker’s point of view. I wish it were really the case…

Any way, I think I’ll get over this feeling soon…it was pretty refreshing to get out of college life and meet up with my friends. It is such a blessing when your friends are from different fields. You can just lock out all your frustrations and sorrows and have a great time with them. You talk about different things, reminisce about old times…you end up bringing back some spice into your life…and that is all I really need J

Subconscious Priorities

When you start dreaming about your college life, it helps you put things into perspective. On the surface, there are a million things to think of; a million things to do and a million things trying to get your attention at the same time. Dreams really just line them all up, starting from the most important to the least important.

Over the past few days, I’ve been dreaming. The important point to note is that, I’ve dreamt about stuff that I have never acknowledged as stuff that has troubled me or made me uneasy when I thought of it. However, I guess I was wrong. It has affected me more than I thought it did, or should I say, more than I wanted it to.

Let’s start with the first.

A dark background all around me…I’m assuming it is night. I’m outside an unknown cabin - a wooden one like in those Cowboy movies. I’m sure I’m alone yet there are a few people with me. I have my cell phone with me, but I don’t feel like calling anybody as of now. Out of nowhere, there come a group of people – no wait, there appear to be two groups of people. I seem to recongise some faces…hell, yeah! These are my Medicine and Surgery Residents. What are they doing here?? They see me. They are shocked to say the least. The very next second, they’re holding my arms. The Medicine group gets to me first. I know I am being kidnapped but can’t really do anything about it.

The Residents start bombarding me with questions -Medicine-related questions. I can answer a few, and at the one question I can’t answer, I’m being dragged off with that group. When this happens, the other group jumps up to my rescue. Not rescue exactly, because, the moment there is a question I can't answer from their list, I'm just dragged off there! And then, I get a phone call. Again, from a surgery resident. He seems to want to tell me something, but just keeps beating about the bush. I'm scared. I can't tell him where I am. I keep wondering whether he is involved in this very operation or not. Ultimately, he doesn't end up doing much to help me. 
I did not get up with a jerk or anything. I got up with an uneasy mind and a tough day to look forward to. I know I haven't been on top of my timetable. But, such dreams are definitely going to push me onto Insomnia big time!
Moving on to the second:
Let me first give a brief background to this one. I've had two such dreams. They are both related to the ICMR project I was intent on doing a few months back. At this moment, in April, I know for a fact that I will not be able to do everything possible, and giving my time to the ICMR project is just going to spoil my chances of doing well in Final year.
The first dream basically had my to-be Guide shouting his head off at me, when I go to tell him that I don't want to do the project. This was obviously related to an incident from day before, when he told our batch off for making too much noise in an evening clinic. It was the first time I had seen him lose his head, and I think, I was a little traumatised by that experience. Hence, the dream. I just stand helpless, waiting for the dream to end, by the way.
The second dream came yesterday. After cajoling myself to at least take a look at the list of selected projects, I found that my project had been selected. So now, my dream had me walking about in college, trying to make up my mind whether to meet my Guide now or not. Out of nowhere, lots of people start coming and wishing me congratulations for having been selected. It appears on Facebook and I seem to be caught in this big trap. I want to say no, but I can't seem to say it. And nobody even wants to listen to what I have to say. Scary.
These two dreams bring me to the main worry I have. Do I want to do the project? I have a stack of points for not doing the project:
1. There is way too much to study in Final year. I know I'm not that strong. So whatever time I get to waste, I want to be able to waste it and not spend in more work.
2. My aim in doing the project was to improve my CV when it came to applying to universities abroad. I am now leaning more towards doing my PG in India, in which case it won't really matter. Also, it isn't necessary to have a project under your belt. I have my academic record and lots of certificates to which I shall add many more in the coming few months.
3. My Ethics certificate hasn't come, in which case, I shall have to wait till June. That is when my Terminals would begin. Not a great time.
4. I'm just not in the mood any more to run around looking for patients.


