Milestones

There are the milestones that we have to learn in paediatrics (haven't had my classes for that yet, but have been informed on what to look forward to), and there are the milestones we all know about. The latter set of milestones are arbitrary points in life, with no specific landmark in time, that indicate how far we have come, the things we have accomplished, how well we maintain relationships and whether we have changed for better or for worse.

These milestones include schooling, graduating from college, getting a good job, getting married, having children, leading a stable family life, giving the children a stable and caring environment, providing them with a good base for a stable future, retirement, grandchildren, the list keeps going. Ordinarily, these milestones seem easy to accomplish, and why worry that they won't?

But when I think about it, there are so many things that can go wrong on this path, and any detour can lead to a loss of confidence or a stigma is associated with it. Graduating from college may be delayed due to shortage of credits. Obtaining a job may not happen as soon as one would like. One may find the love of their life, but cannot get married, or they get divorced. Infertility issues or the loss of a child can affect a couple's lives. Continuous migration or instability of jobs and finances create less opportunities for a stable growing environment for children. Retirement may not occur in certain fields, due to the invaluable experience of the older workers (medicine is such a field). Will one live to see their grandchildren? Will one stay in touch with their children to get to know their grandchildren?

We all blindly believe that these are the things that are guaranteed to happen in our life. Granted, we even try to plan out when exactly each milestone should take place, but how sure are we that each and every event we plan out, works in our favour?

I guess it is when one hears about events like those that I have mentioned, they strive to not get into the same position. They work hard to stay true to the path they have set for themselves, and despite the turns that lie ahead, they hope that in the end, they achieve what they have always wanted.

"Once you make a decision, the universe conspires to make it happen." - Ralph Waldo Emerson

Communication skills

2012 didn't end on December 21st, as the myth went about. For me, it ended with decent results to one of the longest exam seasons to date.('Don't get ahead of yourself! Final year awaits!', as one of my best friends who has completed the final year, and will soon be a medical intern would say.) I spent the last few days of 2012 with my family and a few friends back home. Three weeks at home went by a lot quicker than three weeks of exams. We got to see the newly developed aspect of the city that I love and cherish. On New Year's Eve, the family and I spent it with friends that I have known for three-fourths of my life. Although we've known each other for so long, there are still things I have learnt about them recently.

My anticipation to go back home was what got me through the gruelling exam period. I had hoped that it would always remain the same, the way things were at home, the childishness that I possess would remain the same, because home is where I grew up, and I could remain a child forever. But, home isn't Neverland. We all grow up, and scarily, we all grow old.

Our classes and clinical postings have taught us that as one ages, there are a variety of diseases that one is predisposed to. The lifestyle one lives, their genetic makeup, risk factors that are hidden in the delicious meals they eat each day all possess a risk in contracting diseases that can cause so much harm to someone and their family indirectly.

The hard part about going back home for a medical student, in my opinion, is learning about the health issues that family members, both in the immediate and distant family. I was visiting relatives before I went back home, and because of my chosen field, my relatives started discussing their symptoms, the medications they were on, their lab reports that they kept in files were shown to me for interpretation and all throughout, I kept thinking about the complications of the diseases, the adverse effects of their medications, and fearing that some of these things that I had listed out in my head would happen to them. Apart from hearing about the illnesses my relatives have from themselves, it is a lot harder to hear the exact details why a relative died while in the hospital from his son.

Six months ago, a relative of mine (it's a lot easier to call him that, because explaining the relationship I had with him is going to take a while) went for a normal check up, and was told that his coronaries were blocked. A Coronary Artery Bypass Graft procedure was called for (CABG in medic language). His son was told that the risk of him not making it through the procedure was 5%. He was kept under observation in the ICU for a few days, and was slowly recuperating. He was in his senses and responded well to the people around him. He was also a diabetic, and because of that, he was prone to gangrene at the peripheries. He developed gangrene on his toe, and was kept in the ICU for a longer time. During his ICU stay, they had performed a tracheostomy, because he was conscious. He developed Pseudomonas pneumonia. They had started him on powerful antibiotics, to no avail. He was struggling until 2.08 A.M, August 1st, after which he slowly started to deteriorate. He passed away at 8 A.M, August 1st.

He was one of the very few people who were genuinely happy that I got into medical school. He was very enthusiastic about education and medical care. Although he was a lecturer at a polytechnic college, he was well aware about other fields. It broke my heart to hear that he passed away with so much suffering.

When this story was recounted in front of the family, they blamed the hospital for not treating their patients properly, when the reality is that Pseudomonas is an acquired infection from hospitals and very resistant to treatment. I then realised that there was a communication gap between doctors and the patient party.

I aim to help bridge the gap that has formed between healthcare providers and their recipients, and it all starts by explaining what exactly they are going through. I have begun to reach that goal by explaining what my family are or were going through, and though it may be time consuming to actually explain in detail the conditions they face, they become more aware, and their family members do not have any misconceptions.

I hope that in the future, I can help bridge this divide on a larger scale, as it is the cause for many preconceived notions about the work that we do in this field and the prejudices many people have about doctors and why lab investigation and treatment costs are increasing. It helps to bring about more information to those that are suffering from diseases that can be dealt with, by adapting a slightly different lifestyle. I will work hard to communicate more with my patients and explain what exactly we are doing to help them get better in time.