For doing the project, there are a few points too:
1. It has been selected. That means it is good enough and there are going to be some results which would really help the future of Medicine.
2. It will add to my CV any way, whether I like it or not.
3. I won't get another chance.


Add on, the fear of facing my to-be guide, yeah, I'm pretty screwed. I just hope he takes it nicely and helps me put my mind at ease. 


I'm doing the Inter-Disciplinary Seminar this time. The topic is 'Hospital-Acquired Infections' and I shall be dealing with the Surgery aspect of it. The reason I am so proud of this is that, I was chosen on the basis of my performance at the University Examination. Initially, there was going to be an elimination round. The Academic Committee, finally decided to just go with the Univ marks.
I'd had a conversation with a friend about our marks after the results came out. He said, it didn't really matter because nobody was going to bother about these marks later. I, on the other hand, was a big supporter of the rank system and was delighted about what all I had achieved. The selection of participants for this time's IDS, simply added weight to my argument. I feel that whatever I get, on the basis of my marks at Univ exams, I thoroughly deserve. That's 'cause I work my ass off for these exams. Thus, I am extremely proud of my selection. I wanted Surgery and I got it too. So I am pretty happy right now.
Our Medicine term-end comes up on Friday the 13th. I hope to do well there. It is going to be a busy week up ahead. Let's hope it shall start well and end well.  

Questions

Our HoU has a smart way of training us into doctors. He has allotted each of us undergraduate students a bed in our Ward. We have to go talk to our patients, ask them for their histories, examine them, and follow them up throughout the time that they are admitted. The moment they get discharged, a new patient gets admitted and the same routine continues.

In the past one month, I’ve only had two patients on the bed allotted to me. Initially, we did not take this allotment that seriously, so I didn’t really talk to the first patient. The few times that I did, I just got a superficial history, nothing more. No, it is the second patient that has made me speculate about the seriousness of becoming a doctor.

To cut things short, this patient has Pneumonia and is a known case of Acute Kidney Injury. The first time I met him, he looked pretty bad. A 60 yr old, coughing incessantly, with a Central line and other tubings put, doesn’t cut a very bright picture. I had a long conversation with his son, who was giving me the history. It included a lot of questions from my side regarding the case, and a lot of questions from his side, regarding the overall prognosis and the future implications.

I have to say, it made me think a great deal. Here was this 40 yr old man asking me, if his father would survive and how long. I, who for all practical purposes, myself, did not know how severe the disease was, had to answer the most important question that a patient can ask a doctor. Such a situation only makes me wonder how brave we have to be, to take up such a responsibility.

I’ve just heard that, ultimately, doctors deal with living beings, so the job is tough. But, we are humans too. How in the world can we just take up the responsibility of deciding how long another of the same kind will live? Patients believe in us. The internet and sophisticated instruments may have made patients more aware, but ultimately they trust us. How strong do we need to be mentally to be able to return that trust?

I told that man pretty nicely that his father would live long in the right precautions were taken. However, when I was going back, I kept asking myself, how was I to know that there was even a need for those precautions? What if that patient was already way past gone? What if I was just giving his son a false ray of hope? Who was I to even pass a small judgment on another fellow?

For such a question, is there even an answer? Even studying all the books on a particular disease will not be able to give me enough power to believe in what I’m saying. If I can’t believe what I’m telling the patient, how can I expect him to believe it? When the patient does believe it, I want to simply shout out to him that I’m not good enough, and he shouldn’t take my word for it.

Such thoughts are scary. Today, I have people above me. Tomorrow, there won’t be any. At such a time, I will need to raise myself up to a level, where I shall get a good night sleep and not worry about whether I have given the right advice to my patients. Self-belief is the toughest to get. When it is a person like me, the task simply gets worse.

The questions that torment me, today, are going to torment me for sometime. After all, I’m not a genius at Medicine. I just hope to strive hard towards being able to answer them. In doing so, I know I shall be able to be what I want to be.

A GOOD DOCTOR.